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Letter
Linezolid induced toxic optic neuropathy
  1. K Kulkarni1,2,
  2. L V Del Priore1
  1. 1Department of Ophthalmology, Columbia University, 635 West 165th Street, New York, NY 10032, USA
  2. 2University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, 675 Hoes Lane, Piscataway, NJ 08854, USA
  1. Correspondence to: Lucian V Del Priore MD, PhD, Robert L Burch III Scholar, Department of Ophthalmology, Columbia University, 635 West 165th Street, New York, NY 10032, USA; ldelprioreyahoo.com

https://doi.org/10.1136/bjo.2005.074237

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    Linezolid is a new oxazolidinone antibiotic with activity against many important pathogens including methicillin resistant Staphylococcus and penicillin resistant Streptococcus.1 We report a case of toxic optic neuropathy from chronic treatment with linezolid. Correct diagnosis and discontinuation of the drug resulted in significant recovery of vision.

    Case report

    A 56 year old man presented with bilateral, progressive decline in visual acuity for 6–8 months. Medical history included chronic diabetes mellitus, below the knee amputation of the right leg, hypertension, sinusitis with nasal allergies, and asthma. Several years earlier he had fractured his left ankle and developed osteomyelitis from methicillin resistant Staphylococcus. He had received linezolid 600 mg by mouth twice a day for 12 months, then once daily for 44 months. Other medications included rosiglitazone, metoprolol, rifampin, furosemide, lisinopril, amlodipine, insulin, and vitamin B complex/folic acid for assistance with wound healing. He was a non-smoker and consumed less than one unit of alcohol per week.

    Best corrected visual acuities were 20/400 in both eyes with eccentric fixation. Ishihara colour plates were 1/8 …

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