pregabalin and Retinal-Diseases

A 55-year-old male presented with a complaint of a painless and sudden loss of vision in the right eye. Fundus photography revealed loss of transparency and edema in the central macular region. Optical coherence tomography showed increased reflectivity and diffused swelling in the inner retinal layers. Fluorescein angiography revealed a large area of capillary non-perfusion with a pronounced hypofluorescent area with distinct borders. To our knowledge, this is the first report of a hemorrhagic macular infarction associated with marijuana and pregabalin misuse.

Topics: Anticonvulsants; Cannabis; Ethanol; Humans; Infarction; Macula Lutea; Male; Middle Aged; Pregabalin; Prescription Drug Misuse; Retinal Diseases; Visual Acuity

To report the role of retinal hypoxia in development of diabetic macular edema and its management--a new concept.. A 24-year-old diabetic female was seen with bilateral visual blurring for 3 weeks, associated with marked diabetic macular edema, diabetic retinopathy, and non-arteritic anterior ischemic optic neuropathy (NA-AION) in both eyes. She was taking three blood pressure lowering drugs for diabetic neuropathy and nephropathy. Stopping two of those arterial hypotensive drugs, without any of the conventional treatments for diabetic macular edema, resulted in rapid improvement of visual acuity from counting fingers to 20/50 in the right eye, and from 20/80 to 20/25 in the left eye, and complete resolution of macular edema and improvement of retinopathy. Similarly, visual field defects in both eyes improved to almost normal.. The evidence from this diabetic patient suggests that hypoxia caused by fall in perfusion pressure in the retinal capillaries may be playing an important role in the development of diabetic macular edema in some, perhaps many, of these cases.

Topics: Adult; Blood Pressure; Diabetic Nephropathies; Diabetic Retinopathy; Female; Fluorescein Angiography; Follow-Up Studies; gamma-Aminobutyric Acid; Humans; Hypoxia; Insulin; Lisinopril; Macular Edema; Optic Neuropathy, Ischemic; Pregabalin; Proteinuria; Retinal Diseases; Tomography, Optical Coherence; Tramadol; Vision Disorders; Visual Acuity; Visual Field Tests; Visual Fields

Topics: Blood Pressure; Diabetic Retinopathy; Fluorescein Angiography; gamma-Aminobutyric Acid; Humans; Hypoxia; Insulin; Lisinopril; Macular Edema; Optic Neuropathy, Ischemic; Pregabalin; Proteinuria; Retinal Diseases; Retinal Vein Occlusion; Tomography, Optical Coherence; Tramadol; Vision Disorders; Visual Acuity; Visual Fields