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Huh, Kim, Han, and Park: Two Cases of Ocular Complications Caused by Phendimetrazine
Case Report
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(6): 895-900.

Published online: 16 June 2012

DOI: https://doi.org/10.3341/jkos.2012.53.6.895

Two Cases of Ocular Complications Caused by Phendimetrazine

Hyoun Do Huh, MD1, Jae Kyong Kim, MD1, Yong Seop Han, MD1, 2, Jong Moon Park, MD, PhD1, 2

1Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea.

2Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea.

Address reprint requests to Jong Moon Park, MD, PhD. Department of Ophthalmology, Gyeongsang National University Hospital, #79 Gangnam-ro, Jinju 660-702, Korea. Tel: 82-55-750-8167, Fax: 82-55-758-4158, parkjm@gnu.ac.kr

Received 13 May 2011       Accepted 18 April 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

The authors of the present study report treatment experience of acute myopia and branch retinal vein occlusion associated with phendimetrazine, a drug used for weight reduction.

Case summary

Case 1: A 32-year-old woman, previously devoid of ocular problems, visited our hospital with bilateral visual disturbance after taking phendimetrazine for weight reduction. Ciliochoroidal effusion and anterior shifting of the lens-iris diaphragm were observed, which resulted in a shallow anterior chamber, myopic shifting and an increase in intraocular pressure due to angle closure. The symptoms were relieved by discontinuing the use of phendimetrazine and administration of intraocular pressure-lowering agents. Case 2: A 26-year-old woman, previously devoid of ocular problems, visited our hospital with left superior visual field disturbance after taking phendimetrazine for weight reduction. The examinations revealed papilledema, disc hemorrhage and tortuous vascular changes in her left eye. Fluorescein angiography was performed, and retinal vein occlusion was diagnosed. The patient discontinued weight reduction agents and recovered while under observation.

Conclusions

Phendimetrazine, used for weight reduction, can cause acute myopia via prostaglandin synthesis and retinal venous occlusion due to vascular constriction.

Keywords: Glaucoma, Myopia, Phendimetrazine, Vascular occlusion

Figures and Tables

Figure 1
(A) Right eye B-scan of the patient at the first visit. There is small amount of ciliochoroidal effusion (arrow). (B) Left eye B-scan of the patient at the first visit. There was small amount of ciliochoroidal effusion, but not prominent (arrow). (C) Right eye B-scan of the patient at 5 days after admission. Ciliochoroidal effusion was enlarged (arrow). (D) Left eye B-scan of patient at 5 days after admission. Ciliochoroidal effusion is enlarged (arrow). (E) Right eye B-scan of the patient at 8 days after admission. Ciliochoroidal effusion was absorbed (arrow). (F) Left eye B-scan of the patient on 8 days after admission. Ciliochoroidal effusion was absorbed (arrow).
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Figure 2
(A) Right eye Pentacam test, at the first visit, shows shallow anterior chamber. (B) Left eye Pentacam test, at the first visit, shows shallow anterior chamber. (C) Right eye Pentacam test, at 5 days after admission, shows deep anterior chamber. (D) Left eye Pentacam test, at 5 days after admission, shows deep anterior chamber.
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Figure 3
(A) A right eye fundus photograph, at the first visit, shows tortuous vascular change. (B) A left eye fundus photograph, at the fist visit, shows tortuos vascular changes, retinal hemorrhages, disc hemorrhages and cotton wool spots. (C) A right eye fundus photograph, after one month, shows similar findings compaed with 1 month before. (D) A left eye fundus photograph, after one month, shows disappearing retinal hemorrhages, disc hemorrhages and cotton wool spots. (E) A right eye fluorescein angiography at mid-phase shows normal finding. (F) A left eye fluorescein angiography at mid-phase shows staining near the disc, leakage along the inferotemporal vein, papilledema, tortuous venous vascular change and blocked fluorescene near the disc, which was induced by retinal hemorrhages.
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