Racecadotril induced bilateral uveal effusion: a case report

Area of Science:

• Ophthalmology
• Pharmacology

Background:

• Uveal effusion is a serious condition that can lead to vision loss through acute angle-closure glaucoma and maculopathy.
• This report details a case of bilateral uveal effusion potentially linked to racecadotril, an enkephalinase inhibitor used for diarrhea treatment.
• This association between racecadotril and uveal effusion has not been previously documented in medical literature.

Purpose of the Study:

• To report a novel case of bilateral uveal effusion associated with racecadotril use.
• To highlight the potential for racecadotril to cause a sight-threatening ocular side effect.
• To emphasize the importance of medication review in diagnosing and managing uveal effusion.

Main Methods:

• A case presentation of a 76-year-old woman with bilateral blurred vision.
• Diagnostic methods included fundoscopy and B-scan ultrasound, revealing bilateral choroidal effusion and a narrow anterior chamber with normal intraocular pressure.
• Medication review identified racecadotril as the only recent addition, with other potential causes of uveal effusion ruled out. Treatment involved topical steroids and atropine.

Main Results:

• The patient presented with bilateral blurred vision and was diagnosed with bilateral uveal effusion.
• Cessation of racecadotril resulted in a complete resolution of the uveal effusion.
• The patient's intraocular pressure remained normal despite a narrow anterior chamber.

Conclusions:

• Bilateral uveal effusion in this patient was likely caused by racecadotril, given its recent introduction and the complete resolution upon discontinuation.
• The mechanism may involve racecadotril-induced increases in enkephalins, altering choroidal function and leading to effusion.
• Uveal effusion should be recognized as a rare but potentially sight-threatening side effect of racecadotril, necessitating prompt diagnosis and management.