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Case Reports
. 2014 Dec 4:2014:bcr2014206690.
doi: 10.1136/bcr-2014-206690.

Bilateral acute angle closure glaucoma associated with hydrochlorothiazide-induced hyponatraemia

Sylvia H Chen  1 , Rustum Karanjia  2 , Robert L Chevrier  1 , David H Marshall  3
Affiliations
Case Reports

Bilateral acute angle closure glaucoma associated with hydrochlorothiazide-induced hyponatraemia

Sylvia H Chen et al. BMJ Case Rep. .

Abstract

We report a case of a 67-year-old woman presenting with bilateral acute angle closure. On investigation, she was found to have bilateral ciliary effusions and profound hyponatraemia. Her effusions resolved with the cessation of hydrochlorothiazide and normalisation of her blood sodium levels by fluid restriction. This case displays a novel association of hyponatraemia as a possible mechanism for the development of bilateral acute angle closure.

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Figures

Figure 1
Figure 1
Indentation gonioscopy with a Sussman lens: (A) Appositional angle closure (B) with minimal peripheral anterior synechiae, (C) elongated and anteriorly rotated ciliary processes.
Figure 2
Figure 2
Ultrasound biomicroscopy reveals anterior uveal effusion: (A) longitudinal view at 9 o'clock OD, (B) transverse view at 9 o'clock OD. Resolution of effusions 1 week later: (C) longitudinal view at 9 o'clock OD, (D) transverse view at 9 o'clock OD.
See this image and copyright information in PMC

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