Table 1

Case reports of drug induced ocular toxicity

Author (year)DrugAdverse reactionPopulationIntervention and outcomeComments
Miller13 (1978)ChlorothiazideOculomotor nerve palsy47 year old male. GTT abnormal on thiazide treatment7 months of diuretic for nephrolithiasis. 3 days' history of orbital pain and ptosis. Diuretic stopped, 3/12 later, palsy resolved and 2 GTTS were normalNo rechallenge but all other causes of palsy ruled out. Proposed mechanism of glucose intolerance induced microangiopathy
Sponsel14 (1992)IndapamideBilateral cataracts39 year old male. Hypertensive and obese3½ years of indapamide. Hyperglycaemia with reduced visual acuity and colour vision changes. Stopping therapy halted progression of visual disturbancesNo rechallenge but no other risk factors for cataracts. Surgery required for cataracts
Wymore15(1982)ChlorpropamideOptic neuropathy65 year old male. NIDDM for 1 yearReduced visual acuity after 1 year of treatment. Dramatic improvement in visual acuity and colour vision on stopping drugRechallenge for 5 days showed reduced visual acuity. Vision returned to baseline after stopping
D'Arcy16(1989)GlibenclamideMyopia35 year old male Symptomatic after 2 days of glibenclamide. Vision returned to normal 3 days after discontinuationNo rechallenge. Patient remained on diet control for diabetes
Lightman17 (1989)Glyburide (Glibenclamide)(1) Hyperopia
(2) crystalline lens deposits
66 year old male. New case of NIDDMOsmotic effects thought to be cause of lens changesNo rechallenge. Alternative explanation proposed by Keller45
Hamill18(1983)Scopolamine (Transdermal)Acute angle closure glaucoma58 year male. NIDDM and hypertensive on methyl dopa and propranololIntraocular pressure >80 mm Hg after 4 days of patch treatment. Probably unrelated to diabetesNo rechallenge. Predictable from pharmacology
Sedwick19(1992)AmiodaroneOptic neuropathy62 year old male. Hypertensive with NIDDM on diazide and glyburideSudden visual loss when given amiodarone. Bilateral optic neuropathyVision improved after stopping amiodarone. After 3 weeks of rechallenge, vision deteriorated
Zenimaru20(1997) InterferonWorsening of retinopathy 38 year old male. Diabetic with hepatitis CDevelopment of retinopathy with massive vitreous haemorrhages after 9 monthsVitreous haemorrhage required surgery. No rechallenge
Dukar26(1993)OKT3 Retinal toxicityTwo post-renal transplant females. One had IDDMCase 1: reduced visual acuity after 1 week of OKT3. Cataract extraction 2 years later. Repeat OKT3 resulted in vision loss. Case2: OKT3 for kidney rejection resulted in total loss in vision after 2nd doseRechallenge in case 1. No other reason for vision loss apart from slight narrowing of retinal vessels
Flipovic21(1997) EthambutolOptic neuropathySeries of casesFew details available
Sorensen22 (1977)Phenformin + ethanolRetinal dysfunction57 year female. Diabetic and obese. Following alcohol bingeSevere reduction in visual acuity. Blindness improved with intensive treatment for lactic acidosisNo rechallenge. Possible mechanism is inhibition of oxidative metabolism
Maddox23 (1977)WarfarinRetinal and vitreous haemorrhagesFemale diabetic underwent mitral valvotomyGiven warfarin 11 mg. After 1 year haemorrhaged into both eyes resulting in blindnessNo recovery. No rechallenge
Caramelli24(1991)StreptokinaseRetinal and vitreous haemorrhage46 year old diabetic male with 3 years proliferative retinopathy. Given streptokinase for MIMarked reduction in vision with some recovery. Cardiac status felt to have benefited from thrombolysisNo rechallenge. Vision improved without further treatment
Jimenez-Lucho25 (1987)IsoniazidOptic neuropathy71 year old. Also on ethambutol, pyridoxine, nifedipine, and allopurinolReduced visual acuity after 7 months of TB treatment. Greatest improvement after stopping isoniazid.No rechallenge
  • Indicates data obtained from abstract.