ABSTRACT
The ocular complications of long-term amiodarone therapy have been recognized for many years, but systematic data on the prognostic significance and the precise incidence of such effects have not been evaluated until recently. One hundred seventy-five patients receiving long-term amiodarone treatment have thus been followed for periods ranging from 3 months to nearly 10 years. Of 103 of these patients studied in greater depth, 98% have shown the characteristic patterns of corneal microdeposits, which progressed over several months and ultimately formed a stable appearance that changed only with an alteration of dose. The abnormalities, the nature of which is not clearly understood, disappeared within 7 months in the 16 patients whose drug was withdrawn for unrelated reasons, and no permanent ocular damage has been detected. Visual symptoms associated with the corneal deposits developed in 6% of patients: 3% had photophobia, 2% halos, and 1% blurring of vision but without impairment of visual acuity. It is concluded that ocular complications of amiodarone therapy are insignificant; they do not pose a threat to vision, and routine ophthalmologic surveillance does not appear mandatory in the majority of patients during long-term drug therapy.
Subject(s)
Amiodarone/adverse effects , Benzofurans/adverse effects , Eye Diseases/chemically induced , Amiodarone/administration & dosage , Amiodarone/therapeutic use , Corneal Diseases/chemically induced , Corneal Diseases/pathology , Humans , Vision Disorders/chemically inducedABSTRACT
Amiodarone, a powerful antiarrhythmic agent recently made available in Britain, is known to cause corneal changes, but the clinical implications of this unwanted effect are still controversial. We have made serial observations on 105 patients treated with the drug for periods ranging from 3 months to over 7 years. Corneal abnormalities were detected by slit-lamp examination in 103 patients (98%). These always progressed over several months but subsequently showed a stable pattern which changed only with alteration of dose. The abnormalities regressed and disappeared within 7 months in the 16 patients whose treatment was discontinued for reasons unconnected with ocular changes. No macular changes or permanent sequelae occurred. Ocular symptoms were unusual: 6 patients had reactions in the skin of the eyelids, and 6 others had minor symptoms related to the corneal changes. We do not believe that ophthalmological surveillance is mandatory in asymptomatic patients on long-term amiodarone therapy.
