Bilateral acute angle closure glaucoma associated with hydrochlorothiazide-induced hyponatraemia

Abstract

SUMMARYWe report a case of a 67-year-old woman presenting with bilateral acute angle closure. On investigation, she was found to have bilateral ciliary effusions and profound hyponatraemia. Her effusions resolved with the cessation of hydrochlorothiazide and normalisation of her blood sodium levels by fluid restriction. This case displays a novel association of hyponatraemia as a possible mechanism for the development of bilateral acute angle closure. BACKGROUND

Millimeter spatial resolution in vivo sodium MRI of the human eye at 7 T using a dedicated radiofrequency transceiver array

“…Cole (53) found that reducing plasma sodium concentration, and thereby plasma osmolarity, led to a decrease in concentrations of sodium in the AH and an increase in intraocular pressure, which lasted for several hours. The notion is further supported by the finding that hyponatremia probably contributes to the pathophysiology of bilateral acute angle closure glaucoma (18).…”

“…A number of studies have found increases in Na þ concentration in cataractous lenses (15,16). Diminished Na þ concentration in the AH (17) probably contributes to the pathophysiology of bilateral acute angle closure glaucoma (18). MRI studies have confirmed that TSC is higher in malignant brain (19) and breast (20) tissue than in their healthy counterparts, suggesting that the same may be true in eye tumors, which are detected in 2500 patients in the United States every year (21).…”

A Novel Association between Oxybutynin Use and Bilateral Acute Angle Closure Glaucoma: A Case Report and Literature Review

“…Medications such as topical anticholinergic, sympathomimetic dilating drops, tricyclic antidepressants, selective serotonin reuptake inhibitor (SSRIs), monoamine oxidase inhibitors, antihistamines, antiparkinsonian drugs, antipsychotic medications, and antispasmolytic agents have been reported to cause secondary AACG [ 3 - 6 ]. Hyponatremia caused by hydrochlorothiazide use was also reported to cause this condition [ 7 ].…”

A Case of Bilateral Acute Angle Closure Attack Induced by Common Cold Medication

“…1-3 약물에 의해 양안에 모두 급성 폐쇄각발작 이 발생한 경우는 이전에 topiramate 4 , hydrochlorothiazide 5,6 , selective serotonin reuptake inhibitors 7,8 , sildenafil citrate …”