Phenylephrine
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Relapse of pigment epithelial defect: case report A man in his 40s developed relapsing pigment epithelial defect (PED) following use of phenylephrine for pupil dilation during eye examination. The man presented to the optometrist for evaluation of a retinal pigment epithelium (RPE) defect in the right eye. He was diagnosed with central serous chorioretinopathy-related (CSCR) PED. His left eye revealed no retinal abnormalities. He was received unspecified conservative treatment and monitored for progression. He was monitored over the following 4 years. During this time, he remained asymptomatic, except mild metamorphopsia. The PED in his right eye persisted. However, there were 2 instances where the PED resolved, but relapsed while in the clinic. On the first occasion, 18 months following his initial presentation, optical coherence tomography (OCT) revealed the absence of his PED and a small volume of residual sub-RPE fluid. However, following 1 hour, slit-lamp biomicroscopy revealed a PED in the same location as before. One hour after the first scan, a repeat OCT confirmed the PED. He was monitored for another 2 years without changes. However, his most recent visit revealed the exact same pattern. Initial OCT image revealed absence of the PED which recurred within an hour when observed on slit-lamp and a second OCT. It was hypothesised that PED resolved in between reviews before some intervention in clinic caused it to recur. On each of these occasions, he underwent undilated OCT, then received phenylephrine 2.5% to dilate pupil before waiting an hour to be examined. On the basis of this temporal association, phenylephrine might have caused the relapsing PED [outcome not stated]. Watson MJG, et al. Relapsing Pigment Epithelial Detachment in Central Serous Chorioretinopathy After Dilated Eye Examination. JAMA Ophthalmology 138: 318-319, No. 803520201 3, Mar 2020. Available from: URL: http://doi.org/10.1001/jamaophthalmol.2019.5946
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Reactions 12 Dec 2020 No. 1834
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