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Bilateral acute angle-closure glaucoma after dexfenfluramine treatment
P Denis1, D Charpentier, P Berros
1Department of Ophthalmology, University Hospital of Pointe-à-Pitre, France.
Summary
Dexfenfluramine, a weight-loss drug, can trigger acute angle-closure glaucoma in patients with narrow eye angles. This highlights the need for ophthalmologist monitoring when prescribing such serotoninergic medications.
Area of Science:
- Ophthalmology
- Pharmacology
Background:
- Acute angle-closure glaucoma is an ophthalmic emergency.
- Narrow iridocorneal angles are a risk factor for angle-closure glaucoma.
- Serotoninergic drugs, like dexfenfluramine, affect neurotransmitter systems.
Observation:
- A patient with narrow angles experienced bilateral acute angle-closure glaucoma.
- The glaucoma attack was precipitated by dexfenfluramine, an appetite suppressant.
- Pupillary block was observed during the glaucoma attack.
Findings:
- Dexfenfluramine's serotoninergic or parasympatholytic effects may cause pupillary block.
- This mechanism can lead to acute angle-closure glaucoma in susceptible individuals.
- The drug's action on the iris sphincter muscle is implicated.
Implications:
- Serotoninergic psychoactive drugs require cautious prescription in patients with narrow angles.
- Ophthalmological monitoring is crucial for patients on these medications.
- This case underscores the importance of considering drug side effects in glaucoma management.