Krawitz Brian D, Sirinek Portia, Doobin David, Nanda Tavish, Ghiassi Maryam, Horowitz Jason D, Liebmann Jeffrey M, De Moraes Carlos G
Department of Ophthalmology, Columbia University Irving Medical Center, New York, NY.
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA.
J Glaucoma. 2021 Mar 1;30(3):e50-e53. doi: 10.1097/IJG.0000000000001763.
To report a case of bilateral acute angle-closure glaucoma associated with hyponatremia in the setting of chlorthalidone use and SARS-CoV-2 infection, and to demonstrate the challenges of managing this patient given her infectious status.
This was a case report.
A 65-year-old woman taking chlorthalidone for hypertension presented to the emergency room with headache, pain, and blurry vision in both eyes and was found to be in bilateral acute angle closure. On laboratory investigation, she was severely hyponatremic and also tested positive for SARS-CoV-2. B-scan ultrasound demonstrated an apparent supraciliary effusion in the right eye. Following stabilization of her intraocular pressures with medical management, she ultimately underwent cataract extraction with iridectomies and goniosynechiolysis in both eyes.
We report a rare case of bilateral acute angle-closure glaucoma associated with hyponatremia. Chlorthalidone use and perhaps SARS-CoV-2 infection may have contributed to this electrolyte abnormality and unique clinical presentation. In addition, we discuss the challenges of managing this complex patient with active SARS-CoV-2 infection during the pandemic.
报告一例在使用氯噻酮及感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的情况下发生的伴有低钠血症的双侧急性闭角型青光眼病例，并说明鉴于该患者的感染状况在管理上所面临的挑战。
这是一篇病例报告。
一名65岁女性，因高血压服用氯噻酮，因双眼头痛、疼痛及视力模糊就诊于急诊室，被诊断为双侧急性闭角型青光眼。实验室检查发现，她严重低钠血症，且SARS-CoV-2检测呈阳性。B超检查显示右眼有明显的睫状体上腔积液。在通过药物治疗稳定眼压后，她最终接受了双眼白内障摘除联合虹膜切除术和房角粘连分离术。
我们报告了一例罕见的伴有低钠血症的双侧急性闭角型青光眼病例。使用氯噻酮以及可能的SARS-CoV-2感染可能导致了这种电解质异常和独特的临床表现。此外，我们讨论了在大流行期间管理这名患有活动性SARS-CoV-2感染的复杂患者所面临的挑战。
