Title:An Updated Review on the Most Common Agents Causing Toxic Optic Neuropathies
Volume: 23
Issue: 4
Author(s): Weronika Wasinska-Borowiec, Kaveh Abri Aghdam, Jukka Matias Saari and Andrzej Grzybowski
Affiliation:
Keywords:
Amiodarone, ethambutol, linezolid, methanol, phosphodiesterase 5 inhibitors, toxic optic neuropathy, tumor necrosis factor alpha
inhibitors.
Abstract: Background: Toxic optic neuropathies (TONs) often present with a gradual and bilateral decrease in
visual acuity, scotomas and optic disc pallor. Obtaining an accurate history is the critical first step in determining
the etiology of TONs.
Methods: This updated review contains a thorough analysis of the current PubMed-indexed literature on the most
common agents responsible for TONs, including methanol, ethambutol, amiodarone, linezolid, tumor necrosis
factor alpha inhibitors and phosphodiesterase 5 inhibitors.
Results: The reviewed articles are mainly case reports presenting new and controversial aspects of the above
agents. New treatment strategies, such as erythropoietin for methanol optic neuropathy, are being proposed for
TONs, a condition that was previously regarded as untreatable.
Conclusion: TONs could cause significant disability due to visual impairment. In case of early diagnosis and
drug withdrawal, most TONs are treatable. Patients need to be appropriately counseled, and prescribing physicians
should be especially made aware of TON-inducing medications.
