Bilateral Cataract after Taking Oxcarbazepine

Hyo Jeong Kim; Na Yeon Jung; Chan Min Yang; Tae-Young Chung; Dong Hui Lim

doi:10.3341/jkos.2019.60.5.486

Journal List > J Korean Ophthalmol Soc > v.60(5) > 1122601

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Kim, Jung, Yang, Chung, and Lim: Bilateral Cataract after Taking Oxcarbazepine

Case Report

Journal of the Korean Ophthalmological Society 2019; 60(5): 486-490.

Published online: 15 May 2019

DOI: https://doi.org/10.3341/jkos.2019.60.5.486

Bilateral Cataract after Taking Oxcarbazepine

Hyo Jeong Kim, MD¹, Na Yeon Jung, MD¹, Chan Min Yang, MD¹, Tae-Young Chung, MD, PhD¹, Dong Hui Lim, MD, PhD^1,²

¹Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

²Department of Preventive Medicine, Graduate School, The Catholic University of Korea, Seoul, Korea.

Address reprint requests to Dong Hui Lim, MD, PhD. Department of Ophthalmology, Samsung Medical Center, #81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. Tel: 82-2-3410-5478, Fax: 82-2-3410-0074, ldhlse@gmail.com

Received 7 June 2018 Revised 25 August 2018 Accepted 23 April 2019

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report a case of bilateral posterior subcapsular cataract after taking oxcarbazepine (Trileptal®, Novartis, Basel, Swiss).

Case summary

A 19-year-old female visited our clinic with decreased vision in both eyes. Her best-corrected visual acuity was 0.3 in the right eye and 0.5 in the left eye, and slit-lamp examination revealed a bilateral cortical opacity and subcapsular cataract. She had been taking oxcarbazepine for epilepsy for 10 years, which was discontinued 3 years ago. Her mother had undergone cataract surgeries when she was approximately 46 years of age. No other risk factors for cataract were present.

Conclusions

In the present case, bilateral cortical opacity and subcapsular cataract were assumed to be associated with the use of oxcarbazepine. We suggest that oxcarbazepine could induce a cataract and recommend a regular follow-up by a qualified ophthalmologist.

Keywords: Anti epileptic drugs, Oxcarbazepine, Subcapsular cataract

Figures and Tables

Figure 1

Molecular structure of oxcarbazepine (10, 11-Dihydro-10-oxo-5H dibenzazepine-5-carboxamide). Oxcarbazepine is a structural derivative of carbamazepine, with a ketone in place of the carbon-carbon double bond on the dibenzazepine ring at the 10 position.

Figure 2

Anterior segment photography at the first visit. It shows cortical opacity and subcapsular cataract on her both eyes.

Figure 3

Optical coherence tomography and ultra-wide-field imaging at the first visit. (A) Disc and macular are clear and flat at bilateral retina. (B) The retina is within normal limit on ultra-wide-field imaging.

Figure 4

The chemical structures of oxcarbazepine and 10-monohydroxy metabolite (MHD). Oxcarbazepine is metabolized to MHD in human liver. MHD inhibits the cytochrome P450, which play a pivotal role in drug metabolism. The poor coupling of the cytochrome P450 catalytic cycle results in the continuous production of reactive oxygen species (ROS) which may oxidize the protein in the crystalline lens, and consequently creating cataracts.

Notes

This work was supported by the National Research Foundation of Korea grant funded by the Korea government Ministry of Education (NRF-2018R1D1A1A02045884; Seoul, Korea), which was received by DHL.

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