J Korean Ophthalmol Soc > Volume 58(12); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(12):1420-1424.
DOI: https://doi.org/10.3341/jkos.2017.58.12.1420    Published online December 15, 2017.
Angle Closure and the Acute Rise of Intraocular Pressure after Administration of Methazolamide.
Kyeong Do Jeong, Bumgi Kim, Won Hyuk Oh
1Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. brio17@naver.com
2Asan City Health Center, Asan, Korea.
메타졸아미드 복용 후 발생한 전방각 폐쇄에 의한 급성 안압상승 1예
정경도1,2ㆍ김범기1ㆍ오원혁1
인제대학교 의과대학 상계백병원 안과학교실1, 아산시보건소2
Correspondence:  Won Hyuk Oh,
Email: brio17@naver.com
Received: 26 July 2017   • Revised: 26 October 2017   • Accepted: 4 December 2017
Abstract
PURPOSE
To report a case involving an unexpected increase in intraocular pressure (IOP) and acute angle closure after oral administration of methazolamide. CASE SUMMARY: A 38-year-old male visited the emergency department complaining of decreased visual acuity (VA) and ocular pain. These symptoms developed after he took two tablets of 50 mg methazolamide because his IOP was above normal after a short course of systemic steroid treatment. His uncorrected VA dropped to 0.04 and the refractive error was −6.5 diopters in both eyes. The anterior chamber was very shallow, and the IOPs were 46 mmHg in the right eye and 42 mmHg in the left eye. Macular retinal folds were observed in both eyes in infrared fundus images. The patient was instructed not to take methazolamide, which was suspected as the cause of this idiosyncratic drug reaction. He was prescribed topical anti-glaucoma medications and cycloplegics to relieve the acute angle closure, and all symptoms disappeared after these treatments. CONCLUSIONS: Methazolamide is a sulfa derivative like topiramate, which can cause acute angle closure involving edema of the ciliary body and anterior displacement of the lens-iris diaphragm. Clinicians should consider this possible IOP increase before prescribing methazolamide.
Key Words: Acute angle closure;Cilioretinal effusion;Idiosyncratic drug reaction;Methazolamide;Sulfa-derivatives


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