Irreversible blindness after amyl nitrite inhalation.

PURPOSE: To present a case of blinding bilateral acute optic nerve disease in a 15-year-old male apparently induced by inhalation of amyl nitrite.

METHODS

Sequentially over four days he lost his four altitudinal visual hemifields, leaving atrophic discs and only 2/60 and a small field in the better eye. Scannings by CT and MRI and a full laboratory research gave no specific clue to the pathogenesis.

CONCLUSIONS

No similar cases have been described in the more than 100-year history of pharmacological use of amyl nitrite for angina pectoris, and pharmacologically it is hard to point out a rationale behind the sequential visual loss As an alternative to frank toxicity, therefore, we have considered a parainfectious mechanism as related to an influenza-like disease immediately prior to the abuse episode.