Optical coherence tomography in a patient with tobacco-alcohol amblyopia

Aim To report optical coherence tomography (OCT) finding in a patient with tobacco-alcohol amblyopia. Methods A 45-year-old man presented with a gradual decrease in vision over 4 years. He had smoked a half to one pack of cigarettes per day and had consumed 350 cc of gin per day for 30 years. A detailed ophthalmologic examination was performed. Results His corrected visual acuities were 20/ 800 OD and 20/200 OS. A Goldmann visual field examination showed ceco-central scotomas in both eyes. OCT using a peripapillary Fast RNFL (retinal nerve fiber layer) programme showed a small decrease in the RNFL thickness of the superotemporal quadrant in the normative diagram of the right eye in spite of a markedly increased RNFL thickness in both eyes. Conclusion During the phase of visual loss in a patient with tobacco-alcohol amblyopia, visual loss may precede optic disc changes as detected by OCT.