Reactions 1704, p70 - 2 Jun 2018 Bilateral serous choroidal effusion: case report A 73-year-old woman developed bilateral serous choroidal effusion during treatment with bimatoprost/timolol [Ganfort] for primary open-angle glaucoma. The woman presented for intraocular pressure control (IOP). Her medical history was significant for primary open- angle glaucoma in both eyes. She was on treatment with bimatoprost/timolol 0.3/5 mg/mL [route not stated] and brimonidine [brimonidine tartrate; Alphagan]. During the physical examination, she was observed to have a visual acuity (VA) of 20/20 in both eyes, an intraocular(IOP) of 24mm Hg in the right eye (RE) and 23mm Hg in the left eye (LE), Shaffer grade IV open angle in the four quadrants of both eyes, papila with cupping of 7/10 with normal colouring, moderate decrease of the neuroretinal ring and vessels rejected towards the nasal, applied retina and macula without alterations; the pachymetry was of 530µ in central cornea in both eyes. She underwent selective laser trabeculoplasty (SLT) in both eyes due to uncontrolled IOP. Subsequently, she was prescribed dexamethasone [Maxidex], betaxolol [betaxolol hydrochloride; Betoptic] and brimonidine/brinzolamide [Simbrinza]. However, she presented to the emergency care due to decreased vision in both eyes 24 hours after SLT. On examination, her VA was 20/25 in the right eye and 20/50 in the left eye, an IOP due to applanation of 6mm Hg in the right eye and 8mm Hg in the left eye, narrow anterior chamber in both eyes, diffuse ciliary hyperaemia and cellularity in anterior chamber (Tyndall) 3+. Based on the International Group for the Standardization of Uveitis Nomenclature (SUN), bilateral 360° serous choroidal effusion was suspected. The diagnosis of bilateral serous choroidal effusion was confirmed by a duplex ocular ultrasound which displayed middle hyperreflectivity at the level of the choroidal effusion. The woman’s treatment with brimonidine/brinzolamide was stopped. She was treated with dexamethasone, atropine [atropine sulfate;Colicursı Atropina] and prednisone. After one week, there was complete resolution of choroidal effusion with a VA of 20/30 in both eyes and the IOP was 40mm Hg in the right eye. She was re-administered brimonidine/ brinzolamide. However, she had elevated IOP in both eyes. Thus she underwent a non-penetrating deep sclerectomy with hydroxyethyl methacrylate [Esnoper V2000], first in the right eye and a month later in the left eye. At the time of report, her IOP of the right eye was 14mm Hg and of the left eye was 15mm Hg without any concomitant medication and VA was 20/20 in both eyes [time to reaction onset not stated]. Author comment: "Our patient used bimatoprost before the [selective laser trabeculoplasty] was performed, which could have contributed to activating this pathway of inflammatory mediators." "We report the case of a female patient with open-angle glaucoma who suffered bilateral serous [choroidal effusion] after [selective laser trabeculoplasty] in [both eyes]." Hernandez Pardines F, et al. Bilateral choroidal effusion after selective laser trabeculoplasty. Archivos de la Sociedad Espanola de Oftalmologia 92: 295-298, No. 6, Jun 2017. Available from: URL: http://doi.org/10.1016/j.oftal.2016.10.001 [Spanish; summarised from a translation] - Spain 803322918 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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