benzofurans and Corneal-Opacity

Topics: Action Potentials; Aged; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Benzofurans; Clinical Trials as Topic; Corneal Opacity; Diethylamines; Electrocardiography; Female; Heart Atria; Heart Rate; Humans; Iodobenzoates; Male; Methods; Middle Aged; Time Factors

Amiodarone hydrochloride is an antiarrhythmic drug which produces a keratopathy and anterior subcapsular lens opacities that are usually asymptomatic. Serial observations for eye findings were made in 21 patients on a daily dosage of 200-600 mg for periods ranging from six months to three years. Corneal deposits developed in all 21 patients and anterior lens opacities developed in 12 of 20 phakic patients. Resolving keratopathy was present in three patients for periods of at least seven to 20 months after amiodarone was discontinued.

Topics: Adult; Aged; Amiodarone; Benzofurans; Cataract; Corneal Opacity; Follow-Up Studies; Humans; Middle Aged; Risk; Tachycardia

Eighteen patients receiving the cardiac drug amiodarone were followed prospectively for the development of amiodarone keratopathy. Seventeen of 18 patients (94%) developed characteristic epithelial keratopathy in at least one eye within three months of the initiation of therapy. The pattern of the epithelial deposits was noted to undergo progressive changes in configuration as a function of the duration of amiodarone therapy. These evolving changes are well defined and allow development of a grading system for amiodarone keratopathy. A grading system as well as a proposed mechanism for evolving pattern of the keratopathy are presented.

Topics: Aged; Amiodarone; Benzofurans; Cornea; Corneal Diseases; Corneal Opacity; Dose-Response Relationship, Drug; Epithelium; Female; Humans; Male; Middle Aged

Amiodarone (AM) is one of the most potent antiarrhythmic drugs, the value of which is limited by reversible and irreversible side-effects (SE). 59 patients, 50 male, 9 female (age 33 to 81 years) entered the study with ventricular tachycardia (VT, 68%), WPW-tachycardia (12%), non-sustained VT (12%) or untreatable paroxysmal atrial fibrillation or supraventricular tachycardia (8%). Prior to AM the patients had received 1 to 8 different antiarrhythmic drugs (m 3.5) and maximal 9 different combinations of antiarrhythmics. The drug regimen started with a loading dose of 1200 mg/d for 1 to 2 weeks and was continued with a maintenance dose of 200 to 600 mg/d. The patients were followed up 1 to 41 months (m 14 m). The drug effect was evaluated using clinical criteria (recurrence of arrhythmias, death), computer-assisted analysis of several 24 hr long-term ECGs and programmed electrophysiological stimulation. Three- to six-monthly the patients were seen in our outpatient department for check up and blood-sample analysis (liver, thyroid gland etc.). Also in the majority of the patients frequent ophthalmological and dermatological investigations, as well as lung functions tests were carried out.. under AM therapy the initial arrhythmias were no longer detectable in 41% of the patients. In 37% a significant amelioration of the formerly life-threatening arrhythmias was found. 7 patients (12%), predominantly with reduced left ventricular function, died during follow up. No pulmonary, hepatotoxic or neurological SE were found. All patients developed reversible AM keratopathy. In 27% ETR and T4 were elevated, but only one patient developed hyperthyroidism with an increase in TT3. Another patient showed signs of hypothyroidism with an elevated TSH prior to TRH stimulation. Increased phototoxicity was found in 31%, whereas in two patients typical AM hyperpigmentation occurred, especially on the face. In conclusion, AM is a highly effective antiarrhythmic agent, despite a negatively selected collective, but it should only be used in patients with refractory arrhythmia in view of the SE.

Topics: Adult; Aged; Airway Resistance; Amiodarone; Arrhythmias, Cardiac; Benzofurans; Cornea; Corneal Opacity; Electric Stimulation; Electrocardiography; Female; Humans; Male; Middle Aged; Skin Pigmentation; Thyroid Function Tests; Ventricular Fibrillation

Topics: Amiodarone; Arrhythmias, Cardiac; Benzofurans; Corneal Opacity; Humans

Among 30 patients (17 men, 46-76 years and 13 women, 15-70 years), treated with the antiarrhythmic drug amiodarone, 21 patients (11 men and 10 women) developed bilateral cornea verticillata. Total doses up to 494 g had been given and the duration of therapy was up to 113 weeks. In 14 patients samples of 50 microliters tear fluid were analyzed for aminodarone. No amiodarone was present in the tears at low serum concentrations but a rapid increase in tear concentrations was seen at serum values above 1.2 micrograms/ml (P less than 0.001). The grade of cornea verticillata was significantly correlated to total dose as well as to duration of treatment (P less than or equal to 0.001). On the day of examination at the eye clinic there was no significant correlation between se-amiodarone, tear-amiodarone concentration and the grade of cornea verticillata. One patient complained of coloured haloes. None had decreased visual acuity, fundus changes, cataract, exophthalmus, increased intraocular pressure, abnormal colour vision, or abnormal central corneal thickness, which could be attributed to the treatment of amiodarone.

Topics: Adolescent; Adult; Aged; Amiodarone; Benzofurans; Corneal Opacity; Female; Humans; Male; Middle Aged; Tears

Topics: Benzofurans; Corneal Opacity; Humans; Male; Middle Aged; Optic Neuritis; Oxazines; Vasodilator Agents

Topics: Angina Pectoris; Benzofurans; Corneal Opacity; Humans

Topics: Antihypertensive Agents; Benzofurans; Cornea; Corneal Opacity; Humans; Male; Middle Aged

Topics: Angina Pectoris; Benzofurans; Corneal Opacity; Humans; Iatrogenic Disease