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Linezolid-associated toxic optic neuropathy

From the Departments of Neurology and Ophthalmology (J.C.R.), Rush University Medical Center, Chicago, IL; Neuro-ophthalmic Consultants Northwest (S.R.H.), Seattle, WA; Departments of Ophthalmology and Pathology (D.B.), Case University, Cleveland, OH; Department of Infectious Disease (C.M.I.), Cleveland Clinic Foundation, Cleveland, OH; and Department of Ophthalmology (M.S.L.), University of Minnesota, Minneapolis, MN.

Address correspondence and reprint requests to Dr. Janet C. Rucker, Department of Neurology, Rush University Medical Center, 1725 West Harrison, Suite 1106, Chicago, IL 60612; e-mail: janet_rucker{at}rush.edu

The oxazolidinone antimicrobial linezolid is effective against gram-positive bacteria. Although maximal recommended therapy is 28 days, treatment durations greater than this are common. Linezolid may cause reversible optic neuropathy and irreversible peripheral neuropathy after months of treatment. Three cases of linezolid-induced optic and peripheral neuropathy are described, and previously reported cases of linezolid-induced optic neuropathy are reviewed. The mechanism of neural toxicity may be impairment of mitochondrial protein synthesis.

Disclosure: The authors report no conflicts of interest.

Received June 20, 2005. Accepted in final form November 29, 2005.

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