dorzolamide and Choroid-Diseases

To report the variability of clinical findings, rapid concentric progression, and successful treatment of macular edema in autosomal dominant vitreoretinochoroidopathy (ADVIRC) associated with a heterozygous c.256G > A missense mutation in the bestrophin-1 (BEST1) gene.. Three affected members of a four-generation ADVIRC family were examined with fundus autofluorescence (FAF), near-infrared autofluorescence (NIA) and spectral domain optical coherence tomography (SD-OCT). Direct sequence analysis of coding and flanking intronic regions of the BEST1 gene was performed.. Disease manifestations presented with high variability with visual problems manifesting between 10 and 40 years of age. Two probands showed marked signs of peripheral degeneration, while this retinal area was not noticeably affected in the third. Cystoid macular edema was present in one proband, which responded to long-term treatment with topic dorzolamide with improved visual acuity. FAF and NIA revealed mid-peripheral retinal degeneration in areas that appeared normal on ophthalmoscopy. The full-field ERG was markedly reduced in two probands. Within a 5-year period a marked increase in concentric progression of degeneration including the posterior pole was documented with FAF, NIA and SD-OCT in one proband after the age of 63 years. Direct sequence analysis of the BEST1 gene revealed a heterozygous c.256G > A missense mutation in the three affected probands.. The findings in this family emphasize the previously noted variability of clinical manifestations in BEST1-associated ADVIRC and the relevance of FAF and NIA imaging. Cystoid macular edema and vascular leakage can be successfully treated using dorzolamide.

Topics: Adult; Bestrophins; Carbonic Anhydrase Inhibitors; Child; Chloride Channels; Choroid Diseases; Disease Progression; Electroretinography; Eye Diseases, Hereditary; Eye Proteins; Female; Fluorescein Angiography; Follow-Up Studies; Fundus Oculi; Genes, Dominant; Humans; Macular Edema; Male; Middle Aged; Mutation, Missense; Optical Imaging; Pedigree; Polymerase Chain Reaction; Retinal Degeneration; Sequence Analysis, DNA; Sulfonamides; Thiophenes; Tomography, Optical Coherence; Visual Acuity

Topics: Aged; Antihypertensive Agents; Choroid Diseases; Female; Fluorescein Angiography; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Sulfonamides; Thiophenes; Visual Acuity

Hypotony with choroidal detachment is a rare complication of glaucoma medication. In this study, we report on a case which supports the hypothesis that has been proposed to explain this phenomenon.. This study was designed as an observational case report.. A woman with chronic glaucoma underwent trabeculectomy on both eyes. Low intraocular pressure (IOP) developed in 1 eye only, with no visual change for many years. After cataract surgery, the IOP increased, necessitating treatment with topical timolol 0.5% and dorzolamide 2%. She developed monocular hypotony and choroidal detachment 3 months later. This complication occurred in the eye that had previously had a low IOP and resolved completely when topical medication was stopped. The choroidal detachment recurred when rechallenged with the same medication.. Topical aqueous suppression therapy can result in hypotony and choroidal detachment in an eye in which relatively low IOP has been maintained for many years after glaucoma filtration surgery. The problem resolves on stopping the medication.

Topics: Adrenergic beta-Antagonists; Antihypertensive Agents; Carbonic Anhydrase Inhibitors; Cataract Extraction; Choroid Diseases; Chronic Disease; Drug Interactions; Drug Therapy, Combination; Female; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Latanoprost; Middle Aged; Ocular Hypotension; Ophthalmic Solutions; Prostaglandins F, Synthetic; Recurrence; Sulfonamides; Thiophenes; Timolol; Trabeculectomy

Choroidal detachment is a known complication of topical hypotensive agents when used to treat eyes sensitized by prior surgery. We document the abrupt development of an extensive choroidal detachment after initiation of dorzolamide therapy in a surgically untreated eye with primary open-angle glaucoma.. Observational case report.. A 76-year-old woman with primary open-angle glaucoma and no history of ocular surgery developed a choroidal detachment 12 hours after initiation of therapy with dorzolamide eye drops. Choroidal detachment was diagnosed clinically and confirmed by echography.. Withdrawal of the drug and initiation of corticosteroid drops resulted in prompt resolution of the choroidal detachment.. Choroidal detachment can occur in surgically untreated eyes after use of a topical carbonic anhydrase inhibitor.

Topics: Aged; Antihypertensive Agents; Carbonic Anhydrase Inhibitors; Choroid Diseases; Female; Glaucoma, Open-Angle; Humans; Sulfonamides; Thiophenes; Ultrasonography

Topics: Aged; Antihypertensive Agents; Cataract Extraction; Choroid Diseases; Drug Therapy, Combination; Female; Humans; Ocular Hypertension; Sulfonamides; Thiophenes; Timolol

Topics: Administration, Topical; Aged; Carbonic Anhydrase Inhibitors; Choroid Diseases; Ciliary Body; Female; Filtering Surgery; Glaucoma; Humans; Intraocular Pressure; Ocular Hypotension; Ophthalmic Solutions; Sulfonamides; Thiophenes; Ultrasonography; Uveal Diseases