Phentermine Hydrochloride에 의한 급성 근시와 전방각 폐쇄 1예
A Case of Phentermine Hydrochloride Induced Acute Myopia and Acute Angle Closure
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목적: 비만치료제로 처방되고 있는 phentermine hydrochloride (푸리민^Ⓡ, 드림파마, 한국)를 복용한 뒤 양안의 급성 근시와 앞방각폐쇄가 발생한 환자 1예를 경험하였기에 국내 최초로 보고하고자 한다. 증례요약: 25세 여자가 체중 감소를 위해 3주 전부터 phentermine hydrochloride을 복용하였고, 이후 발생한 양안의 시력저하와 안통을 주소로 본원에 내원하였다. 굴절검사상 심한 근시가 동반되었고 세극등 검사상 수정체-홍채 격막의 전방 이동이 관찰되고 안저검사상 망막주름이 관찰되었다. Phentermine hydrochloride에 의한 급성 근시와 앞방각 폐쇄가 의심되어 약물 복용을 중지하고 조절마비제와 안압하강제 투여 후 증상이 소실되었다. 결론: Phentermine hydrochloride는 정확한 기전은 알 수 없으나 이전에 보고된 토피라메이트처럼 모양체-맥락막 삼출과 모양체 부종을 유발하고, 수정체-홍채 격막의 전방 이동으로 앞방이 얕아져 급성근시와 앞방각 폐쇄를 유발한 것으로 생각된다.
Abstract
Purpose: To describe a case of bilateral acute myopia and acute angle-closure associated with phentermine hydrochloride,a drug used for obesity treatment. Case summary: A 25-year-old woman visited our hospital with blurry vision and ocular pain after taking phentermine hydrochloride for three weeks. Manifest refraction accompanied myopic shift in the both eyes, slit-lamp examination showed forward displacement of the lens-iris diaphragm and fundus examination revealed retinal folds. Suspecting phentermine hydrochloride induced acute myopia and acute angle closure, discontinuation of the drug and administration of cycloplegic agents and antiglaucomatic agent successfully resolved the symptoms. Conclusions: Although the exact mechanism is unknown, phentermine hydrochloride may generate ciliochoroidal effusion and ciliary edema, lead to acute myopia and acute angle closure resulting from forward displacement of the lens-iris diaphragm.
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