Prevalence of optic neuropathy in alcoholic patients and predictive value of optic nerve alterations for its diagnosis

Abstract

AbstractPurpose Optic neuropathy (ON) is one of the complications of alcohol. The aim of this study was to assess the prevalence of alcoholic ON in a cohort of patients hospitalized for alcohol withdrawal. Secondary objective was to explore the predictive value of optic nerve changes for diagnosis of ON.Methods This was a single‐center prospective study. A complete eye examination was performed during the patient's alcohol withdrawal. The definition of alcoholic ON used was an assocation of alterations of visual field with impaired color vision. Optic nerve function and morphology were assessed using visual evoked potentials, optical coherence tomography (OCT), Nerve Fiber Indicator from polarimetry (GDx) and Moorfields Regression Analysis of the Heidelberg Retina Tomograph II (MRA‐HRT II).Results Two hundred patients were included prospectively from January 2010 to June 2013 (145 men and 55 women) with a mean age of 47 ± 12 year. The average alcohol consumption was 220 ± 122 g/day. 46 patients (23%) responded to alcoholic ON defintion (13.5 % in both eyes and 9.5% in only one eye). Diagnostic sensitivity and specificity for visual evoked potentials were of 55.5% and 54.5% respectively; for GDx 18% and 97%, respectively; for OCT 38% and 92%, respectively; and for MRA‐HRT II 19% and 79%, respectively.Conclusion A high prevalence of alcoholic ON observed in this study should prompt screening and early treatment. From predictive value of objective optic nerve changes, we discuss the best couple of exams to complete the screening of alcoholic ON.