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Objective:To refine the criteria for the diagnosis of amiodarone-related optic neuropathy by including a broader spectrum of clinical features,thus helping to differentiate this entity from nonarteritic anterior ischemic optic neuropathy coincidentally affecting a patient taking amiodarone.Methods:A retrospective case review of 22 patients who developed optic neuropathy while taking amiodarone,in whom other systemic causes were excluded.Results:We identified 3 groups of patients:those in whom a diagnosis of amiodarone-induced optic neuropathy seems probable(n=14),those in whom an association with amiodarone optic neuropathy is indeterminate(n=5),and those in whom the occurrence of nonarteritic anterior ischemic optic neuropathy seems to be coincidental(ie,unrelated to amiodarone)(n=3).We formulated specific diagnostic criteria for each of these categories.Conclusions:We recommend a systematic approach that includes assessment of bilaterality,mode of onset,degree of optic nerve dysfunction,structure of the uninvolved optic disc in unilateral cases,and systemic toxic effects.Such well-defined diagnostic criteria can help the clinician in the treatment of patients with this disorder.
Objective: To refine the criteria for the diagnosis of amiodarone-related optic neuropathy by including a broad spectrum of clinical features, thus helping to differentiate this entity from nonarteritic anterior ischemic optic neuropathy coincidentally affecting a patient taking amiodarone. Methods: A retrospective case review of 22 patients who developed optic neuropathy while taking amiodarone, in whom other systemic causes were were excluded. Results: We identified 3 groups of patients: those in whom a diagnosis of amiodarone-induced optic neuropathy seems probable (n = 14), those in whom an association with amiodarone optic neuropathy is indeterminate (n = 5), and those in whom the occurrence of nonarteritic anterior ischemic optic neuropathy seems to be coincidental (ie, unrelated to amiodarone) (n = 3) .We formulated specific diagnostic criteria for each of these categories.Conclusions: We recommend a systematic approach that includes assessment of bilaterality, mode of onset, degree of optic nerve dysfunct ion, structure of the uninvolved optic disc in unilateral cases, and systemic toxic effects. Well-defined diagnostic criteria can help the clinician in the treatment of patients with this disorder.