{"pk":1022,"title":"Reversible Total Vision Loss Caused by Severe Metformin-associated Lactic Acidosis: A Case Report","subtitle":null,"abstract":"Introduction:\n Metformin is a biguanide used to treat diabetes mellitus (DM). Metformin-associated lactic acidosis (MALA) carries a high mortality and can occur in patients with renal failure from drug bioaccumulation. Reversible vision loss is a highly unusual, rarely reported complication of MALA. We present a case of a patient whose serum metformin concentration was unusually high and associated with vision loss.\nCase Report:\n A 60-year-old woman presented to an outside hospital emergency department with acute vision loss after being found at home confused, somnolent, and hypoglycemic, having last being seen normal two days prior. She reported vomiting and diarrhea during that time and a recently treated urinary tract infection. The visual loss resolved with continuous renal replacement therapy.\nConclusion:\n This novel case of a patient with Type II DM prescribed metformin and insulin who developed reversible vision loss while suffering from MALA highlights the potential for vision loss in association with MALA.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Metformin"},{"word":"metabolic"},{"word":"diabetic"},{"word":"vision loss"},{"word":"concentrations"},{"word":"case report"}],"section":"Case Reports","is_remote":true,"remote_url":"https://escholarship.org/uc/item/5qr3n778","frozenauthors":[{"first_name":"Andrew","middle_name":"","last_name":"Koons","name_suffix":"","institution":"Lehigh Valley Health Network, Department of Emergency and Hospital Medicine, Allentown, Pennsylvania","department":"None"},{"first_name":"Alexandra","middle_name":"M.","last_name":"Amaducci","name_suffix":"","institution":"Lehigh Valley Health Network, Department of Emergency and Hospital Medicine, Allentown, Pennsylvania","department":"None"},{"first_name":"Kenneth","middle_name":"D.","last_name":"Katz","name_suffix":"","institution":"Lehigh Valley Health Network, Department of Emergency and Hospital Medicine, Allentown, Pennsylvania","department":"None"}],"date_submitted":"2021-05-07T00:29:06Z","date_accepted":"2021-05-07T00:29:06Z","date_published":"2021-05-07T00:30:13Z","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/1022/galley/769/download/"}]}