Sumatriptan-induced angle-closure glaucoma: A case report

Medicine (Baltimore). 2017 Jun;96(22):e6953. doi: 10.1097/MD.0000000000006953.

Abstract

Rationale: Drug-induced bilateral angle-closure glaucoma is a rare event and should be treated correctly and promptly to prevent visual loss.

Patient concerns: We report a rare case of sumatriptan-induced bilateral angle-closure glaucoma in a young woman with migraine, and explore the possible mechanism.

Diagnoses: We describe the clinical outcome of a patient with sumatriptan-induced bilateral angle-closure glaucoma. The patient presented with bilateral acute elevation of intraocular pressure (IOP) and myopic shift.

Interventions: The clinical symptoms and signs resolved rapidly after treatment with a topical cycloplegic agent, topical steroid, and aqueous suppressant.

Outcomes: Based on the suspicious of malignant glaucoma, we prescribed topical phenylephrine, whose application immediately lowered the IOP. All symptoms resolved after treatment with a long-acting cycloplegic agent, topical steroid, and aqueous suppressant for 3 days.

Lessons: We presume that the mechanism underlying sumatriptan-induced bilateral angle-closure glaucoma may be correlated to the malignant glaucoma. Timely diagnosis and appropriate treatment are essential for resolving this ophthalmic emergency.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Female
  • Glaucoma, Angle-Closure / chemically induced*
  • Glaucoma, Angle-Closure / diagnostic imaging
  • Glaucoma, Angle-Closure / drug therapy
  • Humans
  • Migraine Disorders / complications
  • Migraine Disorders / drug therapy
  • Sumatriptan / adverse effects*
  • Sumatriptan / therapeutic use
  • Vasoconstrictor Agents / adverse effects*
  • Vasoconstrictor Agents / therapeutic use

Substances

  • Vasoconstrictor Agents
  • Sumatriptan