scholarly journals Angle-closure glaucoma, iris-lens contact, ciliochoroidal effusion, and transient myopia induced by topiramate

2021 ◽  
pp. 57-62
Author(s):  
T.V. Sokolovskaya ◽  
◽  
V.N. Yashina ◽  
N.A. Mahno ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Nd:Yag Laser ◽  
Scientific Literature ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Migraine Treatment ◽  
Transient Myopia ◽  
Ciliochoroidal Effusion ◽  
Peripheral Iridectomy ◽  
Myopic Shift

Topiramate is a sulphonamide derivative indicated in the treatment of epilepsy and migraine. In foreign scientific literature there are reported cases of topiramate-induced bilateral angle-closure glaucoma and acute myopia with ciliochoroidal effusion. Purpose. To evaluate outcomes of laser iridectomy in a patient with topiramate-induced angle-closure glaucoma and acute myopia with ciliochoroidal effusion. Material and methods. A case is reported of bilateral angle-closure glaucoma, iris-lens contact, ciliochoroidal detachment and acute myopia following topiramate for migraine treatment in a 32-year-old patient. Laser peripheral iridectomy was performed in the both eyes according to the standard technology (Nd:YAG laser Selecta Trio, Lumenis Ltd., Israel) to decrease IOP and restore visual functions. Results. After laser iridectomy, the examination showed normal IOP with no medication, ciliochoroidal effusion and induced myopic shift were relieved. Conclusion. Laser iridectomy is an effective and safe in the treatment of topiramate-induced angle-closure glaucoma, acute myopia, and ciliochoroidal detachment. It contributes to normalization of IOP and improvement of visual acuity. Key words: topiramate, angle-closure glaucoma, ciliochoroidal effusion, transient myopia.

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 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.

Single-pass four-throw pupilloplasty for secondary angle-closure glaucoma associated with silicon oil tamponade

2018 ◽  
Vol 29 (5) ◽  
pp. 561-565 ◽  
Author(s):  
Priya Narang ◽  
Ashar Agarwal ◽  
Amar Agarwal
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Anterior Segment ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Single Pass ◽  
Silicon Oil ◽  
The Mean

Purpose: To describe the feasibility and efficacy of performing single-pass four-throw pupilloplasty for secondary angle-closure glaucoma post silicon oil tamponade. Methods: The procedure was performed in five eyes of five patients. All the cases underwent silicon oil removal with single-pass four-throw pupilloplasty. Single-pass four-throw procedure involves a single pass of needle through the iris tissue that is to be apposed followed by taking four throws by passing the suture end through the loop that is withdrawn from the anterior chamber as in a modified Siepser’s slip-knot technique. Both the suture ends are pulled and this leads to sliding of the loop into the anterior chamber. Surgical pupilloplasty stretches the peripheral iris tissue and helps in breaking the peripheral anterior synechia. Intraoperative gonioscopy and anterior segment optical coherence tomography were performed in all the cases. Results: Intraoperative gonioscopy and anterior segment optical coherence tomography demonstrated opening of the anterior chamber angles with breakage of peripheral anterior synechia. The mean preoperative and postoperative best-corrected visual acuity in logarithm of minimum angle of resolution was 1.24 ± 0.23 and 0.56 ± 0.18, respectively (p < 0.001). The mean preoperative and postoperative intraocular pressure was 38.2 ± 4.97 and 13.0 ± 2.35 mm Hg, respectively. There was a significant decrease in intraocular pressure and marked improvement in visual acuity in all the cases. Conclusion: Surgical pupilloplasty helps to relieve the post-silicon oil-induced secondary angle-closure glaucoma by breaking peripheral anterior synechia and significantly opening the anterior chamber angles.

scholarly journals Outcomes of Small Size Ahmed Glaucoma Valve Implantation in Asian Chronic Angle-Closure Glaucoma

2021 ◽  
Vol 10 (4) ◽  
pp. 813
Author(s):  
Ke-Hao Huang ◽  
Ching-Long Chen ◽  
Da-Wen Lu ◽  
Jiann-Torng Chen ◽  
Yi-Hao Chen
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Angle Closure Glaucoma ◽  
Adult Patients ◽  
Angle Closure ◽  
Posterior Chamber ◽  
Ahmed Glaucoma Valve ◽  
Probability Of Success ◽  
The Mean

For chronic angle-closure glaucoma (ACG), Ahmed glaucoma valve (AGV) is a useful drainage device for intraocular pressure (IOP) control but there are few reports discussing the outcomes of small size AGV in adult patients. This retrospective study involved 43 Asian adult patients (43 eyes) with chronic ACG. All patients had undergone small size AGV insertion and were divided into anterior chamber (AC) group and posterior chamber (PC) group. In the AC group, tube was inserted through sclerectomy gap into the anterior chamber. In the PC group, tube was inserted into posterior chamber through a needling tract. Outcome measures were intraocular pressure (IOP), visual acuity, number of antiglaucoma medications, survival curve and incidence of complications. In total, 43 eyes of 43 patients, 24 in the AC group and 19 in the PC group, were reviewed. The mean follow-up period was 28.5 months (95% confidence interval: 25.5–31.4). Mean IOP had significantly decreased following AGV insertion. The Kaplan–Meier survival analysis demonstrated a probability of success at 24 months of 67.4% for qualified success and 39.5% for complete success. There were no significant differences between the AC and PC groups in terms of the mean IOP, cumulative probability of success, visual acuity change or antiglaucoma medication change, except IOP at 1-day and 1-month mean IOP. The most common complications noted was hyphema in the PC group. For adult chronic ACG patients, small size AGV insertion could be effective at lowering IOP. Besides, tube insertion into AC with sclerectomy may prevent the hypertensive phase in the early postoperative period.

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