Racecadotril induced bilateral uveal effusion: a case report

Uveal effusion is a sight threatening condition, due to possible acute angle-closure glaucoma and maculopathy. We present a case of bilateral uveal effusion after taking racecadotril, an enkephalinase inhibitor used as a medical treatment for diarrhea. Uveal effusion after the use of racecadotril has not been described in literature.

A 76-year-old woman presented with blurred vision in both eyes. Fundoscopy and B-scan ultrasound showed bilateral choroidal effusion. The anterior chamber was narrow, but the intra ocular pressure remained normal. The medication review showed that the only recently added medication was racecadotril. Other potential causes of uveal effusion were excluded. Topical steroids and atropine were started. After cessation of racecadotril, a complete resolution of the uveal effusion was observed.

This case of bilateral uveal effusion was probably caused by racecadotril, since this was the only recently started drug, and we observed a complete resolution of the effusion after cessation of the drug. It is possible that the increase in enkephalins caused by racecadotril intake, leads to changes in the choroid, causing choroidal effusion. It is important to recognize uveal effusion as a rare side effect of racecadotril, because of its possible sight threatening character.