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Haruhiko Yamada; Risk of drug-induced acute angle closure glaucoma in northeast Osaka. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2742.
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© ARVO (1962-2015); The Authors (2016-present)
Acute angle closure glaucoma (AACG) occurs mostly in middle to senior aged adult with short ocular axial length. East Asian people tend to have higher risk of AACG than that of caucasians. In this study, we surveyed retrospectively about the risk of drug-induced AACG in northeast Osakan area.
We retrospectively retrieved the patients who consulted Kansai Medical Univesity hospital and were diagnosed as AACG between Jan. 2007 and Nov. 2017 by clinical records. We selected the patients who had AACG induced by drug among them. Then we investigated the time from onset to first visit, specialty of doctors who transferred patients, intraocular pressure at first visit, type of causative drug, and best corrected visual acuity (BCVA) at final visit in drug-induced AACG cases.
118 cases (125 eyes) were recruited as AACG and among them, drug-induced AACG were 12 cases (16 eyes, 13% of total AACG eyes). Average time from onset to first visit was 47.8 hours. The patients were transferred from ophthalmologist (7 cases), general surgeon (3 cases), orthopedic surgeon (1 case), and otolaryngologist (1 case). Average value of IOP at first visit was 47.8mmHg. Causative drugs were phenilephrine hydrochloride (8 eyes), tropicamide (5 eyes), drugs for systemic anesthesia (4 eyes), and drug for pain relief (1 eye). Average value of BVCA at final visit was 0.68 by decimal visual acuity.
Drug-induced AACG cases occupy 13% of all AACG cases. Most of them arised from ophthalmic inspection treatment. In some cases, drugs for systemic anesthesia caused AACG. This result contains very strong warning message to ophthalmologist and other field of doctors not to use drugs which cause mydriasis before considering the risk of AACG.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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