Reactions 1400 - 5 May 2012

SCitalopram

Cystoid macular oedema: case reportA 55-year-old woman developed cystoid macular

oedema (CME) while receiving citalopram [route anddosage not stated].

The woman presented with approximately 1-monthhistory of sudden onset vision deterioration in her righteye. She reported that she had been noticing tiny floaters inher right eye for 5 years, which had also eventuallyappeared in her left eye. She had received treatment forneurotic decompensation and psychotic personalityalterations 20 years earlier, and her disease had becomepoorly controlled approximately 1 year prior to the onset ofher ophthalmological symptoms. She had started receivingalprazolam and quetiapine; quetiapine treatment had notbeen well tolerated, and had been switched to citalopram,after which she had experienced tongue tingling and severefatigue. She had also developed swelling of lowerextremities, which had resolved after she receivedWobenzym. Her eye problems appeared approximately2 months after citalopram initiation. Her best correctedvisual acuity (BCVA) was 5/30 in her right eye (OD), and arelatively dense asteroid hyalosis was present in hervitreous humour bilaterally. Optical coherencetomography (OCT) and fluorescein angiographyexaminations demonstrated the occurrence of CME.

Citalopram was switched to sulpiride. The woman’s HLAantigen results were negative for B27 and A29, and positivefor B7. One month after citalopram discontinuation, shereported a mild improvement of her eyesight. Her BCVAwas 5/15 OD, the previous serous ablation of fovea was nolonger evident on OCT, and cystoid spaces in theneuroretina, and oedema had decreased. Furtherimprovement was noted 1 month later. Her BCVA was5/10 OD, and cystoid spaces in the neuroretina andoedema had completely disappeared. She no longer hadsubjective complaints another month later. Her BCVA was5/7 OD, and OCT showed practically physiologicalfindings.

Author comment: We are convinced that citalopram isthe causal factor of CME occurrence based on the negativemedical history, HLA blood test results, but especiallybecause of the rapid and complete disappearance of macularoedema after citalopram discontinuation.Alexik M. Unilateral cystoid macular edema induced by citalopram--a case report.Ceska a Slovenska Oftalmologie: Casopis Ceske Oftalmologicke Spolecnosti aSlovenske Oftalmologicke Spolecnosti 67: 136-8, No. 4, Oct 2011 [Slovakian;summarised from a translation] - Slovakia 803069756

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Reactions 5 May 2012 No. 14000114-9954/10/1400-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved