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In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
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Minocycline-Induced Ocular Ochronosis.

Carla Baaklini1, Natasha Kesav2, William Reinhart2

  • 1Ophthalmology, University of Missouri, Columbia, USA.

Cureus
|September 13, 2023
PubMed
Summary

Minocycline, an antibiotic, can cause ocular ochronosis, a rare condition leading to blue-gray discoloration of the sclera, retina, and skin. This persistent pigmentation may occur even after discontinuing the medication.

Keywords:
hyperpigmentationminocyclineocular ochronosisretinal pigment epithelium depositsscleral hyperpigmentation

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Area of Science:

  • Ophthalmology
  • Dermatology
  • Pharmacology

Background:

  • Minocycline is a widely used antibiotic with known side effects.
  • Hidradenitis suppurativa is a chronic inflammatory skin condition.
  • Ocular ochronosis is a rare condition characterized by pigment deposition in ocular tissues.

Observation:

  • A 65-year-old male developed blue-gray hyperpigmentation of the sclera, nail beds, and gingiva.
  • The patient had a four-year history of minocycline treatment for hidradenitis suppurativa.
  • Ophthalmic examination revealed scleral discoloration and retinal pigmentary changes.

Findings:

  • Minocycline-induced ocular ochronosis presented with scleral, retinal, and cutaneous manifestations.
  • Optical coherence tomography and fundus examination showed choroidal hyperpigmentation and retinal pigment epithelium deposits.
  • The observed discoloration persisted for six years post-minocycline discontinuation.

Implications:

  • This case highlights the potential for persistent ocular and cutaneous pigmentation from long-term minocycline use.
  • Ophthalmologists and dermatologists should be aware of this rare adverse effect.
  • Monitoring for pigmentary changes is crucial in patients on prolonged minocycline therapy.