Ocular effects in long-term amiodarone therapy.

The ocular complications of long-term amiodarone therapy have been recognized for many years, but systematic data on the prognostic significance and the precise incidence of such effects have not been evaluated until recently. One hundred seventy-five patients receiving long-term amiodarone treatment have thus been followed for periods ranging from 3 months to nearly 10 years. Of 103 of these patients studied in greater depth, 98% have shown the characteristic patterns of corneal microdeposits, which progressed over several months and ultimately formed a stable appearance that changed only with an alteration of dose. The abnormalities, the nature of which is not clearly understood, disappeared within 7 months in the 16 patients whose drug was withdrawn for unrelated reasons, and no permanent ocular damage has been detected. Visual symptoms associated with the corneal deposits developed in 6% of patients: 3% had photophobia, 2% halos, and 1% blurring of vision but without impairment of visual acuity. It is concluded that ocular complications of amiodarone therapy are insignificant; they do not pose a threat to vision, and routine ophthalmologic surveillance does not appear mandatory in the majority of patients during long-term drug therapy.