Circumscribed ciliochoroidal effusion presenting as an acute angle closure attack

Abstract

Purpose:To report a case of choroidal effusion probably caused by angiotensin receptor II blocker.Case Report:A 52-year-old man with aplastic anemia and high blood pressure who developed unilateral acute angle closure glaucoma after receiving oral cyclosporine and angiotensin II receptor blocker (losartan). Ophthalmic examination revealed visual acuity of 20/30 in the left eye, mild mydriasis, iris bombe, no anterior chamber reaction, mild conjunctival hyperemia, and the intraocular pressure of 30 mmHg. After laser YAG iridotomy, funduscopy was performed showing a choroidal circumscribed lesion at the inferotemporal quadrant. Diagnostic tests ruled out any inflammatory or malignancy process, and the choroidal lesion spontaneously disappeared. After 20 months of follow-up, patient's ocular remained stable.Conclusion:This is the third case of choroidal effusion associated with angiotensin II receptor blockers. Since idiosyncratic ciliochoroidal effusion is a diagnosis of exclusion, it is mandatory to rule out more frequent causes, such as inflammatory or malignant processes.

Exudative Retinal Detachment and Ciliochoroidal Effusion in Preeclampsia

“…14 However, secondary angle-closure glaucoma has been reported as a complication of choroidal effusion resulting from drug toxicity, glaucoma surgery, and idiopathic uveal effusion syndrome. 15–17 Choroidal effusion, which has also been called ciliochoroidal detachment, causes angle closure via anterior displacement of the lens–iris diaphragm, 18 as was seen in our patient.…”

Angiotensin receptor blocker-induced bilateral ciliochoroidal effusion

“…Use of ARBs for systemic hypertension may rarely cause ciliochoroidal effusion. [ 1 2 3 ] Intraocular angiotensin II production and ocular blood flow regulation depend on the local renin-angiotensin system. [ 4 ] Bradykinin results in endothelium-dependent vasodilatation and increased ocular blood flow.…”