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A. Chomsky, D. Bustos; Retrospective Chart Review of ScreeningOphthalmologic Examination Findings in Patients on Amiodarone Therapy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):6011. doi: https://doi.org/.
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Controversy exists over the need to perform screening ophthalmologic examinations for the presence of optic neuropathy in patients taking Amiodarone therapy. The purpose of this study was to determine whether these screening examinations identified unique historical or clinical eye findings.
A retrospective chart review was performed on 107 patients taking Amiodarone from April 2005 to September 2006 who had a complete eye examination. These where compared to 101 patients not on Amiodarone who underwent a complete examination during the same time period, age greater than 55 and who had at least two vascular risk factors (diabetes, coronary artery disease, hyperlipidemia, hypertension). The groups where compared as to age, visual complaints, visual acuity, optic nerve findings including cup/disc ratio and presence of relative afferent pupillary defect (RAPD).
The Amiodarone group was older than the Control group, 71.2 years versus 67.4 years (p = 0.0235) and had a higher percentage of visual acuity deficit of 20/50 or worse, 13.2%, 27/204 eyes versus 4.0%, 8/202 eyes (p = 0.0012). The Amiodarone group was less likely than the Control group to have visual complaints, 42% versus 58% (p = 0.0181). There was no statistically significant difference for unexplained visual loss, presence of RAPD or cup/disc ratio.
Patients taking Amiodarone are older and have more ocular pathology causing vision loss when compared to a control group. However, this study suggests screening examinations on patients taking Amiodarone beyond what is recommended based on age and systemic conditions may not be warranted given there was no increase in unexplained visual loss or symptoms in this group. Patients may be better served by instructing them to report urgently to an Ophthalmologist should they have any visual symptoms. This study, however, is limited in its retrospective nature and sample size.
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