Choroidal detachment induced by dorzolamide 20 years after cataract surgery

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Abstract
A 70 year old white woman with a 12 year history of OH was treated effectively (intraocular pressure was 15 mm Hg in both eyes) by topical timolol 0.5 % once daily. She also had a 20 year history of bilateral extracapsular cataract extraction with no postoperative complications and no history of choroidal effusion or choroidal detachment. In February 2002, she was examined for a routine follow up. Her corrected visual acuity and intraocular pressure (IOP) were 6/10 and 22 mm Hg in both eyes. She was switched from timolol 0.5% to twice daily topical combination of timolol 0.5% and chlorhydrate dorzolamide 2%. Five days later, she came to the emergency department with headaches and ocular pain. Her corrected visual acuity was 6/10 in the right eye and 3/10 in the left eye. Her IOP was 25 mm Hg in the right and 35 mm Hg in the left eye. She had a bilateral angle closure. Ocular examination showed a bilateral choroidal detachment that was confirmed by an ocular echography. The topical combination of timolol and chlorhydrate dorzolamide was discontinued and 0.5% topical timolol once daily associated with 1% topical rimexolone four times daily were started. Five days later she was examined for follow up. Her corrected visual acuity and intraocular pressure were 6/10 and 16 mm Hg, the choroidal detachment and the functional symptoms had resolved in both eyes.