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KMID : 0360220090500060936
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Journal of the Korean Ophthalmological Society
2009 Volume.50 No. 6 p.936 ~ p.941
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A Case of Amantadine-Induced Corneal Edema
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Hwang Bo-Sung
Wee Won-Ryang
Lee Sang-Bumm
Cha Soon-Cheol
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Abstract
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Purpose: To report a rare case of corneal edema caused by amantadine.
Case summary: A 35-year-old man was diagnosed with hypoxic brain damage caused by ventricular fibrillation. The patient showed Parkinsonism and was started on treatment with amantadine. Thirty-seven months after the commencement of amantadine treatment, the patient suffered a corneal ulcer in his right eye, which healed with opacity and thinning after medical treatment. After healing, slit-lamp examination revealed a bilateral, epithelial and stromal edema without obvious guttae and keratic precipitates. The corneal edema did not improve with topical treatment of 5% NaCl and 0.02% fluorometholone in both eyes. Three months after leaving the hospital, the patient’s corrected visual acuity decreased to 0.2 (-2.0 Dsph -0.5 Dcyl Ax 90) in the right eye and 0.4 (-0.75 Dsph -2.0 Dcyl Ax 90) in the left eye. Amantadine medication was discontinued after discussion with the patient’s neurologist. At the 1-month follow-up, corneal examination revealed resolution of the epithelial and stromal edema in both eyes. Corrected visual acuity was improved to 0.5 (-1.5 Dsph) in the right eye and 0.7 (-1.0 Dsph -1.0 Dcyl Ax 90) in the left eye.
Conclusions: In cases of corneal edema without an obvious causative disease, the patient’s systemic medication list must be reviewed and amantadine should be considered as a possible cause.
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KEYWORD
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Amantadine, Corneal edema, Corneal endothelium, Parkinsonism
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