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舒马曲坦诱发的闭角型青光眼:一例报告。

Sumatriptan-induced angle-closure glaucoma: A case report.

作者信息

Hsu Cherng-Ru, Chen Yi-Hao, Tai Ming-Cheng, Lu Da-Wen

机构信息

Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Medicine (Baltimore). 2017 Jun;96(22):e6953. doi: 10.1097/MD.0000000000006953.

Abstract

RATIONALE

Drug-induced bilateral angle-closure glaucoma is a rare event and should be treated correctly and promptly to prevent visual loss.

PATIENT CONCERNS

We report a rare case of sumatriptan-induced bilateral angle-closure glaucoma in a young woman with migraine, and explore the possible mechanism.

DIAGNOSES

We describe the clinical outcome of a patient with sumatriptan-induced bilateral angle-closure glaucoma. The patient presented with bilateral acute elevation of intraocular pressure (IOP) and myopic shift.

INTERVENTIONS

The clinical symptoms and signs resolved rapidly after treatment with a topical cycloplegic agent, topical steroid, and aqueous suppressant.

OUTCOMES

Based on the suspicious of malignant glaucoma, we prescribed topical phenylephrine, whose application immediately lowered the IOP. All symptoms resolved after treatment with a long-acting cycloplegic agent, topical steroid, and aqueous suppressant for 3 days.

LESSONS

We presume that the mechanism underlying sumatriptan-induced bilateral angle-closure glaucoma may be correlated to the malignant glaucoma. Timely diagnosis and appropriate treatment are essential for resolving this ophthalmic emergency.

摘要

理论依据

药物性双侧闭角型青光眼是一种罕见的情况,应正确、及时地进行治疗以防止视力丧失。

患者情况

我们报告了一例年轻偏头痛女性患者中由舒马曲坦诱发双侧闭角型青光眼的罕见病例,并探讨了可能的机制。

诊断

我们描述了一名舒马曲坦诱发双侧闭角型青光眼患者的临床结果。该患者出现双侧眼压急性升高和近视性移位。

干预措施

使用局部睫状肌麻痹剂、局部类固醇和房水抑制剂治疗后,临床症状和体征迅速缓解。

结果

基于对恶性青光眼的怀疑,我们开具了局部用去氧肾上腺素,用药后眼压立即降低。使用长效睫状肌麻痹剂、局部类固醇和房水抑制剂治疗3天后,所有症状均得到缓解。

经验教训

我们推测舒马曲坦诱发双侧闭角型青光眼的潜在机制可能与恶性青光眼相关。及时诊断和适当治疗对于解决这一眼科急症至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1872/5459710/d601293555ee/medi-96-e6953-g001.jpg

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