J GlaucomaSeptember 20202 citations

Zonisamide-induced Choroidal Effusion: A Case Report.

Baradad Jurjo Maria C, Sanz Moreno Sílvia, Moix Gil Eugènia, Lillo Sopena Juan, Caminal Mitjana Josep M

View on PubMed DOI: 10.1097/IJG.0000000000001596

AI Summary

Zonisamide can cause choroidal effusion, as seen in this case. Early drug cessation is crucial for reversal, highlighting zonisamide's role in unexplained effusion differential diagnosis.

Abstract

Purpose

To describe a case of zonisamide-induced bilateral choroidal effusion.

Case report: A 72-year-old woman presented with a 4-day history of bilateral blurred vision 9 days after initiating oral zonisamide for essential tremor. Clinical examination revealed an asymmetric choroidal detachment with open anterior chamber angle and intraocular pressure within the normal range. Posterior segment ultrasonography and ultrasound biomicroscopy both confirmed the presence of bilateral ciliochoroidal effusion. Zonisamide treatment was discontinued. One month after treatment discontinuation, the ophthalmological examination was normal and no further treatment was needed.

Conclusion

Zonisamide can cause an idiosyncratic reaction leading to choroidal effusion with or without acute angle closure. Early withdrawal of the causative agent is the key to reversing this condition. These findings indicate that zonisamide and other sulfa-derived drugs must be ruled out in the differential diagnosis of choroidal effusion of unknown cause.

MeSH Terms

AgedAnticonvulsantsChoroidal EffusionsFemaleHumansIntraocular PressureMicroscopy, AcousticVision DisordersZonisamide

Shields Classification

Ch. 4Optic Nerve, Retina, and Choroid

Ch. 19Glaucomas Associated with Disorders of the Retina, Vitreous, and Choroid

Ch. 28Principles of Medical Therapy for Glaucoma

Key Concepts6

Zonisamide can cause an idiosyncratic reaction leading to choroidal effusion with or without acute angle closure.

MechanismCase seriesCase Reportn=1 patient

Early withdrawal of the causative agent, such as zonisamide, is crucial for reversing zonisamide-induced choroidal effusion.

TreatmentCase seriesCase Reportn=1 patientCh28

Zonisamide and other sulfa-derived drugs must be considered in the differential diagnosis of choroidal effusion of unknown cause.

DiagnosisExpert OpinionCase Reportn=1 patient

A 72-year-old woman presented with bilateral blurred vision 4 days after initiating oral zonisamide for essential tremor, which was diagnosed as asymmetric choroidal detachment with open anterior chamber angle and normal intraocular pressure.

DiagnosisCase seriesCase Reportn=1 patient

Posterior segment ultrasonography and ultrasound biomicroscopy confirmed bilateral ciliochoroidal effusion in a 72-year-old woman who developed blurred vision after initiating oral zonisamide.

DiagnosisCase seriesCase Reportn=1 patientCh4Ch5

One month after discontinuation of zonisamide treatment, the ophthalmological examination was normal and no further treatment was needed for the zonisamide-induced bilateral choroidal effusion in a 72-year-old woman.