PURPOSE: To report a case of sequential anterior ischemic optic neuropathy temporally related to the sequential use of a decongestant nasal spray. METHODS: A 43-year-old woman was evaluated for sequential bilateral vision loss following the use of oxymetazoline nasal spray. RESULTS: Thorough investigation of possible etiologies causing the bilateral anterior ischemic optic neuropathy was negative. Our patient had several predisposing risk factors for ischemic optic neuropathy, including diabetes mellitus, hypertension, and crowded optic nerve heads. Before each acute optic neuropathy, the patient used two to three puffs of oxymetazoline nasal spray. CONCLUSION: Decongestants have been associated with ischemic and hemorrhagic vascular events. Vasoconstriction secondary to oxymetazoline use may precipitate anterior ischemic optic neuropathy.
A 57-year-old woman developed bilateral optic neuritis after being treated for 6 months with tamoxifen in the dosage of 30 to 40 mg orally a day. As the neuritis progressed during continued treatment and no other causal explanation could be found, tamoxifen was stopped and the optic neuritis regressed. Since tamoxifen might cause optic neuritis the authors recommend the monitoring of ocular symptoms in treated patients
[Diseases & symptoms linked to drugs] [Adverse reactions (media/articles)]