Which agent has been linked to retinal vascular occlusions or NAION in reports?

• A. Sumatriptan
• B. Propranolol
• C. Ribavirin
• D. Dorzolamide

Answer: (C)

Retinal vascular occlusions and ischemic optic neuropathy have been reported in association with systemic therapies used for hepatitis C, particularly when interferon-based regimens are used alongside ribavirin. The combination can involve vascular stress and microangiopathy that may trigger occlusive events in the retina or anterior optic nerve. Ribavirin is the agent most consistently linked to these ocular vascular complications in reports, especially in the context of interferon therapy.

The other drugs listed are not as strongly associated with retinal vascular occlusions or NAION in the literature. Sumatriptan can cause vasospasm, but reports of retinal vascular occlusions or NAION are much less common. Propranolol, dorzolamide, and similar agents do not have a well-established link to these specific vascular ocular events.