Reversible Amantadine-Induced Corneal Edema-A Case Report

金鋼銨致可逆性眼角膜水腫之病例報告

楊茹雯(Ju-Wen Yang) ； 蕭靜熹(Ching-His Hsiao) ； 孫啟欽(Chi-Chin Sun) ； 馬惠康(David Hui-Kang Ma) ； 陳永豐(Phil Y. F. Chen)

《中華民國眼科醫學會雜誌》 49卷1期 (2010/03) Pp. 68-72

https://doi.org/10.30048/ACTASOS.201003.0010

摘要

目的：針對使用金鋼銨致可逆性眼角膜水腫提出病例報告。
方法：病例報告。
結果：一位64歲女性發現視力模糊一個月至本院就醫發現有眼角膜水腫的情形，當時右眼裸視為零點零九，左眼裸視為零點零七，右眼眼壓為13.5毫米汞柱，左眼眼壓為10.4毫米汞柱，雙眼結膜有微有充血，雙眼中央眼角膜水腫伴隨有點狀角膜及角膜緻密層皺褶，角膜內皮細胞顯微鏡發現雙眼的眼角膜內皮細胞密度下降，右眼平均內皮細胞密度為每平方毫米584個，左眼平均內皮細胞密度為每平方毫米460個。病人否認相關的家族史。追蹤病人過去的病史，發現病人罹患巴金森氏症，並長期接受藥物治療，使用金鋼銨每天300毫克已達年之久。回溯過去的文獻報告，關於金鋼銨引起眼角膜水腫已有數例報告。我們建議病患停止使用金鋼銨，三個月後，病患的雙眼角膜水腫消退。
結論：回顧病患的病史及用藥有助於眼角膜水腫的鑑別診斷，停止金鋼銨的使用可以使眼角膜水腫消退，關於使用金鋼銨導致眼角膜水腫，兩者的關連性值得注意。

並列摘要

Purpose: To report a case of reversible corneal edema caused by amantadine.
Method: Case report.
Result: A 64-year-old woman presented with bilateral corneal edema. Central corneal edema was noted with guttata and descemet's membrane folding. The initial visual acuities of the right and left eyes were 0.09 and 0.07, respectively. Intraocular pressures were 13.5 mmHg in the right eye and 10.4 mmHg in the left eye. Tracing the past history showed that she had suffered from Parkinson's disease for 10 years and had been under continuous medical control. The use of amantadine had been 100 mg three times daily for 3 years. Previous literature has reported the association between corneal edema and amantadine. After discontinuing the use of amantadine, bilateral corneas cleared up.
Conclusion: Reviewing the systemic medications helps in differential diagnosis of corneal edema and preventing the progression. The relation between corneal edema and amantadine warrants clinical attention.

並列關鍵字

Amantadine ； corneal edema