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This case report details a presumed link between furosemide and bilateral angle-closure glaucoma in a pregnant woman. Prompt treatment with prednisone resolved the condition, highlighting a potential drug-induced ocular side effect.

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Area of Science:

  • Ophthalmology
  • Pharmacology
  • Obstetrics

Background:

  • Angle-closure glaucoma is a serious ocular condition characterized by sudden blockage of the drainage angle in the eye.
  • Furosemide is a diuretic commonly used to treat fluid overload, but its potential ocular side effects are not well-documented.
  • Pregnancy can alter physiological parameters, potentially influencing drug responses and ocular health.

Observation:

  • A 21-year-old pregnant woman developed acute bilateral angle-closure glaucoma after initiating furosemide treatment.
  • Clinical examination revealed elevated intraocular pressures, shallow anterior chambers, and narrow angles.
  • Spectral domain anterior segment optical coherence tomography imaging was utilized for diagnostic assessment.

Findings:

  • The patient's intraocular pressures normalized within 3 days of initiating oral prednisone and topical brimonidine.
  • Anterior chamber depth increased, and angles widened following treatment, confirmed by slit-lamp examination and gonioscopy.
  • The patient experienced an uneventful pregnancy with normalized ocular pressures post-delivery.

Implications:

  • This is the first reported case suggesting a link between furosemide and bilateral angle-closure glaucoma.
  • The findings suggest an idiosyncratic reaction to furosemide, possibly related to its sulphonamide structure, similar to other reported drug reactions.
  • Discontinuation of furosemide and prompt corticosteroid treatment are proposed management strategies for similar cases.