What are the other Names for this Condition? (Also known as/Synonyms)

• AAON (Amiodarone Associated Optic Neuropathy)
• Amiodarone Optic Neuropathy
• Optic Neuropathy from Amiodarone

What is Amiodarone Associated Optic Neuropathy? (Definition/Background Information)

• Amiodarone is an antiarrhythmic medication used to treat a variety of conditions, such as tachycardia and ventricular fibrillation, which cause irregular heartbeats. Several side effects of the medication are documented
• Amiodarone Associated Optic Neuropathy (AAON) is an eye condition that develops secondary to the use of amiodarone, as an adverse reaction of the eye to the medication. Besides optic nerve damage (optic neuropathy), the condition can cause irreversible vision loss
• Stopping or discontinuing the use of such medications may decrease progression of Amiodarone Associated Optic Neuropathy and/or may result in resolution of the condition. The prognosis is good in a majority of cases with prompt recognition of the condition

Who gets Amiodarone Associated Optic Neuropathy? (Age and Sex Distribution)

• Individuals of all ages may be affected, although most cases of Amiodarone Associated Optic Neuropathy are noted in adults
• Both males and females are affected; although, most cases are reported in men
• Worldwide, individuals of all races and ethnicity may be affected

What are the Risk Factors for Amiodarone Associated Optic Neuropathy? (Predisposing Factors)

• The key risk factor for Amiodarone Associated Optic Neuropathy is the use of amiodarone (to treat certain health issues) that results in the eye condition as a side effect

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Amiodarone Associated Optic Neuropathy? (Etiology)

• Amiodarone Associated Optic Neuropathy develops from the use of amiodarone medication that is administered for various heart health conditions causing arrhythmias
• The toxic nature of amiodarone results in damage to the eye structures (especially the optic nerve); it is reported that the medication tends to accumulate in the nerve cells of the optic nerve

What are the Signs and Symptoms of Amiodarone Associated Optic Neuropathy?

The signs and symptoms of Amiodarone Associated Optic Neuropathy may vary from one individual to another. It may also be mild or severe and is related to the usage (dose) of the drug. The condition is known to get better after stoppage of the offending medication.

The signs and symptoms may include:

• Eye pain
• Peripheral vision impairment
• Double vision
• Flashes of light
• Optic disc swelling, which is seen in 85% of the individuals
• Unable to distinguish between colors
• Vision loss that may be mild to severe
• A single eye or both eyes may be affected (unilateral or bilateral condition); some reports indicate that nearly 65% of the cases are bilateral

The appearance of symptoms due to the drug may be sudden or slow and gradual; these may be observed after several months to many years; the mean duration being 9 months.

How is Amiodarone Associated Optic Neuropathy Diagnosed?

Amiodarone Associated Optic Neuropathy may be diagnosed by the following observations and tests:

• Complete physical examination with comprehensive evaluation of medical history (which includes the use of amiodarone medication)
• Assessment of the signs and symptoms
• General eye exam
• Fundoscopic (ophthalmoscopic) examination by an eye specialist, who examines the back part of the eye (or the fundus)
• Visual acuity test using a special and standardized test chart (Snellen chart)
• Slit-lamp examination
• Visual evoked potential (VEP) test
• Fundus fluorescein angiography

Note: It is important to differentiate between non-arteritic anterior ischemic optic neuropathy (NAION) and Amiodarone Associated Optic Neuropathy, as the two present similar symptoms.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Amiodarone Associated Optic Neuropathy?

The complications of Amiodarone Associated Optic Neuropathy may include:

• Irreversible damage of optic nerve
• Loss of vision that may be permanent; if left unchecked, the condition can result in complete blindness
• Decreased quality of life

How is Amiodarone Associated Optic Neuropathy Treated?

An early discontinuation of amantadine that is responsible for the side effect may result in a cure, or in improvement of Amiodarone Associated Optic Neuropathy (AAON).

• However, it is important to consult a cardiologist prior to discontinuing the medication
• Currently, no specific medications are available to treat AAON
• Regular medical screening at periodic intervals with tests and physical examinations are recommended

How can Amiodarone Associated Optic Neuropathy be Prevented?

Presently, it is difficult to prevent Amiodarone Associated Optic Neuropathy.

• When possible, amiodarone may be discontinued and/or alternative medication prescribed; nevertheless, this has to be decided by the cardiologist
• Avoid self-medication or bringing about any changes to one’s medication dosage without consulting the healthcare provider
• Individuals, who are prescribed amiodarone, are highly recommended to undertake periodic ophthalmic screenings (eye checkups)

What is the Prognosis of Amiodarone Associated Optic Neuropathy? (Outcomes/Resolutions)

• The prognosis for Amiodarone Associated Optic Neuropathy may be good, upon early recognition of the eye condition. A prolonged usage of amiodarone can result in permanent blindness
• According to some studies, nearly 60% got better following stoppage of medication; while, over 20% showed no vision improvement. However, in about 21% of the individuals, a further worsening of the condition was noted

Additional and Relevant Useful Information for Amiodarone Associated Optic Neuropathy:

Please visit our Eye & Vision Health Center for more physician-approved health information:

https://www.dovemed.com/health-topics/vision-center/