Amiodarone induced ischemic optic neuropathy: a case report

Abstract

Amiodarone is an anti-arhythmic drug that is used commonly to treat ventricular and supra ventricular arrhythmia [1]. Its use has increased over the past years due to its efficacy at restoring sinus rhythm and its use in cardiac resuscitation [2]. Despite its increasing popularity, amiodarone has been associated with various side effects. The side effects of amiodarone are due to its cationic amphophilic properties which allow interactions with lipid compounds which accumulate in multiple tissues [3]. Among the tissues affected is the optic nerve which can give rise to optic neuropathy. The reduction in visual acuity has been reported to be significant and permanent, which massively effects patient’s quality of life. Nevertheless, making the diagnosis of amiodarone induced optic neuropathy (AON) is challenging due to the lack of diagnostic tests and is mostly a clinical diagnosis. Furthermore, the alternative differential diagnosis of non-arteritic ischaemic optic neuropathy (NAION) is similarly made on clinical grounds. This makes the diagnosis of AON highly dependent on the typical clinical features seen in AON which makes it a diagnostic challenge when one or more atypical features are present in the clinical presentation. In this case, we present the diagnostic challenge in a case of amiodarone induced ischemic optic neuropathy (AON) which occurred in a 55-year-old man over an atypically shorter time course.