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VOLUME 13 , ISSUE 3 ( September-December, 2019 ) > List of Articles

REVIEW ARTICLE

Drug-induced Acute Angle-closure Glaucoma: A Review

Ken Y Lin

Keywords : Acute angle-closure glaucoma, Acute angle-closure crisis, Adrenergic drugs, Drug-induced, Drug-induced acute angle-closure glaucoma, Iatrogenic, Paradoxical pilocarpine reaction, Pupillary block

Citation Information : Lin KY. Drug-induced Acute Angle-closure Glaucoma: A Review. J Curr Glaucoma Pract 2019; 13 (3):104-109.

DOI: 10.5005/jp-journals-10078-1261

License: CC BY-NC 4.0

Published Online: 01-04-2020

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Aim: Our goal is to review current literature regarding drug-induced acute angle-closure glaucoma (AACG) and provide ophthalmologists and general practitioners with a thorough understanding of inciting medications and treatment pitfalls to be avoided. Background: Drug-induced AACG is an ophthalmological emergency that ophthalmologists and general practitioners should be familiar with, given its potentially blinding consequences. Common anatomical risk factors for AACG include a shallow anterior chamber depth, short axial length, plateau iris configuration, thick lens, anteriorly positioned lens, and rarely, intraocular tumor. Demographic risk factors include female sex, Asian ethnicity, family history, and advanced age. In patients with predisposing factors, acute angle closure can be triggered by various classes of medications including adrenergic agonists, anticholinergics, cholinergics, sulfonamides, supplements, and serotonergic medications. Physicians prescribing such inciting medications should be aware of their potentially sight-threatening adverse effects and to inform patients of the warning symptoms. Patients typically present with elevated intraocular pressure (IOP), headache, nausea, blurry vision, and halos around lights. Review results: There are two main mechanisms of drug-induced AACG, both with different treatment strategies. The first mechanism of drug-induced AACG is pupillary block and iridocorneal angle closure secondary to thickening of iris base with mydriasis. The second mechanism of drug-induced AACG is anterior displacement of the lens–iris diaphragm due to mass effect (e.g., blood, misdirected aqueous humor, and tumors), uveal effusion, or weakened zonules. Conclusion: This paper reviews drug-induced AACG, high-risk anatomical features, underlying mechanisms, inciting medications, and options for treatment and prevention. Clinical significance: With proper understanding of the underlying mechanism of drug-induced AACG, physicians can respond promptly to save their patients’ vision by employing the correct treatment strategy.

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  1. Weinreb RN, Aung T, Medeiros FA. The pathophysiology and treatment of glaucoma: a review. JAMA 2014;311(18):1901–1911. DOI: 10.1001/jama.2014.3192.
  2. Nongpiur ME, Ku JY, Aung T. Angle closure glaucoma: a mechanistic review. Curr Opin Ophthalmol 2011;22(2):96–101. DOI: 10.1097/ICU.0b013e32834372b9.
  3. Kumar RS, Tantisevi V, Wong MH, et al. Plateau iris in Asian subjects with primary angle closure glaucoma. Arch Ophthalmol 2009;127(10):1269–1272. DOI: 10.1001/archophthalmol.2009.241.
  4. Suwan Y, Jiamsawad S, Tantraworasin A, et al. Qualitative and quantitative evaluation of acute angle-closure mechanisms. BMC Ophthalmol 2017;17(1):246. DOI: 10.1186/s12886-017-0635-8.
  5. Razeghinejad MR, Myers JS, Katz LJ. Iatrogenic glaucoma secondary to medications. Am J Med 2011;124(1):20–25. DOI: 10.1016/j.amjmed.2010.08.011.
  6. Nicoară SD, Damian I. Bilateral simultaneous acute angle closure attack triggered by an over-the-counter flu medication. Int Ophthalmol 2018;38(4):1775–1778. DOI: 10.1007/s10792-017-0628-x.
  7. Rudkin AK, Gray TL, Awadalla M, et al. Bilateral simultaneous acute angle closure glaucoma precipitated by non-prescription cold and flu medication. Emerg Med Australas 2010;22(5):477–479. DOI: 10.1111/j.1742-6723.2010.01338.x.
  8. Zenzen CT, Eliott D, Balok EM, et al. Acute angle-closure glaucoma associated with intranasal phenylephrine to treat epistaxis. Arch Ophthalmol 2004;122(4):655–656. DOI: 10.1001/archopht.122.4.655.
  9. Barrett V, Jordan T. Angle closure risk from proprietary medicines. Eye (Lond) 2001;15(Pt 2):248–249. DOI: 10.1038/eye.2001.82.
  10. Rho DS. Acute angle-closure glaucoma after albuterol nebulizer treatment. Am J Ophthalmol 2000;130(1):123–124. DOI: 10.1016/S0002-9394(00)00465-7.
  11. Shah P, Dhurjon L, Metcalfe T, et al. Acute angle closure glaucoma associated with nebulised ipratropium bromide and salbutamol. BMJ 1992;304(6818):40–41. DOI: 10.1136/bmj.304.6818.40.
  12. Coakes RL, Siah PB. Effects of adrenergic drugs on aqueous humour dynamics in the normal human eye. I. Salbutamol. Br J Ophthalmol 1984;68(6):393–397. DOI: 10.1136/bjo.68.6.393.
  13. Wolfs RC, Grobbee DE, Hofman A, et al. Risk of acute angle-closure glaucoma after diagnostic mydriasis in nonselected subjects: the Rotterdam study. Invest Ophthalmol Vis Sci 1997;38(12):2683–2687.
  14. Park JH, Lee YC, Lee SY. The comparison of mydriatic effect between two drugs of different mechanism. Korean J Ophthalmol 2009;23(1):40–42. DOI: 10.3341/kjo.2009.23.1.40.
  15. Friedman Z, Neumann E. Benzhexol-induced blindness in Parkinson's disease. Br Med J 1972;1(5800):605. DOI: 10.1136/bmj.1.5800.605.
  16. Reid WH, Blouin P. Outpatient psychiatric medications and glaucoma. Psychosomatics 1976;17(2):83–85. DOI: 10.1016/S0033-3182(76) 71149-6.
  17. Jaroudi M, Fadi M, Farah F, et al. Glycopyrrolate induced bilateral angle closure glaucoma after cervical spine surgery. Middle East Afr J Ophthalmol 2013;20(2):182–184. DOI: 10.4103/0974-9233. 110620.
  18. Kalra L, Bone MF. The effect of nebulized bronchodilator therapy on intraocular pressures in patients with glaucoma. Chest 1988;93(4):739–741. DOI: 10.1378/chest.93.4.739.
  19. Gani J, Perlis N, Radomski SB. Urologic medications and ophthalmologic side effects: a review. Can Urol Assoc J 2012;6(1):53–58. DOI: 10.5489/cuaj.371.
  20. Altan-Yaycioglu R, Yaycioglu O, Aydin Akova Y, et al. Ocular side-effects of tolterodine and oxybutynin, a single-blind prospective randomized trial. Br J Clin Pharmacol 2005;59(5):588–592. DOI: 10.1111/j.1365-2125.2005.02356.x.
  21. Haddad A, Arwani M, Sabbagh O. A novel association between oxybutynin use and bilateral acute angle closure glaucoma: a case report and literature review. Cureus 2018;10(6):e2732. DOI: 10.7759/cureus.2732.
  22. Sung VC, Corridan PG. Acute-angle closure glaucoma as a side-effect of oxybutynin. Br J Urol 1998;81(4):634–635. DOI: 10.1046/j.1464-410x.1998.00403.x.
  23. Fraunfelder FT. Transdermal scopolamine precipitating narrow-angle glaucoma. N Engl J Med 1982;307(17):1079. DOI: 10.1056/NEJM198210213071713.
  24. Münchau A, Bhatia KP. Uses of botulinum toxin injection in medicine today. BMJ 2000;320(7228):161–165. DOI: 10.1136/bmj.320.7228.161.
  25. Ah-Kee EY, Egong E, Shafi A, et al. A review of drug-induced acute angle closure glaucoma for non-ophthalmologists. Qatar Med J 2015;2015(1):6. DOI: 10.5339/qmj.2015.6.
  26. Tsai JC. Acute angle closure following periorbital botulinum toxin injection in a patient with retinitis pigmentosa. Taiwan J Ophthalmol 2017;7(2):104–107. DOI: 10.4103/tjo.tjo_41_17.
  27. Corridan P, Nightingale S, Mashoudi N, et al. Acute angle-closure glaucoma following botulinum toxin injection for blepharospasm. Br J Ophthalmol 1990;74(5):309–310. DOI: 10.1136/bjo.74.5.309.
  28. Tiligada E, Ennis M. Histamine pharmacology: from Sir Henry Dale to the 21st century. Br J Pharmacol 2018. DOI: 10.1111/bph.1 4524. PubMed PMID: 30341770.
  29. See JL, Aquino MC, Aduan J, et al. Management of angle closure glaucoma. Indian J Ophthalmol 2011;59(Suppl):S82–S87. DOI: 10.4103/0301-4738.73690.
  30. Stamper RL, Lieberman MF, Drake MV. Cholinergic drugs. In: Becker-Shaffer's Diagnosis and Therapy of the Glaucomas., 8th ed., 2009. pp. 420–430.
  31. Grewal DS, Goldstein DA, Khatana AK, et al. Bilateral angle closure following use of a weight loss combination agent containing topiramate. J Glaucoma 2015;24(5):e132–e136. DOI: 10.1097/IJG.0000000000000157.
  32. Kulkarni C, Chaudhuri UR, Jagathesan A. Bilateral acute angle-closure glaucoma following treatment with topiramate for headache. Neurol Ther 2013;2(1–2):57–62. DOI: 10.1007/s40120-013-0008-z.
  33. Ritch R. The pilocarpine paradox. J Glaucoma 1996;5(4):225–227. DOI: 10.1097/00061198-199608000-00010.
  34. Day AC, Nolan W, Malik AN, et al. Pilocarpine induced acute angle closure. BMJ Case Rep 2012;2012:bcr0120125694. DOI: 10.1136/bcr.01.2012.5694.
  35. Zhao C, Rakesh KP, Ravidar L, et al. Pharmaceutical and medicinal significance of sulfur (SVI)-containing motifs for drug discovery: a critical review. Eur J Med Chem 2019;162:679–734. DOI: 10.1016/j.ejmech.2018.11.017.
  36. Aminlari A, East M, Wei W, et al. Topiramate induced acute angle closure glaucoma. Open Ophthalmol J 2008;2:46–47. DOI: 10.2174/1874364100802010046.
  37. Levy J, Yagev R, Petrova A, et al. Topiramate-induced bilateral angle-closure glaucoma. Can J Ophthalmol 2006;41(2):221–225. DOI: 10.1139/I06-012.
  38. Weiler DL. Zonisamide-induced angle closure and myopic shift. Optom Vis Sci 2015;92(2):e46–e51. DOI: 10.1097/OPX.0000000000000475.
  39. Singer JR, Pearce ZD, Westhouse SJ, et al. Uveal effusion as a mechanism of bilateral angle-closure glaucoma induced by chlorthalidone. J Glaucoma 2015;24(1):84–86. DOI: 10.1097/IJG.0000000000000037.
  40. van Issum C, Mavrakanas N, Schutz JS, et al. Topiramate-induced acute bilateral angle closure and myopia: pathophysiology and treatment controversies. Eur J Ophthalmol 2011;21(4):404–409. DOI: 10.5301/EJO.2010.5979.
  41. Rhee DJ, Ramos-Esteban JC, Nipper KS. Rapid resolution of topiramate-induced angle-closure glaucoma with methylprednisolone and mannitol. Am J Ophthalmol 2006;141(6):1133–1134. DOI: 10.1016/j.ajo.2006.01.021.
  42. Wiciński M, Kaluzny BJ, Liberski S, et al. Association between serotonin-norepinephrine reuptake inhibitors and acute angle closure: what is known? Surv Ophthalmol 2019;64(2):185–194. DOI: 10.1016/j.survophthal.2018.09.006.
  43. Chen HY, Lin CL, Lai SW, et al. Association of selective serotonin reuptake inhibitor use and acute angle-closure glaucoma. J Clin Psychiatry 2016;77(6):e692–e696. DOI: 10.4088/JCP.15m10038.
  44. Ezra DG, Storoni M, Whitefield LA. Simultaneous bilateral acute angle closure glaucoma following venlafaxine treatment. Eye (Lond) 2006;20(1):128–129. DOI: 10.1038/sj.eye.6701815.
  45. Shifera AS, Leoncavallo A, Sherwood M. Probable association of an attack of bilateral acute angle-closure glaucoma with duloxetine. Ann Pharmacother 2014;48(7):936–939. DOI: 10.1177/1060028014529645.
  46. Lee JTL, Skalicky SE, Lin ML. Drug-induced myopia and bilateral angle closure secondary to Zolmitriptan. J Glaucoma 2017;26(10):954–956. DOI: 10.1097/IJG.0000000000000742.
  47. Shen E, Farukhi S, Schmutz M, et al. Acute angle-closure glaucoma associated with aripiprazole in the setting of plateau iris configuration. J Glaucoma 2018;27(2):e40–e43. DOI: 10.1097/IJG.0000000000000836.
  48. Zelefsky JR, Fine HF, Rubinstein VJ, et al. Escitalopram-induced uveal effusions and bilateral angle closure glaucoma. Am J Ophthalmol 2006;141(6):1144–1147. DOI: 10.1016/j.ajo.2006.01.033.
  49. Loskutova E, O'Brien C, Loskutov I, et al. Nutritional supplementation in the treatment of glaucoma: a systematic review. Surv Ophthalmol 2018;64(2):195–216. DOI: 10.1016/j.survophthal.2018.09.005.
  50. Kang JM, Lin S. Ginkgo biloba and its potential role in glaucoma. Curr Opin Ophthalmol 2018;29(2):116–120. DOI: 10.1097/ICU.0000000000000459.
  51. Wang SY, Singh K, Lin SC. The association between glaucoma prevalence and supplementation with the oxidants calcium and iron. Invest Ophthalmol Vis Sci 2012;53(2):725–731. DOI: 10.1167/iovs.11-9038.
  52. Bussel II, Aref AA. Dietary factors and the risk of glaucoma: a review. Ther Adv Chronic Dis 2014;5(4):188–194. DOI: 10.1177/2040622314530181.
  53. Butawan M, Benjamin RL, Bloomer RJ. Methylsulfonylmethane: applications and safety of a novel dietary supplement. Nutrients 2017;9(3):E290. DOI: 10.3390/nu9030290.
  54. Hwang JC, Khine KT, Lee JC, et al. Methyl-sulfonyl-methane (MSM)-induced acute angle closure. J Glaucoma 2015;24(4):e28–e30. DOI: 10.1097/IJG.0000000000000027.
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