Drug-induced bilateral secondary angle-closure glaucoma: A literature synthesis

Rory M. Murphy, Belal Bakir, Colm O'Brien, Janey L. Wiggs, Louis R. Pasquale

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42 Scopus citations

Abstract

Purpose: We performed a literature synthesis to identify the full spectrum of compounds implicated in drug-induced, bilateral secondary angle-closure glaucoma (21 ACG). Methods: Systematic PubMed literature review identified relevant bilateral 2 ACG case reports. We evaluated these reports with both the Naranjo adverse drug reaction probability scale to assess the causality of reported drug reactions and a 2 ACG scale scoring system we developed to determine the likelihood that the event represented bilateral 2 ACG. Two independent graders performed these analyses and their scores were averaged for interpretation. The Naranjo scale ranges from -4 to +13 and the drug reaction was considered definite if the score was ≥9, probable if 5 to 8, possible if 1 to 4, and doubtful if ≤0. The 2 ACG score ranges from 0 to 7. We considered a 2 ACG score of ≥4 as evidence of significant likelihood that the drug reaction represented bilateral 2 ACG. Results: No drug had a definite Naranjo score, but the following drug entities had probable Naranjo scores and 2 ACG scores ≥4: acetazolamide, "anorexiant mix," bupropion, cabergoline, "ecstasy," escitalopram, flavoxate, flucloxacillin, hydrochlorothiazide, hydrochlorothiazide/ triamterene, mefenamic acid, methazolamide, oseltamivir, topiramate, topiramate/bactrim, and venlafaxine. Root chemical analysis revealed that sulfur-containing and non-sulfur-containing compounds contributed to bilateral 2 ACG. Conclusions: Several compound preparations were implicated in drug-induced bilateral 2 ACG. Treating physicians should be aware that some forms of recreational drug use, which the patient may not admit to, could contribute to this vision-threatening side effect.

Original languageEnglish
Pages (from-to)e99-e105
JournalJournal of Glaucoma
Volume25
Issue number2
DOIs
StatePublished - 28 Jan 2016
Externally publishedYes

Keywords

  • Causative drugs
  • Drug-induced secondary angle-closure glaucoma
  • Naranjo scale

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