Optic neuropathy associated with linezolid: systematic review of cases.

Objective: Collect and analyze all the described cases of optic neuropathy associated with linezolid.

Method: A systematic review of cases was carried out through a search in PubMed-Medline, Embase and ScienceDirect, between September 2002 and April 2018. The demographic, clinical and ophthalmology  characteristics of each patient were evaluated.

Results: A total of 33 cases from 26 independent articles were analyzed. The mean age was 44.97 ± 21.40 years (range: 6-79) and 16  (50%) of 32 cases were women. The duration of treatment with linezolid  until onset of symptoms was greater than 28 days in 29 (90.6%) of 32  documented cases. The mean time of exposure to onset of symptoms was 8.5 ± 8.6 months (range: 0.33-50). A total of 12 of 26 adult patients  received linezolid 600 mg/24 h, starting. In 30 (90.9%) patients loss of  visual acuity was documented. Linezolid was withdrawn in all cases once the diagnosis was confirmed, with clinical improvement in 31 (93.9%) cases. Conclusions: Optic neuropathy is a reversible complication related to the  prolonged use of linezolid and regardless of the dose. We recommend follow- up in patients with long treatments (> 28 days) and ophthalmological exploration in those with visual alterations for the early  diagnosis of neuropathy and early withdrawal of linezolid.