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EV0024

Is subclinical alcohol- and tobacco-induced toxic optic neuropathy (ATTON) a reversible entity?

IS SUBCLINICAL ALCOHOL-TOBACCO TOXIC OPTIC NEUROPATHY (ATTON) A REVERSIBLE ENTITY?

A prospective cohort study is proposed to investigate whether subclinical optic neuropathy in adults with alcohol dependence reverses with abstinence over a 3-month follow-up; the poster contains no outcome data.

The study aims to investigate whether subclinical optic neuropathy, measured by retinal nerve fiber layer thickness, is reversible over a 3-month follow-up in adults with alcohol (and tobacco) dependence who abstain from alcohol compared with those who do not. The poster presents a proposed prospective cohort study with a nested comparison arm; participants are adults diagnosed with alcohol (and tobacco) dependence according to ICD-11, and all participants receive usual care with monthly follow-up for 3 months and are grouped as abstinent or non-abstinent from alcohol. The flowchart indicates a baseline assessment of n=432 and approximately 50% attrition; clinical instruments include the AUDIT, SADQ, RCQ-TV, FTND, and MMSE; laboratory investigations include vitamin (B1, B9, B12) levels, complete blood count, AST, ALT, GGT, CDT, CRP, HbA1c, and urine testing for opioids, cannabis, and cotinine; other investigations include optical coherence tomography (OCT), visual evoked potentials (VEP), and nerve conduction studies (NCS), which are repeated at month 3. The rationale section reports that approximately 15% of adults in India (about 160 million people) consumed alcohol in the past year, approximately 30 million people live with alcohol dependence, and tobacco dependence, the most common comorbidity, occurs in up to 90%. It emphasizes that toxic optic neuropathy caused by the neurotoxic effects of alcohol and tobacco may progress to irreversible optic atrophy and permanent vision loss, but may be reversible with early diagnosis and treatment. The poster reports no findings; the study is expected to clarify whether early diagnosis and treatment can reverse subclinical optic nerve damage. The findings could guide preventive strategies to reduce irreversible vision loss by establishing the value of routine OCT screening in individuals with chronic alcohol and tobacco use.

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