Department of Pharmacology and Therapeutics, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland.
Division of Ophthalmology and Optometry, Department of Ophthalmology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland.
Surv Ophthalmol. 2019 Mar-Apr;64(2):185-194. doi: 10.1016/j.survophthal.2018.09.006. Epub 2018 Sep 29.
Serotonin-norepinephrine reuptake inhibitors are widely used antidepressants with a relatively safe profile. One of the complications associated with this group of drugs is acute angle closure. The mechanisms linking serotonin-norepinephrine reuptake inhibitors and acute angle closure are complex and may be interlinked with the effects of the drug on the inhibition of serotonin and noradrenaline reuptake, as well as pseudo-anticholinergic effects, dopaminergic effects, and idiosyncratic reactions with the drug molecule in the eye. Individual characteristics, such as polymorphisms of the gene encoding the 2D6 subunit of cytochrome P450, may affect the metabolism of the serotonin-norepinephrine reuptake inhibitor, whereas the combination with other drugs may lead to an increased risk of iridocorneal angle closure and may further exacerbate other mechanisms. Improved knowledge of the mechanisms linking serotonin-norepinephrine reuptake inhibitors and acute angle closure and of the risk factors predisposing to patients to acute angle closure will reduce the number of patients affected by this dangerous complication.
5-羟色胺-去甲肾上腺素再摄取抑制剂是广泛应用的具有相对安全谱的抗抑郁药。该类药物的并发症之一是急性闭角型青光眼。将 5-羟色胺-去甲肾上腺素再摄取抑制剂与急性闭角型青光眼联系起来的机制较为复杂，可能与药物对 5-羟色胺和去甲肾上腺素再摄取的抑制作用、拟副交感神经作用、多巴胺作用以及药物分子在眼中的独特反应有关。个体特征，如细胞色素 P450 2D6 亚基编码基因的多态性，可能会影响 5-羟色胺-去甲肾上腺素再摄取抑制剂的代谢，而与其他药物的联合应用可能会增加房角关闭的风险，并进一步加重其他机制。更好地了解 5-羟色胺-去甲肾上腺素再摄取抑制剂与急性闭角型青光眼之间的联系以及导致患者发生急性闭角型青光眼的危险因素，将减少受这种危险并发症影响的患者数量。
