PMID- 24925440
OWN - NLM
STAT- MEDLINE
DCOM- 20141205
LR  - 20140627
IS  - 1423-0259 (Electronic)
IS  - 0030-3747 (Linking)
VI  - 52
IP  - 1
DP  - 2014
TI  - Effects of multiple doses of voriconazole on the vision of healthy volunteers: a 
      double-blind, placebo-controlled study.
PG  - 43-52
LID - 10.1159/000359952 [doi]
AB  - PURPOSE: To investigate the effects, and their reversibility, of multiple oral 
      voriconazole doses on a variety of visual tests in healthy male volunteers. 
      METHODS: Single-center, double-blind, randomized, placebo-controlled, 
      parallel-group study in 36 volunteers who received voriconazole (n=18, 400 mg 
      every 12 h on day 1, then 300 mg every 12 h for 27.5 days) or matched placebo 
      (n=18). Electroretinograms (ERGs) and ophthalmological examinations were 
      performed at screening, throughout the study and at follow-up. RESULTS: Fifteen 
      (83.3%) volunteers treated with voriconazole experienced >/=1 treatment-related 
      visual adverse events (AEs); these included enhanced visual perceptions, blurred 
      vision, color vision changes and photophobia. No serious AEs were reported. 
      Voriconazole reduced from baseline scotopic maximal a- and b-wave amplitude, 
      shortened implicit time and decreased oscillatory potential amplitude compared 
      with placebo. Under photopic conditions, the 30-Hz flicker response amplitude was 
      significantly reduced and was accompanied by a slight but nonsignificant 
      prolongation of peak time. These effects did not progress in degree over the 
      treatment period, and mean changes from baseline in ERG parameters were similar 
      to placebo by day 43 (14 days after end of treatment). In the first week, color 
      vision discrimination was impaired in the tritan axis, although this resolved by 
      end of treatment and was similar to placebo by day 43. Mean deviation in the 
      static visual field indicated increased sensitivity following voriconazole 
      treatment, correlating with decreased amplitude in conjunction with shortened 
      implicit time. CONCLUSIONS: Effects of voriconazole on altered visual perception, 
      ERG, color vision and static visual field thresholds are nonprogressive over a 
      treatment period and reversible. It is hypothesized that voriconazole has a 
      pharmacological effect on rod and cone pathways including a possible mechanism of 
      disinhibition that reversibly puts the retina in a more light-adapted state and 
      leads to increased relative contrast sensitivity.
CI  - (c) 2014 S. Karger AG, Basel.
FAU - Zrenner, Eberhart
AU  - Zrenner E
AD  - Center of Integrative Neuroscience and Institute for Ophthalmic Research, 
      University of Tubingen, Tubingen, Germany.
FAU - Tomaszewski, Konrad
AU  - Tomaszewski K
FAU - Hamlin, Julia
AU  - Hamlin J
FAU - Layton, Gary
AU  - Layton G
FAU - Wood, Nolan
AU  - Wood N
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20140607
PL  - Switzerland
TA  - Ophthalmic Res
JT  - Ophthalmic research
JID - 0267442
RN  - 0 (Antifungal Agents)
RN  - JFU09I87TR (Voriconazole)
SB  - IM
MH  - Administration, Oral
MH  - Adult
MH  - Antifungal Agents/*administration & dosage/adverse effects
MH  - Color Vision/*drug effects
MH  - Double-Blind Method
MH  - Electroretinography/drug effects
MH  - Healthy Volunteers
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Photoreceptor Cells, Vertebrate/*drug effects
MH  - Visual Fields/*drug effects
MH  - Visual Perception/*drug effects
MH  - Voriconazole/*administration & dosage/adverse effects
MH  - Young Adult
EDAT- 2014/06/14 06:00
MHDA- 2014/12/15 06:00
CRDT- 2014/06/14 06:00
PHST- 2013/05/22 00:00 [received]
PHST- 2014/01/22 00:00 [accepted]
PHST- 2014/06/14 06:00 [entrez]
PHST- 2014/06/14 06:00 [pubmed]
PHST- 2014/12/15 06:00 [medline]
AID - 000359952 [pii]
AID - 10.1159/000359952 [doi]
PST - ppublish
SO  - Ophthalmic Res. 2014;52(1):43-52. doi: 10.1159/000359952. Epub 2014 Jun 7.