Drug-induced Angle-Closure Glaucoma

Khurana, Atika; Khurana, Bhawna; Khurana, Ashok K

doi:10.5005/jp-journals-10008-1100

Cited by 8 publications

(5 citation statements)

References 91 publications

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“…AACG is a rare side effect of sulfa drugs like topiramate through a non-pupillary mechanism [9] . An idiosyncratic reaction can lead to ciliary body oedema and anterior rotation of the ciliary body, narrowing the angle even in patients with no pre-existing angle narrowing [10] . A peripheral iridotomy is not effective in treating this form of angle closure, as no pupil block is present.…”

Section: Discussionmentioning

confidence: 99%

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Acute angle closure glaucoma following COVID-19 vaccination

Mahjoubi¹,

Dahmani

Souilem³

et al. 2024

Therapies

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Section: Discussionmentioning

confidence: 99%

“…The management required immediate discontinuation of the triggering medication and administration of a cycloplegic agent that helped retract the ciliary process deepen the anterior chamber [9] . The topical corticosteroids reduce the inflammation [10] .…”

Section: Discussionmentioning

confidence: 99%

Acute angle closure glaucoma following COVID-19 vaccination

Mahjoubi¹,

Dahmani

Souilem³

et al. 2024

Therapies

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“…The mechanisms of non-pupillary block drug-induced acute angle closure can involve lens thickening and forward movement, ciliary body rotation and ciliochoroidal effusion. 5 Several medications have been reported to cause this type of drug-induced angle closure, most of which are sulfonamide derivatives such as topiramate, acetazolamide, methazolamide, indapamide and hydrochlorothiazide. 6 Other compounds such as venlafaxine, 7 escitalopram, 8 isotretetoin, 9 zolmitriptan 10 and sumatriptan 11 have also been described in the literature.…”

Section: Discussionmentioning

confidence: 99%

Acute bilateral angle closure induced by monoclonal antibody (Daratumumab) infusion

Saengsirinavin

Wutthayakorn

Chansangpetch

et al. 2021

American Journal of Ophthalmology Case Reports

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Purpose To report a case of daratumumab-induced bilateral angle closure glaucoma and myopia that showed no recurrence after repeated drug administration with prophylactic cycloplegia. Observations A 63-year-old man with relapsing multiple myeloma presented with acute bilateral eye pain and blurred vision 14 hours after first daratumumab infusion. Eye examination revealed raised intraocular pressure and shallow anterior chamber. Anterior segment ocular coherence tomography and ultrasound biomicroscopy showed ciliochoroidal effusions in both eyes. The diagnosis of bilateral acute angle closure glaucoma and induced myopia was made. Cycloplegia- and intraocular-pressure-lowering medications were given, which gradually deepened the anterior chambers and normalized intraocular pressure and refraction. The ciliochoroidal effusions completely resolved on day 14. The cycloplegic was given as a premedication for subsequent infusions. There was no recurrence of effusion throughout his 6-month daratumumab treatment course. Conclusions and importance Daratumumab can induce ciliochoroidal effusion, which results in acute secondary angle closure and myopia. The potential prophylactic effect of the cycloplegic drug may enable continuation of daratumumab infusion under close monitoring.

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“…Sympathomimetic agents like α1- and β2-adrenergic agonists cause pupillary dilation by acting on the dilator pupillae muscle, leading to thickening of the iris base and crowding of the iridocorneal angle, which can precipitate AAC in predisposed patients [ 6 ]. Anticholinergic agents such as tropicamide, atropine, homatropine, and cyclopento-late can also lead to mydriasis and AAC by relaxing the ciliary muscles [ 7 ]. Cholinergic agents such as pilocarpine constrict the pupil and increase the conventional outflow of the aqueous through the trabecular meshwork.…”

Section: Discussionmentioning

confidence: 99%

“…Management depends on the underlying mechanism of drug-induced AAC. Laser peripheral iridotomy is required in cases of drug-induced pupillary block, while immediate discontinuation of the triggering medication is required in topiramate-induced acute angle closure, along with topical corticosteroids and cycloplegic drops [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Olanzapine-Induced Acute Angle Closure

Alarfaj

Almater

2021

Am J Case Rep

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Patient: Male, 59-year-old Final Diagnosis: Acute angle closure Symptoms: Pain • red eye Medication: — Clinical Procedure: — Specialty: Ophthalmology Objective: Unusual clinical course Background: Drug-induced acute angle closure glaucoma is an uncommon ocular emergency that may follow the administration of certain topical and systemic medications. Acute angle closure can be triggered by various classes of drugs, including adrenergic agonists, anticholinergics, and serotonergic medications. Here, we report a rare case of drug-induced acute angle closure glaucoma secondary to olanzapine. Case Report: A 59-year-old male patient of Arabian Peninsula descent, known to have schizophrenia, presented to our Emergency Department with a 3-day history of right ocular pain and decrease in vision. He was started recently on olanzapine 5 mg once daily by his psychiatrist 1 week prior to the onset of his symptoms. The diagnosis of drug-induced pupillary block was made based on clinical and radiological findings. The patient was started on topical and systemic IOP-lowering agents. A therapeutic Nd: YAG laser peripheral iridotomy for the right eye was performed. On follow-up, his symptoms alleviated and clinical examination showed significant improvement. Conclusions: The reported case highlights the importance of systemic medical history in secondary acute angle closure glaucoma. Physicians from other specialties should be aware of drugs triggering pupillary block and therefore be able to educate patients about symptoms of acute angle closure glaucoma.

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Drug-induced Angle-Closure Glaucoma

Cited by 8 publications

References 91 publications

Acute angle closure glaucoma following COVID-19 vaccination

Acute angle closure glaucoma following COVID-19 vaccination

Acute bilateral angle closure induced by monoclonal antibody (Daratumumab) infusion

Olanzapine-Induced Acute Angle Closure

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