J Korean Ophthalmol Soc.  2012 Jun;53(6):895-900.

Two Cases of Ocular Complications Caused by Phendimetrazine

• Huh HD
• Kim JK
• Han YS
• Park JM

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.

Keyword

Glaucoma; Myopia; Phendimetrazine; Vascular occlusion

MeSH Terms

Adult
Anterior Chamber
Constriction
Diaphragm
Eye
Female
Fluorescein Angiography
Glaucoma
Hemorrhage
Humans
Intraocular Pressure
Morpholines
Myopia
Papilledema
Retinal Vein Occlusion
Retinaldehyde
Visual Fields
Weight Loss
Morpholines
Retinaldehyde

Figure

• 

  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).

• 

  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.

• 

  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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