pubmed.ncbi.nlm.nih.gov

Indapamide-induced transient myopia with supraciliary effusion: case report - PubMed

  • ️Tue Jan 01 2013

Case Reports

Indapamide-induced transient myopia with supraciliary effusion: case report

Mihály Végh et al. BMC Ophthalmol. 2013.

Abstract

Background: Ingestion of sulphonamide-derived drugs has been reported to possibly have ocular side-effects. Authors aimed to present a rare case of indapamide-induced transient myopia with ciliary body edema and supraciliary effusion.

Case presentation: A 39 years old caucasian female patient presented at the Department of Neurology with headache and sudden bilateral loss of distant vision. Neurological assessment and cranial CT scans were unremarkable. For her hypertension, twice a day bisoprolol 2.5 mg and once a day indapamide 1.5 mg tablets were prescribed several days before. At her presenting, ophthalmic findings were as follows: visual acuity 0.08-7.25Dsph = 1.0 and 0.06-7.25Dsph = 1.0; IOP 25 mmHg and 24 mmHg, anterior chamber depth (ACD) 2.32 mm and 2.49 mm, lens thickness (L) 4.02 mm and 4.09 mm in the right and the left eye, respectively. By means of ultrasound biomicroscopy (UBM), thickened (720 / 700 micron) and detached ciliary body, its forward movement (ciliary body-cornea angle 108' / 114') and forward rotated ciliary processes were seen. Angle opening distance (AOD500) were 300 / 314 microns. By the following days, the myopia gradually diminished, and a week after her first symptoms, her uncorrected visual acuity was 1.0 in both eyes, IOP 13 mmHg and 17 mmHg, ACD 3.68 mm and 3.66 mm, L 3.78 mm and 3.81 mm in the right and the left eye, respectively. Ciliary body edema and detachment disappeared (ciliary body thickness 225 / 230 micron), both of the ciliary body-cornea angle 134' / 140' and the AOD500 (650 / 640 microns) increased. At this point, the patient admitted that she had stopped taking indapamide two days before.

Conclusions: Our case report is the third one in the literature to present indapamide-induced transient myopia, and the first to employ UBM for describing the characteristics of this rare condition. According to the findings, authors suggest that both ciliary muscle contraction and ciliary body edema may play role in the pathomechanism. UBM seems to be a useful tool in the differential diagnosis of acute myopia. Further, authors wish to draw attention to one of the potential adverse effects of this drug which was not listed by its package insert.

PubMed Disclaimer

Figures

Figure 1
Figure 1

Ciliary body-cornea angles during the acute phase (left side) and the convalescence (right side). The angle between the anterior aspect of the ciliary body and the inner surface of the cornea reflects the forward movement of the ciliary body. Several days after discontinuation of taking indapamide, the ciliary body-cornea angle increased by approximately 25 degrees compared to the acute phase (left side).

Figure 2
Figure 2

Ciliary body thickness during the acute fase phase and the convalescence. The ciliary body thickness (thick double arrows), measured at a 2.0 mm distance (thin double arrows) from the scleral spure, was doubled during the acute phase (left side) compared to the normal value (right side).

Figure 3
Figure 3

Changing of angle opening distance. The angle opening distance measured between the inner aspect of the cornea and the anterior surface of the iris at a 500 microns distance from the scleral spure. During the acute phase (left side), it was markedly decreased compared to that of convalescence (right side).

Similar articles

Cited by

References

    1. Grant WM, Schuman JS. Toxicology of the eye. Springfield, Illinois: Charles C Thomas; 1993.
    1. Krieg PH, Schipper I. Drug-induced ciliary body oedema: a new theory. Eye. 1996;13:121–126. doi: 10.1038/eye.1996.21. - DOI - PubMed
    1. Ramos-Esteban JC, Goldberg S, Danias J. Drug induced acute myopia with supraciliary choroidal effusion in a patient with Wegener’s granulomatosis. Br J Ophthalmol. 2002;13:594–596. doi: 10.1136/bjo.86.5.594. - DOI - PMC - PubMed
    1. Boissonot L, Boissonot M, Charles-Gervais C, Breux JP. Myopie aiguë due à l’indapamide. Presse Med. 1986;13:802–803. - PubMed
    1. Blain P, Paques M, Massin P, Erginay A, Santiagi PY, Gaudric A. Acute transient myopia induced by indapamide. Am J Ophthalmol. 2000;13:538–540. doi: 10.1016/S0002-9394(99)00402-X. - DOI - PubMed

Publication types

MeSH terms

Substances