Effect of acetazolamide on ocular hemodynamics in pseudotumor cerebri associated with inflammatory bowel disease.
OBJECTIVE
To describe the hemodynamic effect of oral acetazolamide administration on ocular perfusion in a patient with pseudotumor cerebri associated with Crohn disease.


METHODS
Interventional case report.


METHODS
A 20-year-old woman with a 5-year history of Crohn disease presented with a 2-week history of headache and blurred vision in both eyes. Ophthalmologic examination was normal. Fluorescein angiography showed a profound delay in retinal and choroidal perfusion. Lumbar puncture showed an opening pressure of 320 mm water. Therapy was initiated with oral acetazolamide 750 mg per day.


RESULTS
A subjective improvement of symptoms was noted over 4 days. Repeat fluorescein angiography showed resolution of the ocular perfusion deficit. No recurrent symptoms were noted 19 months after cessation of therapy.


CONCLUSIONS
Crohn disease may present with pseudotumor cerebri and severe ocular perfusion deficits that are reversible with oral acetazolamide therapy.
Villain
Max A
MA
Service d'Ophtalmologie, Hôpital Gui de Chauliac, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France. villainmax@aol.com
Pageaux
Georges P
GP
Veyrac
Michel
M
Arnaud
Bernard
B
Harris
Alon
A
Greenfield
David S
DS
D000086:Acetazolamide / Q000627:therapeutic use*; D000284:Administration, Oral; D000328:Adult; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use*; D002829:Choroid / Q000098:blood supply; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography; D006261:Headache / Q000209:etiology; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007427:Intracranial Pressure; D010211:Papilledema / Q000209:etiology* / Q000503:physiopathology; D011559:Pseudotumor Cerebri / Q000209:etiology* / Q000503:physiopathology; D012171:Retinal Vessels / Q000503:physiopathology*; D014792:Visual Acuity; D014794:Visual Fields
D002257:Carbonic Anhydrase Inhibitors; D000086:Acetazolamide