Possible optic nerve side effeects associated with nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the largest-selling groups of drugs in the world. We evaluated 144 cases of possible optic nerve abnormalities associated with the use of these agents, which were reported to the National Registry of Drug-Induced Ocular Side Effects. The findings include papillitis, retrobulbar optic neuritis, and papilledema. Although several NSAIDs have been reported to cause papilledema associated with or without pseudotumor cerebri, our data suggest the possibility that on rare occasions most NSAIDs are suspect. Although 120 cases of papillitis or retrobulbar optic neuritis associated with NSAID use have been reported to the Registry, a cause-and-effect relationship cannot be established. In general, visual complaints from patients taking NSAIDs were most commonly reported by those taking indomethacin, but only at a rate of 1.14 ± 0.46 incidents per 100 patient years. Patients with significant visual complaints who are taking NSAIDs may need to be evaluated for possible optic nerve abnormalities.