New insights into amiodarone induced retinal and optic nerve toxicity: functional and structural changes

Weam Mohamed Ebeid; Amany Abd El-Fattah El-Shazly; Norhan Mohamed Kamal; Emad Effat Fakhary; Amr Mansour; Doaa Maamoun Ashour

doi:10.1177/25158414231194159

New insights into amiodarone induced retinal and optic nerve toxicity: functional and structural changes

Ther Adv Ophthalmol. 2023 Sep 9:15:25158414231194159. doi: 10.1177/25158414231194159. eCollection 2023 Jan-Dec.

Authors

Weam Mohamed Ebeid^{1

2}, Amany Abd El-Fattah El-Shazly¹, Norhan Mohamed Kamal¹, Emad Effat Fakhary³, Amr Mansour³, Doaa Maamoun Ashour⁴

Affiliations

¹ Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
² Armed Forces College of Medicine, Cairo, Egypt.
³ Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
⁴ Department of Ophthalmology, Faculty of Medicine, Ain Shams University Hospitals, Ramsis Street, Abbasiya, Cairo 11591, Egypt.

Abstract

Background: Amiodarone is widely used for heart arrhytmia. Previous studies have suggested the possibility of optic neuropathy with the chronic use of this drug.

Objectives: To identify structural or functional changes in the retina and optic nerve in patients on chronic amiodarone therapy without visual complaints.

Methods: This observational study included 15 eyes of 15 patients with cardiac arrythmia on chronic amiodarone treatment and 15 healthy matched subjects as a control group. All subjects underwent electrophysiological tests [pattern visual evoked potential (PVEP), pattern electroretinogram (PERG), multifocal electroretinogram (mfERG), and optical coherence tomography (OCT) and angiography (OCTA)].

Results: There were no statistically significant differences between the two groups regarding the PVEP, PERG, and the mfERG parameters. Macular and optic nerve head OCT and OCTA have not shown statistically significant differences except for the morphological parameters of the optic disc (p = 0.008 for the horizontal and p = 0.013 for vertical cup/disc ratio and p = 0.045 for rim area).

Conclusion: Patients on chronic amiodarone therapy have not shown evident structural or functional changes in the retinal or optic nerve as demonstrated by electrophysiological tests, OCT, and OCTA results compared to controls.

Keywords: Amiodarone; electroretinography; multifocal electroretinography; optic neuropathy; optical coherence tomography angiography; visual evoked potential.