Chaves-Samaniego Maria J, Molina Lespron Aleyda, Cervera Sanchez Zaira, Amat Peral Pedro, Ruiz Moreno José M
Vissum, Miranza Group, Alicante, Spain.
Case Rep Ophthalmol. 2022 Sep 30;13(3):711-716. doi: 10.1159/000526681. eCollection 2022 Sep-Dec.
The aim of this report was to present a case of bilateral choroidal detachment following treatment with topical therapy dorzolamide/timolol without history of previous surgery. An 86-year-old woman, with intraocular pressures of 40.00/36.00 mm Hg, was treated with preservative-free double therapy with dorzolamide/timolol. One week later, she presented with bilateral vision loss and irritative symptoms in the face, scalp, and ears, with well controlled pressures. The anterior exam showed LOCS III N4C3 cataracts, and the fundus and ultrasound exams revealed a bilateral infero-temporal choroidal detachment in the absence of neoplasia or other systemic cause. One week in absence of hypotensive treatment and receiving topical prednisolone, she showed reattachment of the choroidal detachment. Six months after cataract surgery, the patient remains stable, without choroidal effusion regression. Hipotensive treatment following chronic angle closure can lead to choroidal effusion similar to cases of acute angle closure treated with oral carbonic-anhydrase inhibitors. The combined strategy of removing hipotensive treatment and topical corticosteroids could be useful for the initial management of choroidal effusion. Also, performing cataract surgery after choroidal reattachment can help with stabilization.
本报告旨在介绍一例在未进行过手术的情况下，使用多佐胺/噻吗洛尔局部治疗后发生双侧脉络膜脱离的病例。一名86岁女性，眼压为40.00/36.00 mmHg，接受了不含防腐剂的多佐胺/噻吗洛尔双重治疗。一周后，她出现双侧视力丧失以及面部、头皮和耳部的刺激症状，眼压得到良好控制。眼前节检查显示LOCS III N4C3级白内障，眼底和超声检查显示双侧颞下脉络膜脱离，未发现肿瘤或其他全身性病因。在未进行降压治疗且接受局部泼尼松龙治疗一周后，她的脉络膜脱离重新附着。白内障手术后六个月，患者情况稳定，脉络膜积液未消退。慢性闭角型青光眼进行降压治疗后可能导致脉络膜积液，类似于口服碳酸酐酶抑制剂治疗急性闭角型青光眼的病例。停用降压治疗和局部使用皮质类固醇的联合策略可能有助于脉络膜积液的初始治疗。此外，在脉络膜重新附着后进行白内障手术有助于病情稳定。
