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Case Reports: Adverse drug reactions and complications
Optic atrophy secondary to minocycline-induced idiopathic intracranial hypertension
  1. Ricky Paramo1 and
  2. Lakshmi Leishangthem2
  1. 1University of Connecticut School of Medicine, Farmington, CT, USA
  2. 2Department of Neurology/Neuro-ophthalmology, UConn Health, Farmington, CT, USA
  1. Correspondence to Lakshmi Leishangthem; drleishang{at}gmail.com

Abstract

An early adolescent female presented with blurry vision, ocular ‘fullness’, pulsatile tinnitus and gait difficulty due to poor vision. She was found to have florid grade V papilloedema, 2 months after the use of minocycline for the treatment of confluent and reticulated papillomatosis for 2 months. MRI of the brain without contrast showed fullness of the optic nerve heads concerning for increased intracranial pressure, which was confirmed on lumbar puncture with an opening pressure greater than 55 cm H2O. She was initially started on acetazolamide, but due to high opening pressure and severity of visual loss, a lumboperitoneal shunt was placed in 3 days. This was complicated by a shunt tubal migration 4 months later, leading to worsening vision of 20/400 in both eyes for which she underwent shunt revision. By the time she presented to the neuro-ophthalmology clinic, she was legally blind with her exam consistent with bilateral optic atrophy.

  • Dermatology
  • Eye
  • Unwanted effects / adverse reactions
  • Neurology (drugs and medicines)
  • Neuroopthalmology

http://dx.doi.org/10.1136/bcr-2022-252731

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    Footnotes

    • Contributors Report was written by RP and LL. RP drafted the article and LL revised it critically for important intellectual content. Both authors approved the final version for publication. Manuscript writing was supervised by LL.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.