View abstract

This abstract is assigned to session OB Free papers 5 - Miscellaneous

Title

Toxic optic neuropathy secondary to disulfiram: a case series

Purpose	To describe the presentation, ophthalmic features and electrophysiological findings in 4 patients with disulfiram (Antabuse) related optic neuropathy.
Methods	Observational case series involving 4 patients. All underwent an extensive ophthalmological work-up, including psychophysical and electrophysiological testing.
Results	All patients took disulfiram (Antabuse) tablets in varying doses and length of time before developing profound, bilateral visual loss. Three patients were smokers and one patient suffered from schizophrenia. Ophthalmic examination in combination with automated and manual perimetry showed reduction of visual acuity, disturbed colour vision and visual field defects consistent with bilateral optic neuropathy. Electrophysiological testing revealed delayed and reduced amplitudes on pVEP. After cessation of disulfiram, visual acuity, perimetry and electrophysiological testing gradually returned to normal or near-normal levels.
Conclusion	Disulfiram is a rare cause of reversible toxic optic neuropathy. Patients who take disulfiram are more likely to abuse tobacco and possibly other drugs or have psychiatric or psychological comorbidity. These patients may also be labelled as cases of malingering. Careful history and examination should alert the clinician to the possibility of disulfiram optic neuropathy.

Author 1

Last name	LUCAS
Initials	RS
Department	Dept of Ophthalmology, Ghent University Hospital, Ghent, Belgium
City	Ghent

Author 2

Last name	LEROY
Initials	BP
Department	Dept of Ophthalmology & Ctr for Medical Genetics, Ghent University Hospital, Ghent, Belgium
City	Ghent