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Ophthalmol Case Rep 2017 Volume 1 Issue 1
August 21-23, 2017 | Toronto, Canada
EYE AND VISION
3
rd
International Conference on
Notes:
T
he toxic optic neuropathies are typically characterized
by subacute or chronic, bilateral, symmetrical and
painless loss of vision. Treatment is initiated by recognition
and drug withdrawal. Historically, methanol (though not a
medication), ethambutol and isoniazid were the first to be
recognized as neurotoxic. Later, cyclosporine, a widely used
immunosuppressant and other chemotherapeutic agents,
like; cisplatin, carboplatin and vincristine were recognized as
having neurotoxic adverse reactions. Amiodarone-associated
optic neuropathyhas beenwidelydiscussed in theophthalmic
literature less than half a century ago. It is still controversial
whether sildenafil and other phosphodiesterase-5 inhibitors
prescribed for erectile dysfunction, cause visual loss by
triggering ischemic optic neuropathy. Vigabatrin, used
around the world as an anti-epileptic drug, was reported to
cause irreversible visual field defects in children. Infliximab,
an anti-tissue necrosis-alpha monoclonal antibody currently
in use for granulomatous diseases, is also known to cause
toxic optic neuritis. A long list of reported drugs is associated
with increased intracranial pressure, though not confirmed
by controlled studies. Vitamin A derivatives, corticosteroids,
tetracyclines,
fluoroquinolones,
gonadal
hormones,
indomethacin, lithium and tamoxifen are just a small part
of this list. Abnormalities of eye movements, including
nystagmus and inappropriate vestibulo-ocular reflex are
reported at toxic levels of neuroactive drugs like: diazepam,
methadone, phenytoin, barbiturates and chloral hydrate.
Drug-induced disturbances of neuromuscular transmission,
occurring at the pre-or-post synaptic levels, include prominent
ptosis and ophthalmoparesis along with variable degrees of
extremity muscle weakness resembling true myasthenia
gravis.
Speaker Biography
Dr. Shlomo Dotan is working as the director of the Neuro-Ophthalmology Service at the
Hebrew University-Hadassah Medical Center in Jerusalem for more than two decades.
He is part of the Editorial Board of the esteemed journal - Neuro-Ophthalmology. His
major research project in the past was The Optic Neuritis Treatment Trial Study and
The International Optic Nerve Trauma Study which were published in The New England
Journal of Medicine and several ophthalmological journals. He is currently involved in
several scientific projects investigating therapeutic aspects in MS, NMO and NAION.
He is member of the Israel Medical Association, Israel Ophthalmological Society,
North American Neuro-Ophthalmology Society, American Academy of Ophthalmology,
European Neuro-Ophthalmology Society, and the European Ophthalmological Society.
He has been giving lectures worldwide on various ophthalmological and neuro-
ophthalmological topics and has published articles in several prestigious medical
journals. He has been part of many esteemed conferences held in Europe, including
Israel.
e:
docdotan@smile.net.ilShlomo Dotan
Hebrew University of Jerusalem, Israel
Neuro-ophthalmic aspects of drug toxicity