A Case of Amantadine-Induced Corneal Edema.

Hwang, Bo Sung; Lee, Sang Bumm; Cha, Soon Cheol; Wee, Won Ryang

doi:2009.50.6.936

J Korean Ophthalmol Soc > Volume 50(6); 2009 > Article

Case Report

Journal of the Korean Ophthalmological Society 2009;50(6):936-941.
DOI: https://doi.org/10.3341/jkos.2009.50.6.936 Published online June 15, 2009.

A Case of Amantadine-Induced Corneal Edema.

Bo Sung Hwang, Sang Bumm Lee, Soon Cheol Cha, Won Ryang Wee

¹Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea. sbummlee@med.yu.ac.kr
²Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

아만타딘에 의한 각막부종 1예

황보성¹ㆍ이상범¹ㆍ차순철¹ㆍ위원량²

Department of Ophthalmology, Yeungnam University College of Medicine¹, Daegu, Korea / Department of Ophthalmology, Seoul National University College of Medicine², Seoul, Korea

Abstract

PURPOSE
To report a rare case of corneal edema caused by amantadine. CASE SUMMARY: A 35-year-old man was diagnosed with hypoxic brain damage caused by ventricular fibrillation. The patient showed Parkinsonism and was started on treatment with amantadine. Thirty-seven months after the commencement of amantadine treatment, the patient suffered a corneal ulcer in his right eye, which healed with opacity and thinning after medical treatment. After healing, slit-lamp examination revealed a bilateral, epithelial and stromal edema without obvious guttae and keratic precipitates. The corneal edema did not improve with topical treatment of 5% NaCl and 0.02% fluorometholone in both eyes. Three months after leaving the hospital, the patient's corrected visual acuity decreased to 0.2 (-2.0 Dsph -0.5 Dcyl Ax 90) in the right eye and 0.4 (-0.75 Dsph -2.0 Dcyl Ax 90) in the left eye. Amantadine medication was discontinued after discussion with the patient's neurologist. At the 1-month follow-up, corneal examination revealed resolution of the epithelial and stromal edema in both eyes. Corrected visual acuity was improved to 0.5 (-1.5 Dsph) in the right eye and 0.7 (-1.0 Dsph -1.0 Dcyl Ax 90) in the left eye. CONCLUSIONS: In cases of corneal edema without an obvious causative disease, the patient's systemic medication list must be reviewed and amantadine should be considered as a possible cause.

Key Words: Amantadine;Corneal edema;Corneal endothelium;Parkinsonism