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Drug-induced Myopia and Bilateral Angle Closure Secondary to Zolmitriptan.
Jonathan Tak Loong Lee1, Simon Edward Skalicky, Ming-Lee Lin
1*Department of Ophthalmology, The Alfred Hospital ‡Departments of Ophthalmology and Surgery, Royal Melbourne Hospital, University of Melbourne §Royal Victorian Eye and Ear Hospital, Melbourne †Discipline of Ophthalmology, University of Sydney, Sydney, Australia.
Journal of Glaucoma
|September 1, 2017
Summary
Zolmitriptan, a migraine medication, can cause temporary myopia and angle-closure glaucoma. Discontinuing the drug led to full vision recovery, highlighting the importance of recognizing drug-induced ocular side effects.
Area of Science:
- Ophthalmology
- Pharmacology
- Toxicology
Background:
- Migraine treatment often involves triptans, which can have ocular side effects.
- Drug-induced ciliochoroidal effusion can lead to angle-closure glaucoma and transient myopia.
- Previous reports have not linked zolmitriptan to these specific ocular adverse events.
Observation:
- A 42-year-old woman developed acute myopia and elevated intraocular pressures (IOP) after prolonged zolmitriptan use.
- Clinical examination revealed shallow anterior chambers and significantly reduced visual acuity.
- The patient's symptoms resolved rapidly upon discontinuation of zolmitriptan.
Findings:
- The patient experienced a myopic shift and bilateral angle-closure glaucoma with IOP of 34 mmHg.
- Cessation of zolmitriptan and initiation of antiglaucoma medication normalized IOP and deepened anterior chambers.
- Visual acuity improved to 20/12.5 and 20/16 respectively, with myopia fully resolved within two weeks.
Implications:
- This case highlights zolmitriptan as a potential cause of drug-induced transient myopia and angle-closure glaucoma.
- Early recognition and discontinuation of the offending agent are crucial for complete visual recovery.
- Ophthalmologists and neurologists should be aware of this potential idiosyncratic reaction to zolmitriptan.
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