Acetazolamide-Induced Bilateral Ciliochoroidal Effusion Syndrome in Plateau Iris Configuration
Xiaofei Man, Raquel Costa, Bernadete M Ayres, Sayoko E Moroi, Xiaofei Man, Raquel Costa, Bernadete M Ayres, Sayoko E Moroi
Abstract
Purpose: Our purpose is to describe a 60-year-old male, who has plateau iris configuration and developed bilateral ciliochoroidal effusion syndrome after ingestion of acetazolamide.
Observations: Our case was a research participant in a multi-center clinical study (ClinicalTrials.gov NCT01677507). During the course of this study, he was treated with a single dose of acetazolamide (500 mg), and seven days later treated with latanoprost one drop daily at bedtime both eyes for seven days, and then was administered another dose of acetazolamide (500 mg). Several hours later he complained of blurred vision in the distance and mild headache. On examination, he had a myopic shift, intraocular pressures of 36 mmHg in right eye and 35 mmHg in left eye, shallow anterior chambers both eyes, and occluded angles by gonioscopy both eyes. An echographic exam confirmed the bilateral ciliochoroidal effusion syndrome. He was treated by no further dosing of acetazolamide and started on timolol, atropine and prednisolone. Two weeks later, the bilateral choroidal effusion and acute angle closure were resolved. Repeat echography showed plateau iris configuration.
Conclusions and importance: To the best of our knowledge, drug-induced bilateral ciliochoroidal effusion syndrome has not been reported with acetazolamide in plateau iris configuration.
Keywords: Acetazolamide; Angle closure; Ciliochoroidal effusion; Drug reaction; Plateau iris; Ultrasound Biomicroscopy.
Figures
References
- Tripathi R.C., Tripathi B.J., Haggerty C. Drug-induced glaucomas: mechanism and management. Drug Saf. 2003;26:749–767.
- Abtahi M.A. Topiramate and the vision: a systematic review. Clin. Ophthalmol. 2012;6:117–131.
- Mancino R. Acute bilateral angle-closure glaucoma and choroidal effusion associated with acetazolamide administration after cataract surgery. J. Cataract. Refract Surg. 2011;37:415–417.
- Ikeda N. Ciliochoroidal effusion syndrome induced by sulfa derivatives. Arch. Ophthalmol. 2002;120:1775.
- Malagola R. Acetazolamide-induced cilio-choroidal effusion after cataract surgery: unusual posterior involvement. Drug Des. Devel Ther. 2013;7:33–36.
- de Rojas V., Gonzalez-Lopez F., Baviera J. Acetazolamide-induced bilateral choroidal effusion following insertion of a phakic implantable collamer lens. J. Refract Surg. 2013;29:570–572.
- Malagola R. Acute cilio-choroidal effusion due to acetazolamide: unusual posterior involvement (OCT aspects) Eye (Lond). 2013;27:781–782.
- Parthasarathi S. Bilateral acetazolamide-induced choroidal effusion following cataract surgery. Eye (Lond) 2007;21:870–872.
- Weiler D.L. Zonisamide-induced angle closure and myopic shift. Optom. Vis. Sci. 2015;92:46–51.
- Fraunfelder F.W., Fraunfelder F.T., Keates E.U. Topiramate-associated acute, bilateral, secondary angle-closure glaucoma. Ophthalmology. 2004;111:109–111.
- Wand M., Pavlin C.J., Foster F.S. Plateau iris syndrome: ultrasound biomicroscopic and histologic study. Ophthalmic Surg. 1993;24:129–131.
- Pavlin C.J., Ritch R., Foster F.S. Ultrasound biomicroscopy in plateau iris syndrome. Am. J. Ophthalmol. 1992;113:390–395.
- Lee D.A., Brubaker R.F., Ilstrup D.M. Anterior chamber dimensions in patients with narrow angles and angle-closure glaucoma. Arch. Ophthalmol. 1984;102:46–50.
- Reis G.M. Utility of ultrasound biomicroscopy in the diagnosis of topiramate-associated ciliochoroidal effusions causing bilateral acute angle closure. Clin. Exp. Ophthalmol. 2014;42:500–501.
- Sakai H. Ciliochoroidal effusion induced by topical latanoprost in a patient with sturge-weber syndrome. Jpn. J. Ophthalmol. 2002;46:553–555.
- Alimgil M.L., Benian O. Choroidal effusion and shallowing of the anterior chamber after adjunctive therapy with latanoprost in a trabeculectomized patient with angle closure glaucoma. Int. Ophthalmol. 2001;24:129–131.
Source: PubMed