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Presentation typeE-poster
TitleAcute-onset bilateral myopia induced by indapamide
PurposeTo describe a clinical case of indapamide-induced bilateral acute myopia and angle narrowing.
MethodsClinical case report.
ResultsA 43-year-old Caucasian male patient presented to the emergency department with acute-onset reduced distant vision. Neurological assessment, blood pressure and cerebral CT scan were normal. The patient was known to have arterial hypertension, treated with perindopril and amlodipine. Because of uncontrolled tensions indapamide (sulfonamide-derived drug) 2,5 mg was started 5 days ago. Distance visual acuity (VA) with his own prescription glasses (-4/-4.25D) was 0.15 and 0.2, respectively. However, best-corrected VA was 1.0 bilaterally with -7.5/-6.75D. Slit lamp examination revealed narrow anterior chambers with narrow but open chamber angles on gonioscopy. Intraocular pressure was 15/17 mmHg. Dilated fundoscopy showed a marked visualization of the ora serrata over 360°, but no other notable abnormalities. B-scan ultrasonography revealed a bilateral ciliochoroidal effusion. One week after discontinuation of indapamide, a complete resolution of the induced myopia (automatic refraction -4/-3.75D), a deep anterior chamber and regression of the ciliochoroidal effusion was observed.
ConclusionSulfonamide-derived drugs, like indapamide, may cause acute myopia and even angle closure secondary to ciliochoroidal effusion. It is suggested that both ciliary muscle contraction and ciliary body edema play role in the pathophysiology. After drug withdrawal, with timely diagnosis, effects are fully reversible. Therefore, it is important to consider a drug-related cause in the differential diagnosis of acute myopia and angle closure.
Conflict of interestNo
Authors 1
DepartmentUZ Gent
Authors 2
Last nameLafaut
DepartmentAZ Sint Jan
Authors 3
Last nameSmeets
DepartmentUZ Leuven
Authors 4
Last nameVanhonsebrouck
DepartmentAZ Sint Jan
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