Corneal Opacity Induced by Antiglaucoma Agents Other Than Brimonidine Tartrate

The aim of this study is to report a patient with corneal opacity that developed after the use of topical antiglaucoma medications other than brimonidine tartrate (BT). An 85-year-old woman presented with corneal opacity and neovascularization in both eyes. A diagnosis of glaucoma was made 20 years...

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Main Authors: Yuka Kasuya, Ichiya Sano, Shinji Makino, Hidetoshi Kawashima
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Ophthalmological Medicine
Online Access:http://dx.doi.org/10.1155/2020/4803651
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author Yuka Kasuya
Ichiya Sano
Shinji Makino
Hidetoshi Kawashima
author_facet Yuka Kasuya
Ichiya Sano
Shinji Makino
Hidetoshi Kawashima
author_sort Yuka Kasuya
collection DOAJ
description The aim of this study is to report a patient with corneal opacity that developed after the use of topical antiglaucoma medications other than brimonidine tartrate (BT). An 85-year-old woman presented with corneal opacity and neovascularization in both eyes. A diagnosis of glaucoma was made 20 years previously, and antiglaucoma agents were prescribed (latanoprost, tafluprost, timolol maleate, travoprost, bimatoprost, ripasudil hydrochloride hydrate, and brinzolamide/timolol maleate) for both eyes. Ocular examination revealed semicircular fan-shaped corneal sterile infiltration with neovascularization. Anterior-segment optical coherence tomography (OCT) showed marked corneal opacity and thickened corneal stroma. The topical drugs were discontinued and replaced with 0.1% betamethasone eye drops. Two weeks after topical drugs were discontinued and replaced with betamethasone, the corneal sterile infiltration markedly improved, although the corneal opacity remained across the stromal layer. In addition, corneal opacity, intermixed with separate transparent sections, was observed as a striped shape. OCT showed an improvement of the thickened corneal stroma. Six weeks after the initial visit, the remaining corneal opacity could be seen as a mixture of opaque and nonopaque areas in stripes. The corneal stromal thickness decreased almost back to the normal range, while the area of the corneal opacity remained unchanged. In vivo laser confocal microscopy showed hyperreflective materials with needle-like structures in the corneal stroma. The corneal opacity showed several similarities to the previous reports of the cases treated with BT. Therefore, clinicians should be mindful of a possible development of corneal opacity in patients treated with antiglaucoma medications other than BT.
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spelling doaj-art-3851d8d9d2c343c9bf245a6d3623dbca2025-02-03T06:46:00ZengWileyCase Reports in Ophthalmological Medicine2090-67222090-67302020-01-01202010.1155/2020/48036514803651Corneal Opacity Induced by Antiglaucoma Agents Other Than Brimonidine TartrateYuka Kasuya0Ichiya Sano1Shinji Makino2Hidetoshi Kawashima3Department of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi, JapanDepartment of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi, JapanDepartment of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi, JapanDepartment of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi, JapanThe aim of this study is to report a patient with corneal opacity that developed after the use of topical antiglaucoma medications other than brimonidine tartrate (BT). An 85-year-old woman presented with corneal opacity and neovascularization in both eyes. A diagnosis of glaucoma was made 20 years previously, and antiglaucoma agents were prescribed (latanoprost, tafluprost, timolol maleate, travoprost, bimatoprost, ripasudil hydrochloride hydrate, and brinzolamide/timolol maleate) for both eyes. Ocular examination revealed semicircular fan-shaped corneal sterile infiltration with neovascularization. Anterior-segment optical coherence tomography (OCT) showed marked corneal opacity and thickened corneal stroma. The topical drugs were discontinued and replaced with 0.1% betamethasone eye drops. Two weeks after topical drugs were discontinued and replaced with betamethasone, the corneal sterile infiltration markedly improved, although the corneal opacity remained across the stromal layer. In addition, corneal opacity, intermixed with separate transparent sections, was observed as a striped shape. OCT showed an improvement of the thickened corneal stroma. Six weeks after the initial visit, the remaining corneal opacity could be seen as a mixture of opaque and nonopaque areas in stripes. The corneal stromal thickness decreased almost back to the normal range, while the area of the corneal opacity remained unchanged. In vivo laser confocal microscopy showed hyperreflective materials with needle-like structures in the corneal stroma. The corneal opacity showed several similarities to the previous reports of the cases treated with BT. Therefore, clinicians should be mindful of a possible development of corneal opacity in patients treated with antiglaucoma medications other than BT.http://dx.doi.org/10.1155/2020/4803651
spellingShingle Yuka Kasuya
Ichiya Sano
Shinji Makino
Hidetoshi Kawashima
Corneal Opacity Induced by Antiglaucoma Agents Other Than Brimonidine Tartrate
Case Reports in Ophthalmological Medicine
title Corneal Opacity Induced by Antiglaucoma Agents Other Than Brimonidine Tartrate
title_full Corneal Opacity Induced by Antiglaucoma Agents Other Than Brimonidine Tartrate
title_fullStr Corneal Opacity Induced by Antiglaucoma Agents Other Than Brimonidine Tartrate
title_full_unstemmed Corneal Opacity Induced by Antiglaucoma Agents Other Than Brimonidine Tartrate
title_short Corneal Opacity Induced by Antiglaucoma Agents Other Than Brimonidine Tartrate
title_sort corneal opacity induced by antiglaucoma agents other than brimonidine tartrate
url http://dx.doi.org/10.1155/2020/4803651
work_keys_str_mv AT yukakasuya cornealopacityinducedbyantiglaucomaagentsotherthanbrimonidinetartrate
AT ichiyasano cornealopacityinducedbyantiglaucomaagentsotherthanbrimonidinetartrate
AT shinjimakino cornealopacityinducedbyantiglaucomaagentsotherthanbrimonidinetartrate
AT hidetoshikawashima cornealopacityinducedbyantiglaucomaagentsotherthanbrimonidinetartrate