Myopic Changes in a Climber after Taking Acetazolamide and the Use of Corrective Lenses to Temporize Symptoms: A Case Report from Mount Kilimanjaro

Hill, Adam D.

doi:10.1016/j.wem.2016.04.002

Cited by 8 publications

(4 citation statements)

References 13 publications

(24 reference statements)

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“…Several pathogenetic theories have been proposed 9 , 10 , 13 . A hypersensitivity reaction is considered less likely, as the reaction occurs upon a first-time administration 13 , 17 , 18 , 19 , as in our case. While remaining uncertain, pathophysiology is attributed to an idiosyncratic uveal reaction provoking an anterior displacement of the iris-lens diaphragm.…”

Section: Discussionmentioning

confidence: 78%

“…A uveal effusion was observed in about half of the patients. When acetazolamide was stopped, all cases recovered completely after a median of 5 days (2 – 14), with the aid of additional cycloplegia, anti-glaucomatous agents, and/or steroid treatment in about a quarter, a third, and more than half of the patients, respectively 1 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 .…”

Section: Discussionmentioning

confidence: 99%

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Acute Myopic Shift after a Single Dose of Acetazolamide: A Case Report and Review of the Literature

Kaisari,

Abouzeid,

Magnin

et al. 2024

Klin Monbl Augenheilkd

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We report the case of a 32-year-old male who presented with an acute myopic shift as a result of uveal effusion following a single administration of 250 mg acetazolamide. The drug was discontinued and following cycloplegia and topical steroid therapy, we observed progressive deepening of the anterior chamber, reopening of the iridocorneal angle, and complete resolution of the myopic shift after 5 days. A literature review since 1956 identified 23 cases, including ours, which developed a myopic shift after a median time of 24 h (3 – 24) following a median dose of 500 mg (125 – 1000) acetazolamide, with about a third complicated by angle closure ocular hypertension. This presumed idiosyncratic reaction can occur without prior drug exposure and independent of the phakic status. Treatment options include systematic drug withdrawal associated with cycloplegia, anti-glaucomatous agents, and/or corticosteroids. Full recovery is achieved within about 5 days (2 – 14). Given the widespread use of acetazolamide, awareness of this idiosyncratic reaction is crucial to avoid complications of acute angle-closure glaucoma.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Acute Myopic Shift after a Single Dose of Acetazolamide: A Case Report and Review of the Literature

Kaisari,

Abouzeid,

Magnin

et al. 2024

Klin Monbl Augenheilkd

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“…While its use for altitude sickness is known to occasionally cause myopia,4 there are no reported cases of choroidal effusions with acetazolamide used in altitude sickness. This is understandable, as patients are usually in isolated rural locations when taking this drug to prevent altitude sickness.…”

Section: Discussionmentioning

confidence: 99%

Bilateral choroidal effusions after taking acetazolamide for altitude sickness

Rothwell¹,

Anderson²

2022

BMJ Case Rep

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A fit and healthy 44-year-old woman took a single dose of oral acetazolamide (125 mg) in preparation for a hiking trip to Everest base camp. She awoke the next morning with profoundly blurred distance vision. She presented to eye casualty later that morning, approximately 18 hours postingestion: examination demonstrated myopia and bilateral choroidal effusions. Acetazolamide is used to minimise symptoms of altitude sickness. Rarely, its use can be linked with ophthalmic side effects, such as myopia. A handful of case reports also describe choroidal effusions secondary to its use as part of ophthalmic treatment (eg, postoperatively). This is the first reported case in which choroidal effusions have been demonstrated as a side effect of its prophylactic use against altitude sickness.

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“…Vannak köztük diuretikumok, antidiabetikumok, vérnyomáscsökkentők, antiepileptikumok és antipszichotikumok. Az elmúlt néhány évtizedben számos közlemény jelent meg a fenti szerek, különösen az acetazolamid általános alkalmazása mellett, idioszinkráziás hatásként jelentkező sugártest-és érhártyaleválás-ról, amit minden publikált esetben tranzitórikus myopia és/vagy akut szemnyomás-emelkedés megjelenése kapcsán diagnosztizáltak [1][2][3][4][5][6][7][8][9][10]. Az utóbbi két tünet megjelenésének a hátterében a sugártest ödémája áll, ami az úgynevezett iris-lencse diaphragma előretolódását, és szükségszerűen az elülső csarnok sekélyebbé válását eredményezi.…”

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Acetazolamid orális alkalmazása mellett jelentkező chorioidealeválás két esete: ismert idioszinkráziás hatás szokatlan megjelenési formája?

et al. 2017

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A szulfonamidszármazékok ("sulpha drugs") széles körben és változatos indikációval alkalmazott gyógyszerek ható-anyagát képezik. Az elmúlt néhány évtizedben számos közlemény jelent meg a fenti szerek, különösen az acetazolamid általános alkalmazása mellett, szemészeti idioszinkráziás hatásként jelentkező sugártest-és érhártyaleválásról, amit minden publikált esetben tranzitórikus myopia és/vagy akut szemnyomás-emelkedés megjelenése kapcsán diagnosztizáltak. Jelen közleményben két olyan esetet ismertetünk, ahol a gyógyszermellékhatásként jelentkező chorioidealeválás véletlen lelet volt, és ahhoz sem a refrakció változása, sem a szemnyomás kiugrása nem társult. Tudomá-sunk szerint ez az első közlemény, amely az acetazolamid okozta chorioideaablatio ezen speciális, "néma" formájáról számol be. Tekintve, hogy az érhártya érintettsége változó mértékű lehet, és -eseteink alapján -nem feltétlenül jár együtt akut glaucomával és rövidlátással, feltételezzük, hogy az acetazolamid szemészeti mellékhatásainak egy része felfedezetlen marad. Cikkünkkel szeretnénk felhívni a társszakmák figyelmét a szemészeti vizsgálat fontosságára szulfonamidtartalmú gyógyszert szedő és látásromlást panaszoló betegeik esetében. Orv Hetil. 2017; 158(50): 1998-2002.Kulcsszavak: acetazolamid, szemészeti mellékhatás, chorioidealeválás, szemészeti idioszinkrázia Case report on choroidal effusion after oral acetazolamide administration: an unusual manifestation of a well-known idiosyncratic effect?Sulpha drugs are widely employed in medicine for various diseases and disorders. During the last several decades, numerous papers had been published on supra ciliary and posterior choroidal effusion likely presenting as an idiosyncratic effect of these drugs especially of acetazolamide. In each publication, the effusion was associated with either an acute angle-closure glaucoma or transitory myopia or both of these as leading symptoms. In the current publication, authors report on two cases where the acetazolamide-induced choroidal effusion was an accidental finding without either a myopic shift in refraction or an acute elevation in intraocular pressure. To our best knowledge, ours is the first report in the literature describing this unusual, "silent" form of a sulpha drug-induced choroidal effusion. Since the choroidal involvement may vary in size and location, and is not necessarily associated with acute glaucoma and myopia, one can assume that a considerable amount of acetazolamide-related ocular side-effects will not be discovered. The above case report aims to draw the attention of other specialities to the need for ophthalmic examination for their patients taking sulpha drugs with acute visual deterioration Keywords: acetazolamide, ocular side-effect, choroidal effusion, ophthalmic idiosyncrasy Hári-Kovács A, Soós J, Gyetvai T, Facskó A, Végh M. [Case report on choroidal effusion after oral acetazolamide administration: an unusual manifestation of a well-known idiosyncratic effect?].

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Myopic Changes in a Climber after Taking Acetazolamide and the Use of Corrective Lenses to Temporize Symptoms: A Case Report from Mount Kilimanjaro

Cited by 8 publications

References 13 publications

Acute Myopic Shift after a Single Dose of Acetazolamide: A Case Report and Review of the Literature

Acute Myopic Shift after a Single Dose of Acetazolamide: A Case Report and Review of the Literature

Bilateral choroidal effusions after taking acetazolamide for altitude sickness

Acetazolamid orális alkalmazása mellett jelentkező chorioidealeválás két esete: ismert idioszinkráziás hatás szokatlan megjelenési formája?

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