Pregabalin is commonly used for the treatment of neuropathic pain and is attributed to adverse effects of peripheral vasodilation and peripheral edema. Central serous chorioretinopathy (CSCR) is characterized by choroidal fluid leaks from choroidal vessels under the retina, causing focal retinal detachment with macular vision loss. Herein, we report two cases admitted to our clinic with vision loss while under pregabalin treatment. Upon eye examination, both patients were diagnosed with acute CSCR. Pregabalin treatment was discontinued upon the diagnosis of CSCR. We consider that the use of pregabalin in the presented two cases may be the causal effect of the CSCR diagnosis, as pathophysiology of CSCR is in parallel with the edema-related adverse effects of pregabalin.
Dear Editor, An 18-year-old female patient was admitted to our clinic with sudden-onset horizontal binocular diplopia, marked headache on the left eyebrow, and limited abduction of the left eye that started one day ago. The patient noted that she had had similar symptoms that resolved spontaneously before, but that this time it was more severe. The patient had no history of febrile illness; trauma; regular medication use; neurologic, psychiatric or other systemic disease; and ocular surgery. A neurologic examination revealed intact visual acuity in both eyes and horizontal diplopia. In the primary position, there was left convergent strabismus (Figure 1). On light reflex examination, the left pupil was meiotic. Bilateral pathology was not observed in extraocular muscles (Figures 2A, 2B). The examination performed by the ophthalmology clinic revealed no pathology in the anterior and posterior segment of the eye, and the optic disc was normal. Visual field examination with visual achromatic perimetry was normal. No pathology was found in the remaining neurologic or ophthalmologic examinations. Cranial computed tomography (CT), CT angiography, and magnetic resonance imaging showed no pathology. Thyroid Ad dress for Cor res pon den ce/Ya z›fl ma Ad re si:
ÖZET 59 yaşında bayan hastada arter dal tıkanıklığı sonrasında optik koherens tomografi (OKT) ve fundus fluorescein anjiografi (FFA) bulguları değerlendirildi. OKT'de erken dönemde iç retinal katmanlarda kalınlık artışı ve hiperreflektivite, fotoreseptör tabakası ve retina pigment epitelinde ise reflektivitede azalma olduğunu görüldü. Foveolar çukurluk, foveadaki fotoreseptör tabakası ve altındaki retina pigment epitelinin normal olduğu görüldü. FFA'da arter akımında yavaşlama ve dolum defektleri görüldü. Geç dönemde tekrarlanan incelemelerde iç retinal tabakalarda atrofi gelişimi ve nöroretinal rimde incelme görüldü. OKT bulguları iskemi sonucu intrasellüler proteinlerin denaturasyonu ve yıkımı sonucu gelişen iç retinal tabakalardaki intrasellüler ödem ve geç dönemde gelişen atrofi ile uyumluluk göstermektedir. Anahtar kelimeler: retinal arter dal tıkanıklığı; optik koherens tomografi; fundus fluoresein anjiografi ABSTRACT 59-years-old female patient after retinal artery branch occlusion optic coherence tomography (OCT) and fundus fluorescein angiography (FFA) findings were evaluated. OCT examination showed increased thickness and hyperreflectivity in the inner retinal layers, and decreased reflexivities in the photoreceptor layer and retinal pigment epithelium. Foveolar depression, foveal photoreceptor layer and underlying retinal pigment epithelium were normal. In FFA, slowing of arterial flow and filling defects were observed. Repeated examinations in the late period revealed atrophy in the inner retinal layers and thinnig at the neuroretinal rim. OCT findings are consistent with intracellular edema in the inner retinal layers, resulting from denaturation and destruction of ischemic intracellular proteins, and late atrophy.
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