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A.J. Flach, B.J. Dolan; Amiodarone Induced Lens Opacities: Twenty–Two Year Follow–Up . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4127.
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Amiodarone hydrochloride is an alpha and beta antagonist initially approved by the Food and Drug Administration for use in cardiac arrhythmias (Cordarone, Wyeth.) We reported the appearance of anterior subcapsular lens opacities in seven of fourteen patients treated with this anti–arrhythmic drug (Arch. Ophthalmol. 101:1554, 1983.) The purpose of this presentation is to describe the status of this group of patients and the appearance of their cataracts twenty–two years later.
We reported the appearance of anterior subcapsular lens opacities in seven of fourteen patients treated with amiodarone (Arch. Ophthalmol. 101: 1554, 1983.) Subsequently, we described how these opacities developed or progressed in all patients from this group that continued to receive amiodarone over the next decade (Doc. Ophthalmol. 83: 323, 1993.) Following Investigational Review Board approval, we reviewed the medical records of the fourteen patients described in 1983 in December 2005.
Nine patients expired during this twenty–two year period. Three patients had their amiodarone discontinued for different reasons: pulmonary fibrosis, ineffective, diagnosis of hyperthyroidism. One patient was lost to follow–up. As shown in photographs, the remaining patient now demonstrates unusual cortical and nuclear cataracts associated with the anterior subcapsular lens changes described twenty–two years ago. These lens changes continue to be visually insignificant for the patient.
The anterior subcapsular lens changes induced by amiodarone appear to develop and progress in most, if not all, patients taking this medication for long enough periods at high enough doses. Furthermore, these anterior subcapsular lens changes may be associated with cortical and nuclear cataracts in subsequent years. However, despite these additional lens changes the visual acuity as measured by Snellen testing does not appear to be significantly decreased.
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