Digoxin visual toxicity with therapeutic blood levels of digoxin.

Abstract

To report two cases of digoxin-related visual disturbances associated with therapeutic blood levels of digoxin. Case reports. One patient reported shimmering lights in the field of vision of both eyes; the second patient had a corrected visual acuity of BE, 20/40 and generalized visual field depression in both eyes. Both patients experienced these symptoms while receiving digoxin. Both patients had digoxin blood levels in the therapeutic range (1.7 and 1.0 ng/ml, respectively). Therapeutic levels are 0.5 to 2.0 ng/ml. After discontinuing digoxin, the first patient noted that the shimmering light symptoms resolved, and the second patient had improved visual acuity and visual fields. Digoxin-related visual toxicity may be associated with therapeutic blood levels of digoxin. Recognition of this entity may avoid unnecessary testing and frustration.