Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
The most common side-effect of the anti-arrhythmic amiodarone is keratopathy. The goal of this study was to assess the frequency of this side-effect in our population of cardiology patients treated with amiodarone. We also wanted to assess the consequences on eye sight. The study was conducted as collaboration between the divisions of ophthalmology and cardiology of Sestre milosrdnice University Hospital, Zagreb and it included patients receiving amiodarone for longer than 6 months (100-800 mg/ day). Changes on the cornea were objectively evaluated using a biomicroscope and have been classified into three stages. Clinical changes on the cornea have been observed in 92% of the patients. Changes in eye sight were not observed. Amiodarone keratopathy is related to dosage and duration of treatment. This keratopathy progresses even with reduced dosage; however, complete regression occurs once administration of medication is discontinued. Taking this study into account, as well as the available published data, we are of the opinion that amiodarone therapy should not be discontinued due to changes in the eye-sight and if the amiodarone therapy is of critical importance to the welfare of the patient.Kod primjene antiaritmika amiodarona najčešće registrirana nuspojava je keratopatija. Cilj ovog rada je ispitati koliko je ova nuspojava frekventna u populaciji naših kardioloških pacijenata na terapiji amiodaronom i od kakvog je značaja za kvalitetu vida. Ispitivanje je provedeno u suradnji klinike za oftalmologiju i kardiologiju KB "Sestre milosrdnice", Zagreb. Uključeni su pacijenti na terapiji amiodaronom duže od 6 mjeseci (100-800 mg/dan). Promjene na rožnici objektivno su registrirane biomikroskopom i svrstane u tri stupnja. One su registrirane kod 92% pacijenata. Promjene kvalitete vida nisu registrirane. Amiodaronska keratopatija u korelaciji je s dnevnom dozom i duljinom trajanja terapije. Smanjenje dnevne doze ne dovodi do regresije keratopatije, dok je kompletna regresija zabilježena nakon prestanka primjene lijeka. S obzirom na ovo istraživanje i podatke iz literature, mišljenja smo, da nije potrebno prekidati terapiju amiodaronom zbog promjena na rožnici ukoliko nema poremećaja vida i ako je terapija amiodaronom od vitalnog značenja za pacijenta
