Multimodal imaging of indapamide-induced bilateral choroidal effusion: a case report

BMC Ophthalmology

Kentaro Nishida¹  Hiroshi Kubota²  Shinichi Usui²  Shizuka Takahashi²  Noriyasu Hashida²  Hirokazu Sakaguchi³  Kohji Nishida⁴ 

[1] Department of Advanced Device Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan;Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan;Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan;Department of Ophthalmology, Gifu University Graduate School of Medicine, Yanagido, Gifu, Japan;Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan;Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan;

关键词: Acute angle-closure glaucoma;    Ciliary body edema;    Drug-induced choroidal effusion;    Indapamide;    Multimodal imaging;    Myopia;   

DOI  :  10.1186/s12886-021-02147-3

来源: Springer

【 摘 要 】

BackgroundIndapamide, a sulfonamide diuretic used to treat hypertension, has been reported to have ocular side effects of acute angle-closure glaucoma, transient myopia and choroidal effusion whose immediate etiology is uncertain. This report aims to clarify the nature of indapamide-induced edema of the entire eyeball using multimodal imaging.Case presentationA 60-year-old woman who was following a long-term carbohydrate-restricted diet and receiving oral treatment for hypertension was referred to our department for eye pain. Indapamide (1 mg daily) was prescribed for uncontrolled hypertension 5 days before her visit; she took the medication for only 3 days and then stopped due to dry eye. However, she began to feel eye pain the day after her last dose, and the pain gradually intensified. She experienced no decrease in visual acuity at the initial visit; however, an extremely shallow anterior chamber was observed in both eyes, along with a slight increase in intraocular pressure. For differential diagnosis, ocular manifestations were evaluated with wide-field fundus photography, optical coherence tomography (OCT) of both anterior and posterior segments, fluorescein / indocyanine green angiography, ultrasound biomicroscopy and head magnetic resonance, showing edema of the entire eyeball. Treatment with tropicamide and phenylephrine hydrochloride drops resulted in rapid recovery of the anterior chamber depth and disappearance of the choroidal effusion within 3 days.ConclusionsMultimodal imaging is useful for diagnosing drug-induced choroidal effusion by evaluating ocular conditions before and after treatment.

【 授权许可】

CC BY