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TitreToxic optic neuropathy secondary to disulfiram: a case series
ButTo describe the presentation, ophthalmic features and electrophysiological findings in 4 patients with disulfiram (Antabuse) related optic neuropathy.
MéthodesObservational case series involving 4 patients. All underwent an extensive ophthalmological work-up, including psychophysical and electrophysiological testing.
RésultatsAll 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.
ConclusionDisulfiram 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.
Auteur 1
NomLUCAS
InitialesRS
InstitutDept of Ophthalmology, Ghent University Hospital, Ghent, Belgium
VilleGhent
Auteur 2
NomLEROY
InitialesBP
InstitutDept of Ophthalmology & Ctr for Medical Genetics, Ghent University Hospital, Ghent, Belgium
VilleGhent
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