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Topikal Karbonik Anhidraz İnhibitörü Kullanımına Bağlı Gelişen Bir Kornea Ödemi Olgusu

A Case With Corneal Edema After Application of Topical Carbonic Anhydrase Inhibitor

Journal Name:

  • Fırat Tıp Dergisi

Publication Year:

  • 2008

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
To report an old patient diagnosed as primary open angel glaucoma (POAG), complicated with irreversible corneal edema after application of topical carbonic anhydrase inhibitor. A 81-year-old man with a previous diagnosis of right and left POAG, of 14-years and 5-years duration respectively, was admitted to our clinic. On ophthalmic examination right eye was absolut glaucoma, and intraocular pressure was measured as 34 mmHg, and visual acuity was 20/200 and intraocular pressure 24 mmHg for the left eye. Gonioscopic examination revealed bilaterally open angles. On anterior segment examination, we observed bilaterally clear cornea, and anterior chamber depths were normal. There was right matur nuclear cataract and left +++ nuclear sclerosis. On fundus examination, there was total right optical atrophy, a left cup/disc ratio of 6/10, and concantric narrowing on left perimetric examination. We considered combined operation, which was refused by the patient. Then treatment with dorzolamide and timolol was started. The patient, who didn't came periodically for follow-ups, was referred to our clinic 3 months later with blurred vision of the left eye. The left eye examination revealed vision had dropped counting fingers at 2-3 m, and we observed difffuse stromal edema on the central cornea. The drugs were changed with topical prednisone 4 drops/day. On pacimetric examination, the corneal thickness was 0.53 mm for the right eye, and 0.59 mm for the left eye. On later follow-ups, corneal edema did not disappear. We consider that topical carbonic anhidraz inhibitors should carefully be selected in old patients under risk of corneal endothelial decompensation. ©2008, Firat University, Medical Faculty
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Abstract (Original Language): 
Primer açı k açılı glokom (PAAG) tanısı ile takip edilen yaşlı bir hastada topikal karbonik anhidraz inhibitörü kullanımı sonrası gelişen geri dönüşümsüz bir kornea ödemi olgusunu değerlendirmek. 81 yaşında erkek hasta, 14 yıllık sağ, 5 yıllık sol PAAG hikayesi mevcut olup, hasta önerilen tedavileri düzenli kullanmamış. Hastanın yapılan muayenesinde sağ göz absolu glokom ve göz içi basıncı 34 mmHg, solda görme 20/200 ve göz içi basıncı 24 mmHg idi. Gonyoskopik muayenede bilateral açılar açık, ön segment muayenesinde bilateral kornea saydam, ön kamara derinlikleri normaldi. Sağda matür nükleer katarakt, solda +++ nükleer skleroz izlendi. Fundus muayenesinde sağ total optik atrofi, sol cup/disk oranı 6/10 ve sol perimetrik muayenede konsantrik daralma mevcuttu. Bu bulgularla sol göze kombine operasyonu kabul etmeyen hastaya dorzolamid, timolol kombinasyonu başlandı. Takiplerine gelmeyen hasta 3 ay sonra sol gözde görme azalması şikayeti ile tekrar kliniğimize başvurdu. Hastanın sol göz görmesi 2-3 metreden parmak sayma mesafesine düşmüştü ve kornea santralinde diffüz stromal ödem izleniyordu. Hastanın ilacı kesildi, prednizolon fosfat günde 4 damla başlandı. Yapılan pakimetride sağ kornea kalınlığı 0.53 mm, sol kornea kalınlığı ise 0.59 mm olarak ölçüldü. Daha sonraki kontrollerinde kornea ödeminin çözülmediği izlendi. Kornea endotelinde dekompensasyon riski bulunan topikal karbonik anhidraz inhibitörlerinin yaşlı hastalarda kulanılırken daha dikkatli olunması düşüncesindeyiz. ©2008, Fırat Üniversitesi, Tıp Fakültesi
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  • 2
134-136
  • Turkish

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