Fasler Katrin, Traber Ghislaine L, Jaggi Gregor Peter, Landau Klara
Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland.
Neuroophthalmology. 2017 Aug 18;42(1):2-10. doi: 10.1080/01658107.2017.1340961. eCollection 2018 Feb.
Amiodarone-associated optic neuropathy (AAON) is a controversial diagnosis with possible impact on vital cardiac therapy decisions. This retrospective case series aims for application of distinguishing features of AAON versus non-arteritic ischaemic optic neuropathy (NAION): Bilaterality, mode of onset, degree of optic nerve dysfunction, structure of uninvolved disc (unilateral cases), and systemic toxic effects. Applying these criteria to patients with disc swelling under amiodarone, the authors identified four unilateral disc swellings, one with NAION-typical features only and three with one or more NAION-atypical features. All three sequential and six bilateral cases showed one or more NAION-atypical features. The 12 cases highlight the persisting diagnostic dilemma arising from diversity of presentation, lack of plausible pathomechanism, and controversial existence of the entity itself.
胺碘酮相关性视神经病变（AAON）是一种存在争议的诊断，可能会对重要的心脏治疗决策产生影响。本回顾性病例系列旨在应用AAON与非动脉炎性缺血性视神经病变（NAION）的鉴别特征：双侧性、发病方式、视神经功能障碍程度、未受累视盘结构（单侧病例）以及全身毒性作用。将这些标准应用于服用胺碘酮后出现视盘肿胀的患者，作者识别出4例单侧视盘肿胀，其中1例仅具有NAION的典型特征，3例具有一个或多个NAION的非典型特征。所有3例相继出现的病例和6例双侧病例均表现出一个或多个NAION的非典型特征。这12例病例凸显了由于临床表现多样、缺乏合理的发病机制以及该疾病实体本身存在争议而导致的持续诊断困境。
