Reactions 590 - 2 Mar 1996

Clomipramine

Amaurosis fugax and glaucoma: case reportA 59-year-old woman developed monocular visual loss on

standing and angle-closure glaucoma during 5 weeks’treatment with clomipramine 75 mg/day for depression.

The woman’s loss of vision, which occurred only in her lefteye, was precipitated by rising from bed or a chair, and lasted1–5 minutes. The intraocular pressure in her left eye was43mm Hg, and 17mm Hg in her right eye. Angle closureglaucoma, precipitated by a tricyclic antidepressant, wasdiagnosed in both eyes. After laser peripheral iridectomies, theintraocular pressure was lowered in both her eyes to 17mmHg.

Two weeks later, the loss of vision recurred in the woman’sleft eye. The intraocular pressure in this eye was 38mm Hg as aresult of spontaneous closure of the iridectomy. This pressureremained at 18mm Hg after further laser treatment. Thepatient experienced no further episodes of amaurosis fugaxand continued treatment with clomipramine.

Further investigations using measurements of the woman’sfinger arterial pressure showed that during clomipraminetherapy, she had mildly impaired baroreflex-mediatedvasomotor control and parasympathetic and adrenergiccardiac control.Schlingemann RO, et al. Amaurosis fugax on standing and angle-closure glaucomawith clomipramine. Lancet 347: 465, 17 Feb 1996 - Netherlands 800425993

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Reactions 2 Mar 1996 No. 5900114-9954/10/0590-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved