Two Cases of Ocular Complications Caused by Phendimetrazine

Abstract

Purpose:The authors of the present study report treatment experience of acute myopia and branch retinal vein occlusion associated with phendimetrazine, a drug used for weight reduction. Case summary: Case 1: A 32-year-old woman, previously devoid of ocular problems, visited our hospital with bilateral visual disturbance after taking phendimetrazine for weight reduction. Ciliochoroidal effusion and anterior shifting of the lens-iris diaphragm were observed, which resulted in a shallow anterior chamber, myopic shifting and an increase in intraocular pressure due to angle closure. The symptoms were relieved by discontinuing the use of phendimetrazine and administration of intraocular pressure-lowering agents. Case 2: A 26-year-old woman, previously devoid of ocular problems, visited our hospital with left superior visual field disturbance after taking phendimetrazine for weight reduction. The examinations revealed papilledema, disc hemorrhage and tortuous vascular changes in her left eye. Fluorescein angiography was performed, and retinal vein occlusion was diagnosed. The patient discontinued weight reduction agents and recovered while under observation. Conclusions: Phendimetrazine, used for weight reduction, can cause acute myopia via prostaglandin synthesis and retinal venous occlusion due to vascular constriction.

Branch retinal artery occlusion in a 49-year-Old woman taking phentermine

“…Consequently, he concluded that the patient's vision loss was due to vasoconstriction of the posterior ciliary arteries secondary to phentermine use. In addition, Cho et al 7 and Huh et al 8 reported on patients who presented with a central retinal vein occlusion (CRVO) after taking prescribed dosages of phendimetrazine, another sympathomimetic amine used as an appetite suppressant. As a result, based on these case reports, sympathomimetic amines like phentermine may have an adverse physiological effect on the retinal vasculature.…”

“… 1 , 2 While studies have shown that this drug is safe, several case reports have demonstrated phentermine being associated with adverse effects including stroke, myocardial infarction, and ischemic ocular diseases. 3 , 4 , 5 , 6 , 7 , 8 In addition, other amphetamine derivatives, especially ones that are abused like methamphetamine and cocaine, have been well documented to have harmful effects on the cardiovascular, neurologic, and psychologic systems. 9 In particular, ocular side effects of amphetamine abuse include mydriasis, decreased accommodation and convergence, visual hallucinations, retinal vasoconstriction and vasculitis, retinal microaneurysms and hemorrhage, and anterior ischemic optic neuropathy.…”