Fledelius H C
Rigshospitalet, University Eye Dept., Copenhagen, Denmark.
Acta Ophthalmol Scand. 1999 Dec;77(6):719-21. doi: 10.1034/j.1600-0420.1999.770625.x.
To present a case of blinding bilateral acute optic nerve disease in a 15-year-old male apparently induced by inhalation of amyl nitrite.
Sequentially over four days he lost his four altitudinal visual hemifields, leaving atrophic discs and only 2/60 and a small field in the better eye. Scannings by CT and MRI and a full laboratory research gave no specific clue to the pathogenesis.
No similar cases have been described in the more than 100-year history of pharmacological use of amyl nitrite for angina pectoris, and pharmacologically it is hard to point out a rationale behind the sequential visual loss As an alternative to frank toxicity, therefore, we have considered a parainfectious mechanism as related to an influenza-like disease immediately prior to the abuse episode.
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