Severe ocular side effects with acetazolamide: Case report
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- 作者：A. Llovet-Rausell ; andrea.llovet@barraquer.com" class="auth_mail" title="E-mail the corresponding author ; F. Ruiz Tolosa ; B. Kudsieh
- 关键词：Acetazolamide ; Acute cilio-choroidal effusion ; Angle-closure ; Myopisation ; Iatrogenesis
- 刊名：Archivos de la Sociedad Española de Oftalmología (English Edition)
- 出版年：2016
- 出版时间：November 2016
- 年：2016
- 卷：91
- 期：11
- 页码：543-546
- 全文大小：1344 K
文摘
A 44-year-old woman arrived in the emergency department complaining of decreased visual acuity (VA) in oculus uterque (OU) of 4 h onset. Signs of myopia, increased intraocular pressure (IOP) in OU, and a narrow grade an class="smallcaps">II an> anterior chamber (AC) were observed. In the posterior segment ultrasound scan, a choroidal peripheral detachment is evident, and a lenticular thickness of 4.05 mm is measured in the anterior segment of the right eye (OD) and 4.00 mm in the left eye (OS). On treatment with oral with naproxen (non-steroidal anti-inflammatory drug), and acetazolamide for migraine. The acetazolamide is suspended and topical treatment is started with timolol and brimonidine every 12 h, with prednisolone and ayclopentolate every 8 h. In the follow-up, a gradual reduction of myopia and lens thickness is observed, as well as anterior chamber expansion. In the last control, the patient had a sphere of −0.75 diopters (D) in OD and −0.25 D in OS. IOP was 15 mmHg in OU and AC was grade an class="smallcaps">III an>. The ultrasound showed a lens thickness of 3.59 mm in OD and 3.61 mm in OS.
absSec_2">Conclusion
ar0010">This was an iatrogenic case of acute angle closure induced by an anterior displacement of the irido-lenticular complex, secondary to the use of acetazolamide. The treatment of this condition involves suspending the drug responsible and applying topical corticosteroids, hypotensive and cycloplegic eye drops, with the aim of lowering the eye pressure and the degree of myopia due to the re-positioning of the irido-lenticular complex.