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Author: Admin | 2025-04-28
Pilocarpine should be avoided. In addition to lowering IOP in the acute phase of the attack, cycloplegics and topical steroids are also indicated to reduce vascular permeability within the uvea itself. Peripheral iridotomy is of no use, as primary pupillary block is not the cause of topiramate-induced angle closure. Myopic shifts may occur as a result of the same mechanism as the angle closure. Acute-onset maculopathy and transient, non-specific visual field defects have also been reported. DMARDsDisease-modifying anti-rheumatic drugs, or DMARDs, is a clinically descriptive term designating a family of medications whose therapeutic effects were first associated with rheumatoid arthritis. In fact, DMARDs are used to treat other inflammatory/autoimmune diseases as well, such as psoriasis and Crohn’s disease.21 The member of the DMARD family that is most well-known for its ocular side effects is the antimalarial drug Plaquenil (hydroxychloroquine, Sanofi Canada). Routine evaluations for its characteristic bull’s eye maculopathy, and daily visual monitoring on the part of the patient are necessary to prevent this permanent and potentially visually-impairing sequela. Fundus photography, visual field studies, fundus autofluorescence and multifocal electroretinogram (mfERG) studies have all shown value in detecting bull’s eye maculopathy. In the past decade or so, SD-OCT studies have become popular as a means of objectively assessing early retinal damage with a high resolution on the order of just a few microns. In 2011, SD-OCT was added to the American Academy of Ophthalmology’s clinical guidelines for detecting hydroxychloroquine and chloroquine toxicity.22 Trexall (methotrexate, Barr Laboratories) was first developed as a
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