To report angiographic findings of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion.


Slit lamp examination, intraocular pressure (IOP) measurement, ultrasound biomicroscopy (UBM), fluorescein angiography (FAG) and Indocyanine green angiography (ICGA) were performed in 4 patients who had acute drug-induced angle closure with ciliochoroidal effusion.


Four patients presented with bilateral decreased vision and ocular pain after medication of mefenamic acid, phendimetrazine tartrate, topiramate and methazolamide respectively. All patients showed shallow anterior chamber and elevated IOP (36-60mmHg) with myopic shift (-0.5 to -17.0 diopters) in both eyes. UBM revealed annular ciliochoroidal effusion with diffuse thickening of the ciliary body in all cases. We analyzed angiographic findings into 2 major sign (multiple hypofluorescent dark dots, multiple pinpoint hyperfluorescence in the late phase) and 4 minor signs (tortous and dilated retinal vessels, peripheral retinal vascular leakage, early choroidal stromal vessel hyperfluorescence and leakage, diffuse hyperfluorescence in intermediate phase of ICGA). The angiographic findings were disappeared within 1 months after cessation of systemic drugs in all cases.


Angiographic features of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion revealed that extravascular fluid accumulation in the choroidal layer involves its pathogenesis.

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Jae Pil Shin