Amantadine therapy for Parkinson's Disease: In Vivo Confocal Microscopy corneal findings, case report and revision of literature.
BMC Ophthalmol
; 22(1): 211, 2022 May 10.
Article
em En
| MEDLINE
| ID: mdl-35538428
ABSTRACT
BACKGROUND:
To report a case of a patient showing bilateral corneal opacities after amantadine chronic treatment for Parkinson's Disease (PD) and corneal edema associated with intra-epithelial and -endothelial depositions. After amantadine discontinuation a complete clinical remission with only a partial ultrastructural corneal recovery was reported. CASE PRESENTATION We describe a 78-year-old man with non-medical-responding bilateral corneal edema in treatment with systemic Amantadine for PD. In vivo confocal Microscopy (IVCM) analysis revealed hyperreflective particles at the epithelial level and expanded hyperreflective keratocyte and a disarrangement of stromal lamellae; endothelial cells showed hyperreflective intracellular inclusions in central and in peripheral areas with central polymegatism and pleomorphism. After 1 and 6 months the amantadine discontinuation, the absence of bilateral corneal edema and opacities were noted at the slit lamp examination, associated with the disappearance of epithelial and stromal abnormalities, but the persistence of endothelial hyperreflective deposits with a pleomorphism and polymegatism worsening at the IVCM exam.CONCLUSION:
The evaluation of a patient's cornea 6 months after the discontinuation of systemic amantadine therapy showed a clinical complete remission, with a complete resolution of the bilateral corneal oedema. On the other hand, ultrastructurally, amantadine toxicity is a completely reversible phenomenon at the epithelial level; conversely IVCM showed persistent endothelial degradation.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Doença de Parkinson
/
Edema da Córnea
Tipo de estudo:
Diagnostic_studies
Limite:
Aged
/
Humans
/
Male
Idioma:
En
Revista:
BMC Ophthalmol
Assunto da revista:
OFTALMOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Itália