ABSTRACT
Amiodarone, one of the most effective anti-arrhythmic drugs, is also known for its ability to accumulate lipid-pharmakon complexes in the lysosomes of different tissues. In the eye the lysosomal storage leads to typical side-effects. Whorl-like epithelial, reversible corneal inclusions occur in about 70 to 100 % of the patients on amiodarone therapy. Tiny lens opacities without visual impairment have been reported in 50 % of patients who had been treated with amiodarone. At present the most severe complication of amiodarone is optic neuropathy with an incidence of 1.3 to 1.8 %. The optic neuropathy, as the rule, is only reversible approximately in (1/2) of the patients after discontinuing the drug. The fundoscopic picture of amiodarone neuropathy is similar to classic AION. Retinal involvement has also been reported; however, a relationship with amiodarone has not been proven yet.
Subject(s)
Amiodarone/adverse effects , Anti-Arrhythmia Agents/adverse effects , Corneal Opacity/chemically induced , Eye/drug effects , Optic Nerve Diseases/chemically induced , Retinal Degeneration/chemically induced , Risk Assessment/methods , Amiodarone/therapeutic use , Animals , Arrhythmias, Cardiac/drug therapy , Corneal Opacity/diagnosis , Dose-Response Relationship, Drug , Humans , Optic Nerve Diseases/diagnosis , Retinal Degeneration/diagnosis , Risk FactorsSubject(s)
Blood Specimen Collection/methods , Cornea , Tissue Donors , Cadaver , Femoral Artery , Humans , Phlebotomy/methodsSubject(s)
Corneal Transplantation/physiology , Endothelium, Corneal/transplantation , Epithelium, Corneal/transplantation , Fetal Tissue Transplantation/methods , Amnion/transplantation , Cartilage/transplantation , Fascia/transplantation , Humans , Mucous Membrane/transplantation , Sclera/transplantation , Tissue Transplantation/methodsSubject(s)
Creutzfeldt-Jakob Syndrome/prevention & control , Creutzfeldt-Jakob Syndrome/transmission , Patient Selection , Tissue Donors , Databases, Factual , Germany/epidemiology , Hospitals, University , Humans , Incidence , Reoperation/statistics & numerical data , Tissue Donors/supply & distributionSubject(s)
Family , Professional-Family Relations , Tissue Donors , Decision Making , Grief , Humans , Physicians , Tissue Donors/supply & distributionABSTRACT
AIM: We analysed the number of the potential cornea donors of the Martin-Luther-University, Halle-Wittenberg over a four-years period, 1995 to 1998 in relationships to the number of the actual donors. PATIENTS AND METHODS: We retrospectively reviewed the data of 2545 patients who died at the hospitals of the Martin-Luther-University, Halle-Wittenberg over a four-years period, from January 1995 to December 1998. The medical records of the patients were inspected and contraindications for cornea donation examined. The patients who were younger than 12 months were omitted in our analysis. The patients with at least one contraindication were excluded as potential cornea donors. Additionally we registered the actual cornea donors of the hospitals of the Martin-Luther-University, Halle-Wittenberg between 1995 to 1998. RESULTS: The mean age of the died patients was 60 years. Because of contraindications 597 patients (23.5 %) were excluded from the cornea donation. An acute sepsis with 25.1 % as well as leukemias and lymphomas with 24.8 % matched about half of the exclusion criteria. In the period of investigation we counted 1948 potential cornea donors. In the hospitals of the Martin-Luther-University, Halle-Wittenberg only 57 (2.9 % of potential donors) actual cornea donors have been registered. CONCLUSIONS: The possible leading causes for the large discrepancy between the number of the potential and actual donors are: (1) the imperfect identification of potential donors, (2) the donor family have not been asked and (3) the denial of consent by the potential donors family.
Subject(s)
Corneal Transplantation/statistics & numerical data , Tissue and Organ Procurement/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Germany , Hospitals, University , Humans , Male , Middle AgedABSTRACT
BACKGROUND: The prevalence of Creutzfeldt-Jakob disease (CJD) is 1.5 cases per million persons. In addition to familial and sporadic forms, fewer than 5% of cases are due to iatrogenic transmission. Corneal transplantation has clearly been implicated as the origin of CJD in four cases. MATERIALS AND METHODS: We examined possible risks factors for corneal transplantation in material from 2545 deceased patients at the University Hospital of Halle. RESULTS: Two patients had died of CJD or slow virus disease. Also in the 109 identified as being at higher risk of CJD no organs or tissues were harvested. CONCLUSION: We strongly recommend that patients at higher risk group of CJD, patients dying of CNS diseases of unknown origin and cause, and patients dying in psychiatric clinics be excluded from donating organ and tissue.