scholarly journals Multimodal etiology of drug induced angle closure with topical glaucoma therapy

2021 ◽  
pp. 101152
Author(s):  
Aditya Mehta ◽  
Andrew Lewis
Keyword(s):  
Angle Closure ◽  
Drug Induced ◽  
Glaucoma Therapy

scholarly journals Angiographic features of drug-induced bilateral angle closure and transient myopia with Ciliochoroidal effusion

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yong Koo Kang ◽  
Byeong Jae Son ◽  
Dong Ho Park ◽  
Jae Pil Shin
Keyword(s):  
Case Series ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Drug Induced ◽  
Idiosyncratic Reaction ◽  
Transient Myopia ◽  
Extravascular Fluid ◽  
Ciliochoroidal Effusion ◽  
Myopic Shift ◽  
Shallow Anterior Chamber

Abstract Background To report five cases of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion and to analyze angiographic findings of these cases. Methods This study is an observational case series. Five patients with acute drug-induced angle closure and transient myopia with ciliochoroidal effusion were examined by fluorescein angiography, indocyanine green angiography (ICGA) and ultrasound biomicroscopy (UBM). Results Five patients presented with bilateral visual loss and ocular pain after intake of topiramate, methazolamide, phendimetrazine tartrate or mefenamic acid. All patients showed elevated intraocular pressure (IOP) with shallow anterior chamber and myopic shift from − 0.5 to − 17.0 diopters (D). UBM showed ciliochoroidal effusions with diffuse thickening of the ciliary body in all cases. Rapid normalization of IOP and decrease of myopic shift occurred in all patients after discontinuing the suspected drugs. We classified the ICGA findings into 2 major signs (hypofluorescent dark spots, hyperfluorescent pinpoints) and 3 minor signs (diffuse choroidal hyperfluorescence, early hyperfluorescence of choroidal stromal vessel, and leakage and dilated retinal vessels). Conclusions The pathogenesis of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion may be idiosyncratic reaction of uveal tissue to systemic drugs. Accumulation of extravascular fluid in the ciliochoroidal layer had a major role in the pathogenesis. ICGA could be a useful method to examine the pathophysiology of this condition by imaging of the choroidal layer.

scholarly journals Bilateral, Simultaneous, Acute Angle Closure Glaucoma in Pseudophakia Induced by Chlorthalidone

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Indra Durai ◽  
Mrunali Mohan Dhavalikar ◽  
Chandran Prem Anand ◽  
Venkatraman Ganesh ◽  
Ramaswami Krishnadas
Keyword(s):  
Case Reports ◽  
Crystalline Lens ◽  
Acute Angle ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Systemic Hypertension ◽  
Drug Induced ◽  
Idiosyncratic Reaction ◽  
Acute Angle Closure ◽  
Acute Angle Closure Glaucoma

Purpose. To report two persons with acute, bilateral, and simultaneous angle closure glaucoma in pseudophakia secondary to uveal effusions induced by administration of chlorthalidone.Methods. Case reports.Results. Bilateral shallow anterior chambers and high intraocular pressure with decline in visual acuity were reported in two patients within days of intake of chlorthalidone for systemic hypertension. Gonioscopy confirmed appositional angle closure while choroidal detachment and ciliochoroidal detachment were revealed on ultrasonographic studies. Discontinuing chlorthalidone and institution of aqueous suppressants to reduce IOP and cycloplegics reversed angle closure and glaucoma.Conclusions. Reports of angle closure glaucoma in pseudophakic eyes induced by idiosyncratic reaction to chlorthalidone confirms that osmotic changes in the crystalline lens has no role in the pathogenesis of drug induced glaucoma and reaffirms that glaucoma is secondary to ciliochoroidal detachment and ciliary body rotation and edema.

scholarly journals A review of drug-induced acute angle closure glaucoma for non-ophthalmologists

2015 ◽  
Vol 2015 (1) ◽  
pp. 6 ◽  
Author(s):  
Elliott Yann Ah-kee ◽  
Eric Egong ◽  
Ahad Shafi ◽  
Lik Thai Lim ◽  
James Li Yim
Keyword(s):  
Acute Angle ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Drug Induced ◽  
Acute Angle Closure ◽  
Acute Angle Closure Glaucoma

Sumatriptan dose increase-induced acute angle closure glaucoma in chronic migraine sufferer

2021 ◽  
Vol 14 (2) ◽  
pp. e235880
Author(s):  
Sokratis Zormpas ◽  
Artemis Matsou ◽  
Diandra Monique Antunes ◽  
Chris Panos
Keyword(s):  
Term Treatment ◽  
Acute Angle ◽  
Angle Closure ◽  
Dose Increase ◽  
Drug Induced ◽  
Long Term Treatment ◽  
Acute Angle Closure ◽  
Acute Angle Closure Glaucoma

In this case study, we explore a case of bilateral acute angle closure (AAC) attack detected in a 52-year-old female patient with no other ophthalmic background or predisposition to angle closure, following an increase of her regular sumatriptan dose used for migraine relief. Even though the initial presentation was misinterpreted as migraine attack, it nevertheless alerted the treating physicians to immediate cessation of the drug, allowing for the pertinent ocular symptomatology to be unveiled. Drug-induced bilateral AAC is a rare occurrence and can lead to significant ocular morbidity if not detected and treated early. Clinicians of emergency care should be aware of this uncommon association, as prompt ophthalmology input is vital. Interestingly, although it would be anticipated that people prone to angle closure attack after sumatriptan intake would exhibit symptoms after initiation of the drug, our patient suffered an attack while on long-term treatment and following dose increase.

Drug-induced Myopia and Bilateral Angle Closure Secondary to Zolmitriptan

2017 ◽  
Vol 26 (10) ◽  
pp. 954-956 ◽  
Author(s):  
Jonathan Tak Loong Lee ◽  
Simon Edward Skalicky ◽  
Ming-Lee Lin
Keyword(s):  
Angle Closure ◽  
Drug Induced

scholarly journals Angiographic Features of Drug-Induced Bilateral Angle Closure and Transient Myopia with Ciliochoroidal Effusion

2019 ◽  
Author(s):  
Yong Koo Kang ◽  
Byeong Jae Son ◽  
Dong Ho Park ◽  
Jae Pil Shin
Keyword(s):  
Indocyanine Green ◽  
Indocyanine Green Angiography ◽  
Case Series ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Drug Induced ◽  
Idiosyncratic Reaction ◽  
Transient Myopia ◽  
Ciliochoroidal Effusion ◽  
Myopic Shift

Abstract Background: To report five cases of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion and to analyze angiographic findings of these cases. Methods: This study is an observational case series. Five patients with acute drug-induced angle closure and transient myopia with ciliochoroidal effusion were examined by fluorescein angiography, indocyanine green angiography (ICGA) and ultrasound biomicroscopy (UBM). Results: Five patients presented with bilateral visual loss and ocular pain after intake of topiramate, methazolamide, phendimetrazine tartrate or mefenamic acid. All patients showed elevated intraocular pressure (IOP) with shallow anterior chamber and myopic shift from -0.5 to -17.0 diopters (D). UBM showed ciliochoroidal effusions with diffuse thickening of the ciliary body in all cases. Rapid normalization of IOP and decrease of myopic shift occurred in all patients after discontinuing the suspected drugs. We classified the ICGA findings into 2 major signs (hypofluorescent dark spots, hyperfluorescent pinpoints) and 3 minor signs (diffuse choroidal hyperfluorescence, early hyperfluorescence of choroidal stromal vessel, and leakage and dilated retinal vessels). Conclusions: The pathogenesis of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion may be idiosyncratic reaction of uveal tissue to systemic drugs. Accumulation of extravascular fluid in the ciliochoroidal layer had a major role in the pathogenesis. ICGA could be a useful method to examine the pathophysiology of this condition by imaging of the choroidal layer. Keywords: Ciliochoroidal effusion; Drug-induced angle closure; Indocyanine green angiography; Transient myopia.

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