Panday Vasudha A, Rhee Douglas J
Wilford Hall Medical Center, San Antonio, TX, USA.
Compr Ophthalmol Update. 2007 Sep-Oct;8(5):271-6.
Sulfonamide medications can cause an idiosyncratic reaction, resulting in acute transient myopia and acute angle-closure glaucoma. The risk of an adverse reaction to a sulfonamide is approximately 3%, and the exact mechanism of the myopia and angle-closure glaucoma remains controversial. Typical clinical presentation includes bilateral involvement with blurring of vision that generally occurs over minutes to hours, nausea or vomiting, red eye, and headache. Examination may show conjunctival injection, corneal edema, anterior chamber inflammation, and flat or shallow anterior chamber. Diagnosis is based on clinical suspicion, although an ultrasound biomicroscopy may be helpful in diagnosing swelling of the ciliary body. Topiramate, a sulfa derivative, is used for the treatment of migraines or seizures. The side effects include acute myopia and angle-closure glaucoma. Treatment of this condition is primarily supportive along with discontinuation of the medication; topical miotics and peripheral iridectomy are not helpful. If intraocular pressure remains uncontrolled, additional therapies, such as topical intraocular pressure-lowering medications, high-dose steroids, and trabeculectomy, may need to be considered.
磺胺类药物可引起特异反应，导致急性短暂性近视和急性闭角型青光眼。磺胺类药物发生不良反应的风险约为3%，近视和闭角型青光眼的确切机制仍存在争议。典型的临床表现包括双眼受累，视力模糊通常在数分钟至数小时内出现，伴有恶心或呕吐、眼红和头痛。检查可能显示结膜充血、角膜水肿、前房炎症以及前房变平或变浅。诊断基于临床怀疑，尽管超声生物显微镜检查可能有助于诊断睫状体肿胀。托吡酯是一种磺胺衍生物，用于治疗偏头痛或癫痫。其副作用包括急性近视和闭角型青光眼。这种情况的治疗主要是支持性治疗并停用药物；局部缩瞳剂和周边虹膜切除术无效。如果眼压仍无法控制，可能需要考虑其他治疗方法，如局部降眼压药物、高剂量类固醇和小梁切除术。
