Zusammenfassung
Amiodaron, ein wirkungsvolles Antiarrhythmikum, führt zur Speicherung von Lipideinschlusskörperchen
in verschiedenen Geweben, auch des Auges, mit typischen okulären Nebenwirkungen. Bei
70 - 100 % der Patienten treten wirbelförmige, epitheliale Hornhauteinlagerungen ab
einer einmonatigen Behandlungsdauer auf. Es wurde auch über spezifische punktförmige,
subkapsuläre Linsentrübungen berichtet, die bei 50 % der untersuchten, mit Amiodaron
behandelten Patienten beobachtet wurden und zu keiner nachweisbaren Visusminderung
führen. Die schwerwiegendste bis jetzt beschriebene Nebenwirkung ist eine Amiodaron-induzierte
Optikusneuropathie. Sie kommt bei 1,3 - 1,8 % der Patienten vor. Die Optikusneuropathie
ist in der Regel beidseitig und nach Absetzen des Amiodarons in der Hälfte der Fälle
reversibel. Der Befund ist funduskopisch identisch mit einer AION. Netzhautschädigungen
wurden ebenfalls beschrieben, ein Zusammenhang der Amiodaron-Therapie mit den Netzhautveränderungen
konnte bislang jedoch nicht gesichert werden.
Abstract
Amiodarone, one of the most effective anti-arrhythmic drugs, is also known for its
ability to accumulate lipid-pharmakon complexes in the lysosomes of different tissues.
In the eye the lysosomal storage leads to typical side-effects. Whorl-like epithelial,
reversible corneal inclusions occur in about 70 to 100 % of the patients on amiodarone
therapy. Tiny lens opacities without visual impairment have been reported in 50 %
of patients who had been treated with amiodarone. At present the most severe complication
of amiodarone is optic neuropathy with an incidence of 1.3 to 1.8 %. The optic neuropathy,
as the rule, is only reversible approximately in œ of the patients after discontinuing
the drug. The fundoscopic picture of amiodarone neuropathy is similar to classic AION.
Retinal involvement has also been reported; however, a relationship with amiodarone
has not been proven yet.
Schlüsselwörter
Amiodaron - okuläre Nebenwirkungen - Cornea verticillata - Optikusneuropathie
Key words
Amiodarone - ocular side-effects - cornea verticillata - optic neuropathy
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Dr. Gulay Turdumambetova
Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg
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Email: T_Gulay@yahoo.com
