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Importantly, BBTMA occurs in an anaerobic environment, which suggests that it is catalyzed not by the CntA/B oxygenase, but rather by a novel oxygen-independent enzymatic pathway for the conversion of metabolites of the l-carnitine pathway to TMA

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In the future, with routine clinical access to genetic analyses, it may be possible to identify individuals at increased risk for these potential complications

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"The use of these drugs has exploded throughout industrialized countries and they have provided very significant benefits in many ways, but future discussions between a patient and their physician should include NAION as a potential risk," said Joseph Rizzo, the study's corresponding author and director at Mass Eye and Ear, according to a statement shared by CNN