Amiodarone associated optic neuropathy, an entity sui generis? Three patients with bilateral optic neuropathy

Background: Optic neuropathy has been reported to occur during antiarrhythmic therapy with amiodarone. Whether or not there is a causal relationship has been discussed controversely. Patients: Three patients presented with a visual impairment three to seven months after starting amiodarone therapy. in all three patients both optic discs were swollen and showed hemorrhages on the margin. After discontinuing amiodarone, the vision improved and the swelling of the optic discs resolved. Conclusion: The bilateral occurrence at the same time, the close time correlation with the amiodarone application and the improvement after discontinuing amiodarone suggest that our three patients suffered from a toxic effect of amiodarone rather than an incidental other disease, as for instance ischemic optic neuropathy.