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II5 Specificity in Digitoxin Toxicity: A Case Report

II5 Specificity in Digitoxin Toxicity: A Case Report Abstract Introduction Visual side effects from the cardiac glycosides are common, especially in cases of overdosage. The most frequent symptoms are blurring, "yellow vision," and flickering scotomata. Many patients also complain that objects appear covered with frost. Although these effects were first reported in 1785,1 good visual field studies of such cases were not described until 1946.2,3 They showed central scotomata in those cases with marked loss of vision. These changes were unaccompanied by any perceptible fundus anomalies, and Wagener2 attributed these effects to a drug action on the optic nerve outside the eye. The same hypothesis has dominated the literature since that time, although there is no additional evidence to support it. Report of Case A 54-year-old white man was admitted to the Ann Arbor Veterans Administration Hospital on Dec 19, 1962 with a two months' history of decreased vision. He complained that his vision was very References 1. Withering, W.: Account of Foxglove, and Some of Its Medical Uses , London: G. G. J. & J. Robinson, 1785, p 184. 2. Wagener, H. P.; Smith, H. L.; and Nickeson, R. W.: Retrobulbar Neuritis and Complete Heart Block Caused by Digitalis Poisoning: Report of Case , Arch Ophthal 36:478-483, 1946.Crossref 3. Gillette, D. F.: Visual Disturbances Due to Digitalis , Trans Amer Ophthal Soc 44:156-165, 1946. 4. Walls, G. L.: How Good Is H-R-R Test for Color Blindness? Amer J Optom 36:169-193, 1959.Crossref 5. Krill, A. E., and Lee, G. B.: Electroretinogram in Albinos and Carriers of Ocular Albino Trait , Arch Ophthal 69:32-38, 1963.Crossref 6. Krill, A. E.: Technique for Evaluating Photopic and Scotopic Flicker Function With One Light Intensity , Docum Ophthal 18:452-461, 1964.Crossref 7. Siegel, S.: Nonparametic Statistics for Behavioral Sciences , New York: McGraw Hill Book Co. Inc., 1956, p 68. 8. Denden, A.: Elektroretinographische Spektralsensitivitat bei Farbigsehen nach Acetyldigitoxinbehandlung , Graefe Arch Ophthal 165:185-194, 1962.Crossref 9. Stiles, W. S.: Color Vision: Approach Through Increment-Threshold Sensitivity , Proc Nat Acad Sci USA 45:100-114, 1959.Crossref 10. Unger, L.: Chromatopie nach Digitalis , Ophthalmologica 136:326-332, 1958.Crossref 11. Alpern, M.; Falls, H. F.; and Lee, G. B.: Enigma of Typical Total Monochromacy , Amer J Ophthal 50:996-1012, 1960. 12. McLaughlin, S. C., Jr.: Automatic-Recording Visual Adaptometer , J Opt Soc Amer 44:312-314, 1954.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

II5 Specificity in Digitoxin Toxicity: A Case Report

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References (13)

Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1965.00970040156004
Publisher site
See Article on Publisher Site

Abstract

Abstract Introduction Visual side effects from the cardiac glycosides are common, especially in cases of overdosage. The most frequent symptoms are blurring, "yellow vision," and flickering scotomata. Many patients also complain that objects appear covered with frost. Although these effects were first reported in 1785,1 good visual field studies of such cases were not described until 1946.2,3 They showed central scotomata in those cases with marked loss of vision. These changes were unaccompanied by any perceptible fundus anomalies, and Wagener2 attributed these effects to a drug action on the optic nerve outside the eye. The same hypothesis has dominated the literature since that time, although there is no additional evidence to support it. Report of Case A 54-year-old white man was admitted to the Ann Arbor Veterans Administration Hospital on Dec 19, 1962 with a two months' history of decreased vision. He complained that his vision was very References 1. Withering, W.: Account of Foxglove, and Some of Its Medical Uses , London: G. G. J. & J. Robinson, 1785, p 184. 2. Wagener, H. P.; Smith, H. L.; and Nickeson, R. W.: Retrobulbar Neuritis and Complete Heart Block Caused by Digitalis Poisoning: Report of Case , Arch Ophthal 36:478-483, 1946.Crossref 3. Gillette, D. F.: Visual Disturbances Due to Digitalis , Trans Amer Ophthal Soc 44:156-165, 1946. 4. Walls, G. L.: How Good Is H-R-R Test for Color Blindness? Amer J Optom 36:169-193, 1959.Crossref 5. Krill, A. E., and Lee, G. B.: Electroretinogram in Albinos and Carriers of Ocular Albino Trait , Arch Ophthal 69:32-38, 1963.Crossref 6. Krill, A. E.: Technique for Evaluating Photopic and Scotopic Flicker Function With One Light Intensity , Docum Ophthal 18:452-461, 1964.Crossref 7. Siegel, S.: Nonparametic Statistics for Behavioral Sciences , New York: McGraw Hill Book Co. Inc., 1956, p 68. 8. Denden, A.: Elektroretinographische Spektralsensitivitat bei Farbigsehen nach Acetyldigitoxinbehandlung , Graefe Arch Ophthal 165:185-194, 1962.Crossref 9. Stiles, W. S.: Color Vision: Approach Through Increment-Threshold Sensitivity , Proc Nat Acad Sci USA 45:100-114, 1959.Crossref 10. Unger, L.: Chromatopie nach Digitalis , Ophthalmologica 136:326-332, 1958.Crossref 11. Alpern, M.; Falls, H. F.; and Lee, G. B.: Enigma of Typical Total Monochromacy , Amer J Ophthal 50:996-1012, 1960. 12. McLaughlin, S. C., Jr.: Automatic-Recording Visual Adaptometer , J Opt Soc Amer 44:312-314, 1954.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Aug 1, 1965

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