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Wu A, Khawaja AP, Pasquale LR, Stein JD. A review of systemic medications that may modulate the risk of glaucoma. Eye (Lond) 2019; 34:12-28. [PMID: 31595027 DOI: 10.1038/s41433-019-0603-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 08/07/2019] [Indexed: 12/16/2022] Open
Abstract
With increasing longevity, patients are developing more and more chronic diseases that require treatment with medications. Yet, it is not fully understood the extent by which these systemic medications affect ocular structures and whether they may increase or decrease the risk of sight-threatening ocular diseases. This review provides a summary of reported associations between different systemic medications and the risk of developing glaucoma or experiencing disease progression. Medication classes covered in this review that are known to or may modulate the risk of open-angle glaucoma include corticosteroids, beta blockers, calcium channel blockers, metformin, statins, selective serotonin reuptake inhibitors, bupropion, postmenopausal hormones, and cannabinoids. Medication classes addressed in this review that may increase the risk of angle closure glaucoma include anticholinergics, adrenergic agonists, certain classes of antidepressants, sulfonamides, and topiramate.
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Affiliation(s)
- Annie Wu
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joshua D Stein
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, MI, USA. .,Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, MI, USA. .,Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA.
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Spontaneous suprachoroidal hemorrhage in a high myopia patient with rhegmatogenous retinal detachment: a case report and literature review. Biosci Rep 2019; 39:BSR20181454. [PMID: 31160485 PMCID: PMC6591562 DOI: 10.1042/bsr20181454] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 05/04/2019] [Accepted: 05/31/2019] [Indexed: 11/17/2022] Open
Abstract
Purpose: To report a rare case of spontaneous suprachoroidal hemorrhage (SSCH) in a high myopia patient with rhegmatogenous retinal detachment (RRD) and successful treatment.Methods: We present a case of SSCH that occurred in a 73 woman with high myopia with RRD and discuss the results of a systemic review of the literature published from 1999 to 2017.Results: Phacoemulsification without intraocular lens implantation and vitrectomy combined with silicone oil injection was performed and retinal detachment and choroidal detachment were reattached after oil removed. In the literature review, we found that among a total of 36 patients (37 eyes), acute secondary glaucoma was a complication in 70.3% (26 eyes) of the cases, and over half of the cases (24 eyes, 64.9%) were treated with surgery. Eighteen cases (50%) were characterized by systemic hypertension and 21 cases (58.3%) had abnormal hemostasis. Age-related macular degeneration (ARMD) was the most common (12 eyes, 32.4%) ocular disease and was followed by glaucoma (7 cases, 18.9%). Visual acuity was classified as hand motion (HM) or worse in 25 eyes (out of 34 eyes, 73.5%) at initial presentation and in 25 eyes (out of 36 eyes, 69.4%) upon final examination. Nine cases experienced significant visual improvement, including six that underwent vitrectomy.Conclusion: Advanced age, systemic anticoagulation, and hypertension are strong risk factors. RRD associated with massive SSCH is an extremely rare event. Vitrectomy and choroidal blood drainage can effectively remove suprachoroidal hemorrhage (SCH) and promote retinal reattachment in these eyes. However, the final visual prognosis usually remains poor.
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Ah-Kee EY, Egong E, Shafi A, Lim LT, Yim JL. A review of drug-induced acute angle closure glaucoma for non-ophthalmologists. Qatar Med J 2015; 2015:6. [PMID: 26535174 PMCID: PMC4614311 DOI: 10.5339/qmj.2015.6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/15/2015] [Indexed: 11/05/2022] Open
Abstract
Acute angle closure glaucoma is an ophthalmic emergency and can lead to blindness if left untreated. Several types of drugs have the potential to precipitate acute angle closure glaucoma. These include adrenergic, cholinergic and anticholinergic, antidepressants, anticoagulants and sulfa-based agents. This article provides a basic overview of the risk factors and pathophysiologic mechanisms involved in angle closure glaucoma and focuses on drug-induced angle closure glaucoma for the non-ophthalmologist. A PubMed search limited to the English language was conducted to find relevant literature for the purpose of this article. Most attacks occur in subjects unaware that they are at risk due to innately narrow iridocorneal angles. Clinicians should always review medications in patients presenting with symptoms of acute angle closure glaucoma. The aim of this article is to bring this ophthalmic condition to the attention of clinicians, particularly those outside the field of ophthalmology who commonly prescribe these medications or see these patients prior to referring to ophthalmologists.
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Affiliation(s)
- Elliott Yann Ah-Kee
- Monklands Hospital, Monkscourt Ave, Airdrie, North Lanarkshire, United Kingdom
| | - Eric Egong
- Monklands Hospital, Monkscourt Ave, Airdrie, North Lanarkshire, United Kingdom
| | - Ahad Shafi
- Monklands Hospital, Monkscourt Ave, Airdrie, North Lanarkshire, United Kingdom
| | - Lik Thai Lim
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, United Kingdom
| | - James Li Yim
- Department of Ophthalmology, University Hospital Ayr, Ayr, Glasgow, United Kingdom
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Hsiao SF, Shih MH, Huang FC. Spontaneous suprachoroidal hemorrhage: Case report and review of the literature. Taiwan J Ophthalmol 2015; 6:36-41. [PMID: 29018708 PMCID: PMC5602124 DOI: 10.1016/j.tjo.2014.10.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 10/24/2014] [Accepted: 10/28/2014] [Indexed: 01/25/2023] Open
Abstract
We present the clinical course, management, and final outcome of spontaneous suprachoroidal hemorrhage (SSCH) in an age-related macular degeneration (AMD) patient—a 64-year-old male receiving antiplatelet therapy who developed SSCH during the Valsalva maneuver. In addition to our case study, we discuss the results of a systemic review of the literature and reference lists of retrieved studies published from January 2001 to December 2013. Among a total of 31 patients (32 eyes), acute secondary glaucoma was a complication in 87.5% of the cases, and over half of the cases (20 eyes, 62.5%) received surgery. Twenty cases (64.5%) were characterized by systemic hypertension (HTN), followed by cardiovascular or cerebral vascular disease in 17 cases (54.8%). The Valsalva maneuver was performed in five cases (16.1%) prior to the episode. Twenty-three cases (74.2%) had abnormal hemostasis, including use of anticoagulants or thrombolytic agents (18 cases), chronic renal failure (CRF, 5 cases), and blood dyscrasia (3 cases). AMD was the most common (17 eyes of 16 patients, 53.1%) ocular disease. Visual acuity was classified as hand motion (HM) or worse in 20 eyes (of 28 eyes, 71.4%) at initial presentation and in 24 eyes (of 30 eyes, 80%) upon final examination. Anticoagulated patients with AMD should be informed of the risk of intraocular hemorrhage. Medical therapy usually fails in the treatment of glaucoma. Surgical intervention provides an option for the purpose of pain relief. Even so, the final visual prognosis is usually poor.
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Affiliation(s)
- Shu-Fang Hsiao
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Min-Hsiu Shih
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Fu-Chin Huang
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC
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AlHarkan DH, AlJadaan IA. Postoperative suprachoroidal hemorrhage in a glaucoma patient on low molecular weight heparin. Middle East Afr J Ophthalmol 2013; 20:179-81. [PMID: 23741139 PMCID: PMC3669497 DOI: 10.4103/0974-9233.110618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Suprachoroidal hemorrhage is a complication associated with intraocular surgery that can occur both intraoperatively and postoperatively. Several intraoperative or postoperative risk factors have been indentified. The use of low-molecular weight heparin (LMWH) is considered one of the risk factors in surgical cases (ocular or non ocular) and non-surgical cases. Here we present a case of suprachoroidal hemorrhage in a glaucoma patient that occurred after preoperative prophylactic LMWH for deep venous thrombosis. The use of LMWH has been reported to cause suprachoroidal hemorrhage even in patients without any risk factors. The use of LMWH continues to increase, hence it is important to be aware of the possibility of suprachoroidal hemorrhage and to determine the risk/benefit ratio, especially in patients with other risk factors.
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Affiliation(s)
- Dora H AlHarkan
- Riyadh Ophthalmology Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia
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Salim S, Shields MB. Glaucoma and systemic diseases. Surv Ophthalmol 2010; 55:64-77. [PMID: 19833365 DOI: 10.1016/j.survophthal.2009.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Accepted: 03/26/2009] [Indexed: 01/24/2023]
Abstract
Glaucoma management may be extremely challenging, especially in elderly patients who have a variety of systemic diseases and take multiple medications. We obtained a comprehensive medical history in patients with primary open-angle glaucoma to determine which systemic diseases are most prevalent and which systemic medications are most commonly used. We have also reviewed the literature that addresses how these concomitant diseases and medical treatments influence the management of glaucoma. Knowledge of systemic diseases and potential drug interactions, especially between various systemic and glaucoma medications, is important for the safe management of glaucoma patients.
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Affiliation(s)
- Sarwat Salim
- Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Jamal BT, Diecidue RJ, Taub D, Champion A, Bilyk JR. Orbital hemorrhage and compressive optic neuropathy in patients with midfacial fractures receiving low-molecular weight heparin therapy. J Oral Maxillofac Surg 2009; 67:1416-9. [PMID: 19531411 DOI: 10.1016/j.joms.2008.12.044] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Revised: 11/09/2008] [Accepted: 12/19/2008] [Indexed: 11/16/2022]
Abstract
While the implementation of deep vein thrombosis (DVT) prophylaxis in the hospital setting is a major concern, the use of antithrombotic agents is fraught with a variety of hemorrhagic complications. Due to increasing reports of adverse reactions to unfractionated heparin (UFH), several manufacturers have initiated product recalls. As a result, the use of low-molecular weight heparins (LMWHs) such as enoxaparin has risen substantially. In this paper, 2 orbital hemorrhagic complications in patients receiving enoxaparin therapy will be presented. The incidence of DVT in the OMS patient, recent prophylactic strategies, and their effectiveness will be reviewed.
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Affiliation(s)
- Basem T Jamal
- Oral and Maxillofacial Surgery Department, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
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Tajika T, Yokozeki H, Ishimaru K, Naito T, Shiota H. A rare case of choroidal hemorrhage complicated with hypertension due to chronic renal failure. THE JOURNAL OF MEDICAL INVESTIGATION 2008; 55:151-5. [DOI: 10.2152/jmi.55.151] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | | | - Katsuo Ishimaru
- Department of Internal Medicine, Tokushima Municipal Hospital
| | - Takeshi Naito
- Department of Ophthalmology and Visual Neuroscience, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Hiroshi Shiota
- Department of Ophthalmology and Visual Neuroscience, Institute of Health Biosciences, The University of Tokushima Graduate School
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Abstract
PURPOSE OF REVIEW Acute angle closure glaucoma is a potentially blinding side effect of a number of local and systemic drugs, including adrenergic, both anticholinergic and cholinergic, antidepressant and antianxiety, sulfa-based, and anticoagulant agents. The purpose of this article is to bring this condition to the attention of clinicians using these compounds as well as ophthalmologists called to see the patient. RECENT FINDINGS Acute angle closure glaucoma due to pupillary block, treatable by peripheral iridotomy, can be caused by adrenergic agents, either locally (phenylephrine drops, nasal ephedrine, or nebulized salbutamol) or systemically (epinephrine for anaphylactic shock), drugs with anticholinergic effects including tropicamide and atropine drops, tri and tetracyclic antidepressants, and cholinergic agents like pilocarpine. A novel anticholinergic form is the use of periocular botulinum toxin diffusing back to the ciliary ganglion inhibiting the pupillary sphincter. Sulfa-based drugs (acetazolamide, hydrochlorothiazide, cotrimoxazole, and topiramate) can cause acute angle closure glaucoma by ciliary body edema with anterior rotation of the iris-lens diaphragm. Iridotomy is not effective. SUMMARY Most attacks of acute angle closure glaucoma involving pupillary block occur in individuals that are unaware that they have narrow iridocorneal angles. Practitioners using any of the above drugs should be aware of their potential to cause acute angle closure.
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Affiliation(s)
- Yves Lachkar
- Department of Ophthalmology, Glaucoma Institute, Saint Joseph Hospital, Paris, France.
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McIlrath ST, Blaivas M, Lyon M. Patient follow-up after negative lower extremity bedside ultrasound for deep venous thrombosis in the ED. Am J Emerg Med 2006; 24:325-8. [PMID: 16635706 DOI: 10.1016/j.ajem.2005.11.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2005] [Revised: 11/23/2005] [Accepted: 11/26/2005] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES To evaluate the rate of patient compliance with follow-up ultrasound (US) examinations 5 to 7 days after emergency physician EP performed US exams to rule out lower extremity deep venous thrombosis (DVT) in the ED. METHODS This was a prospective observational study at a level I ED with a residency program, US training program, and an annual census of 75000. Hospital-based emergency US credentialing is available and derived from American College of Emergency Physicians guidelines. Five US-credentialed emergency physicians participated in the study. All patients who received negative lower extremity DVT US exams were eligible. All higher risk patients were given verbal and written instructions and provided with prescriptions to have a follow-up US examination 5 to 7 days after their examination in the ED. Those classified as "low risk" based on Wells criteria were excluded. After 3 months, patients were contacted via telephone and asked questions regarding their follow-up US examinations, reasons for not following up, continued symptoms, and thromboembolic events. Statistical methods included descriptive statistics. RESULTS One hundred fifty-nine patients were eligible for enrollment during the 10-month study period. Eighty-five patients (54%) fell into the higher risk category of these; 54 (64%) were contacted successfully. Fifteen (28%) of the patients contacted had obtained a follow-up US exam. Of the 39 who did not follow-up, 29% were told by their physician that a follow-up US was unnecessary, 21% forgot to follow-up, 8% did not follow-up for financial reasons, 16% felt better, 5% could not arrange a study, 21% were unsure. One patient died from sepsis before a follow-up scan. Two patients were diagnosed with DVT, one at 7 days follow-up and the other 9 months later (this particular patient had their 7-day scan cancelled by their primary care physician). CONCLUSION Patients who were instructed to obtain follow-up lower extremity US examinations to rule out propagation of unseen, distal DVTs did so at a very low rate in our study. One of the largest impediments in our study population was a patients' primary care physician who may not understand the need for a follow-up US examination.
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Affiliation(s)
- S Timothy McIlrath
- Section of Emergency Ultrasound, Department of Emergency Medicine, Medical College of Georgia, Augusta, GA 30912-4007, USA
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Weingessel B, Richter-Müksch S, Sacu S, Schmidt-Erfurth U, Vécsei-Marlovits PV. Sinnhaftigkeit der Fundusbegutachtung vor Marcoumarisierung. SPEKTRUM DER AUGENHEILKUNDE 2006. [DOI: 10.1007/bf03164674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2002; 11:621-36. [PMID: 12462142 DOI: 10.1002/pds.663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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