Drug-induced ciliary body oedema: a new theory.
Drug-induced oedema of the ciliary body is rare, and occurs predominantly following exposure to sulphonamides. In a 31-year-old patient in her 37th week of pregnancy, we observed reversible myopia of -4.75 dioptres following the ingestion of chlorthalidone. In a second case report we describe, in a 61-year-old patient suffering from aspirin-sensitive asthma, recurrent ciliary body oedema with a marked spastic component which was triggered by the medications acetazolamide, dipivefrine and pilocarpine. We explain oedema of the ciliary body on the basis of the eicosanoids. We believe that the oedema is caused mainly by prostaglandins and that leucotrienes are predominantly responsible for the spastic component. We postulate a drug-induced elevation in eicosanoid concentrations, as well as certain interrelationships between ciliary body oedema and aspirin-sensitive asthma.
Krieg
P H
PH
Ophthalmology Clinic, Cantonal Hospital, Lucerne, Switzerland.
Schipper
I
I
D000086:Acetazolamide / Q000009:adverse effects; D000328:Adult; D001249:Asthma / Q000139:chemically induced; D002752:Chlorthalidone / Q000009:adverse effects; D002924:Ciliary Body / Q000187:drug effects*; D004232:Diuretics / Q000009:adverse effects; D004487:Edema / Q000139:chemically induced*; D004837:Epinephrine / Q000009:adverse effects / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008297:Male; D008528:Mefenamic Acid / Q000009:adverse effects; D008875:Middle Aged; D018721:Muscarinic Agonists / Q000009:adverse effects; D009216:Myopia / Q000139:chemically induced*; D010862:Pilocarpine / Q000009:adverse effects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*; D014603:Uveal Diseases / Q000139:chemically induced
D004232:Diuretics; D018721:Muscarinic Agonists; D010862:Pilocarpine; D008528:Mefenamic Acid; C015173:dipivefrin; D000086:Acetazolamide; D002752:Chlorthalidone; D004837:Epinephrine