Transient Drug-Induced Myopia

Abstract

Myopia is the most common eye disease and is one of the leading causes of vision impairment worldwide [1,2]. Prevalence of myopia is significantly different among racial groups, although its worldwide prevalence is approximately 30% (3%-84%) [3]. The highest prevalence is found in East Asia, such as mainland China [3]. The prevalence of myopia in the US population was estimated in the early 1970s to be 25% in persons aged 12 to 54 years [4]. A recent meta-analysis of population-based studies found a prevalence of 25% in persons over age 40 [5].Myopia (nearsightedness) is a refractive error, a condition in which the cornea and lens of the nonaccommoding eye have too much plus power for the length of eye. As a result, images of distant objects are focused in front of the retina and thus appear blurred.Myopia has been recognized as a distinct visual disability for millennia and has been known for more than 2000 years and was first described by the ancient Greeks [6,7]. It was probably the ancient Greeks who coined the term, using the roots myein (to close) and ops (eye) to characterize those individuals who narrow their eyelids to improve distance visual acuity, the pinhole effect. The focus of distant parallel rays of light falls anterior to the retinal plane and produces a blurred image in myopia. This situation can arise because either the primary refractive components are too powerful or the globe is too long. Thus, myopia can be due to increased corneal or lenticular curvature, or an increase in the lens index of refraction, as occurs with the development of nuclear sclerosis. More commonly, myopia is the result of axial elongation of the posterior segment of the eye.Transient drug-induced myopia is a myopia induced by a drug as a transient side effect. A side effect (adverse drug reaction) is basically an unintended, unwanted occurrence that results from taking a drug. An adverse drug reaction is an expression that describes harm associated with the use of given medication at a normal dosage during normal use. Adverse drug reactions may occur following a single dose or prolonged administration of a drug or result from the combination of two or more drugs [8]. All drugs that come in the market may cause side effects, where many are minor and few are serious. Myopia (nearsightedness) is a refractive error, a condition in which the cornea and lens of the nonaccommoding eye have too much plus power for the length of eye. As a result, images of distant objects are focused in front of the retina and thus appear blurred. Transient drug-induced myopia is a myopia induced by a drug as a transient side effect. Several case reports of transient drug-induced myopia have been reported. These cases have been associated with secondary angle closure glaucoma and other ocular conditions such as choroidal detachment, maculopathy, retinal folds. Drugs known to produce this effect include sulfa drugs and other medications. The possible mechanism is thought to be an allergic reaction to the drug. Both ciliary muscle contraction a...

Alemtuzumab-induced alopecia universalis and transient accommodation spasm in a patient with multiple sclerosis

“…Given our patient’s onset of symptoms, within a few hours after the second daily dose of alemtuzumab, and observing a rapid improvement following cessation of treatment and administration of cycloplegics, we speculate that alemtuzumab administration could explain the accommodation spasm we describe in this patient. Drug-induced accommodative spasm has been reported following miscellaneous drugs, for example, sulphonamide-derivatives; 4 however, none of the premedications of our protocol have been reported to date to cause this condition. Of note, our patient had previously developed a rare but well-reported autoimmune adverse event following the first course of alemtuzumab; alopecia universalis.…”

Transient myopic shift due to ciliary body detachment as the sole ocular manifestation of hypertensive emergency – A case report

“…Transient myopia has been previously reported as a rare side effect of sulphonamide drugs. 2 , 3 , 4 , 5 Our patient was taking Coversyl Plus for her hypertension, which contains both perindopril and indapamide. Indapamide is a sulphonamide-derived, thiazide-like diuretic which has been indicated in the treatment of hypertension.…”

Drug-Induced Myopia: Pathogenesis, Diagnosis, and Treatment

“…Muayenede sığ ön kamara, konjonktival hiperemi, korneal ödem ve ön kamara reaksiyonu görülebilir. [6,15] Genel olarak diğer sulfanomid derivelerin türevleri ile benzer mekanizmalarla miyopiye sebep olduğu daha öne gösterilmiş iken, bir olgu bildiriminde ise sülfasalazin tarafından indüklenen refraktif değişikliklerin kornea ödemi ve özellikle arka tabakaların ödemi ile ilişkili olduğu ve bu nedenle saptanabilir bir keratometrik değişiklik olmadığı hipotezi öne sürülmüştür. [24] Bildirilen vakalarda sulfasalazin tedavi kesilmesi sonrasında en geç ikinci haftanın sonunda miyopik kaymanın düzeldiği görülmüştür.…”

“…[4,5] Miyopide uzak nesnelerin görüntüsü retinanın önüne düşer ve bulanık görme oluşur. [6] Miyopide ana mekanizma; kornea ve lensin gözün aksiyel uzunluğuna göre yüksek kırma gücüne sahip olması veya globun uzun olmasıdır. Bu durumda görüntünün odaklanması makula önüne oluşur.…”

“…Sistemik ajanların miyopiye sebep olma mekanizmalarına bakılacak olursa üç ana sebep ön plana çıkmaktadır: o İlk olarak silier kas spazmı ile lensin refraktif gücünün artması, o ikinci olarak su tutulması sonucu lensin refraktif gücünün artması, o Son olarak ise silier proseslerin şişmesi (siliokoroidal efüzyon) ve lensin öne doğru yer değiştirmesi ile ilaca bağlı miyopi gelişmektedir. [6] Muhtemel mekanizmanın ilaca karşı gelişen allerjik reaksiyon olduğu düşünülmektedir. Bazı ilaçlar üveal dokuda idiyosenkritik cevaba sebep olur ve bu reaksiyon doz bağımsızdır .…”