Escitalopram-induced uveal effusions and bilateral angle closure glaucoma

Am J Ophthalmol. 2006 Jun;141(6):1144-7. doi: 10.1016/j.ajo.2006.01.033.

Abstract

Purpose: To report the onset of bilateral angle closure glaucoma resulting from ciliochoroidal effusions noted after taking escitalopram.

Design: Case report.

Methods: A 41-year-old woman with a medical history of depression was placed on escitalopram and presented with acute bilateral angle closure glaucoma. A medical history and ophthalmic examination (including slit-lamp photography and high-frequency ultrasonography) were performed at the time of diagnosis and at resolution of her symptoms.

Results: High-frequency ultrasonography revealed bilateral choroidal effusions with ciliary body detachments and angle closure. Attempts to reduce intraocular pressure with topical ocular antihypertensive drugs and subsequent laser peripheral iridotomy were unsuccessful. Over the course of four days, the use of topical cycloplegics, corticosteroids, and discontinuation of escitalopram resulted in normalization of intraocular pressures, deepening of anterior chamber depths, and resolution of her uveal effusions.

Conclusions: The use of escitalopram resulted in uveal effusions, angle rotation, and acute bilateral angle closure glaucoma. Discontinuation of escitalopram and corticosteroid therapy resulted in normalization of the patient's eyes.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Anterior Eye Segment / diagnostic imaging
  • Citalopram / adverse effects*
  • Depressive Disorder / drug therapy
  • Exudates and Transudates
  • Female
  • Functional Laterality
  • Glaucoma, Angle-Closure / chemically induced*
  • Glaucoma, Angle-Closure / diagnostic imaging
  • Glaucoma, Angle-Closure / drug therapy
  • Glucocorticoids / therapeutic use
  • Humans
  • Intraocular Pressure
  • Selective Serotonin Reuptake Inhibitors / adverse effects*
  • Ultrasonography
  • Uveal Diseases / chemically induced*
  • Uveal Diseases / diagnostic imaging
  • Uveal Diseases / drug therapy

Substances

  • Glucocorticoids
  • Serotonin Uptake Inhibitors
  • Citalopram