Drug-induced Transient Myopia and Angle-closure Glaucoma Associated With Supraciliary Choroidal Effusion

• Published in: American journal of ophthalmology Vol. 122; no. 1; pp. 110 - 112
• Main Authors: Postel, Eric A., Assalian, Alfred, Epstein, David L.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.1996; Elsevier
• Subjects: Adult; Anterior Chamber - diagnostic imaging; Anterior Chamber - pathology; Anti-Infective Agents - adverse effects; Anti-Infective Agents - therapeutic use; Biological and medical sciences; Choroid - blood supply; Choroid Diseases - chemically induced; Choroid Diseases - diagnostic imaging; Choroid Diseases - physiopathology; Ciliary Body - blood supply; Drug toxicity and drugs side effects treatment; Exudates and Transudates; Female; Glaucoma, Angle-Closure - chemically induced; Glaucoma, Angle-Closure - physiopathology; Gonioscopy; Humans; Iris - diagnostic imaging; Iris - surgery; Laser Therapy; Medical sciences; Myopia - chemically induced; Myopia - physiopathology; Pharmacology. Drug treatments; Toxicity: eye; Trimethoprim, Sulfamethoxazole Drug Combination - adverse effects; Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use; Ultrasonography; Uveal Diseases - chemically induced; Uveal Diseases - diagnostic imaging; Uveal Diseases - physiopathology; Human; Sulfanilamide derivatives; Drug combination; Effusion; Toxicity; Vision disorder; Myopia; Choroid; Uvea disease; Angle closure glaucoma; Transitory; Case study; Eye disease; Athalamia; Refractive error; Antiinfectious
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/S0002-9394(14)71972-5

We investigated the mechanism of drug-induced transient myopia, anterior chamber shallowing, and secondary angle-closure glaucoma in a young woman. Ultrasound biomicroscopy was performed and the effects of cycloplegic eyedrops and unilateral laser iridotomy were evaluated. Cycloplegic eyedrops and unilateral laser iridotomy had no effect. Ultrasound biomicroscopy identified the presence of a supraciliary choroidal effusion that caused forward displacement of the lens-iris diaphragm, resulting in increased myopia, anterior chamber shallowing, and angle-closure glaucoma. Discontinuance of trimethoprim and sulfamethoxazole combination led to the complete resolution of the condition. Idiosyncratic drug reactions may produce a supraciliary choroidal effusion, resulting in myopia and secondary angle-closure glaucoma from the induced forward shift in the position of the crystalline lens and ciliary body.