Amantadine, corneal edema

Amantadine has also been used for the treatment of PD-related dementia (Greulich and Fenger, 1995). Amantadine has been reported to reduce the duration of levodopa-induced dyskinesia and improves motor disability in PD. Although some beneficial effects are noted in patients after amantadine treatment, this drug is known to induce corneal edema that begins few months to several years after institutional therapy (Jeng et al., 2008). 

Hood CT, Langston RH, Schoenfield LR, Dupps WJ Jr. Amantadine-associated corneal edema treated with Descemet s stripping automated endothelial keratoplasty. 

French DD, Margo CE. Postmarketing surveillance of corneal edema, Fuchs dystrophy, and amantadine use in the Veterans Health Administration. Cornea 2007 26 1087-9. 

Case reports Three patients who took amantadine developed diffuse corneal edema [272 ]. In two cases the symptoms started within a few weeks and in the third case after 6 years. In the first two cases withdrawal of amantadine resulted in resolution of the corneal edema. However, the other patient received a full-thickness corneal transplant while still taking amantadine, and edema developed in the grafted cornea withdrawal of amantadine then resulted in resolution of the comeal edema in both eyes, but the ungrafted comeal eventually also became edematous, requiring transplantation. Histopathology showed significant loss of endothelial cells. As in the last of these cases, another report documented comeal edema in a corneal transplant until amantadine withdrawn [273" ]. 

A 74-year-old woman took amantadine for 8 years without problems after a break she started taking it again and after a further 2 years developed bilateral corneal edema, which resolved within 1 month of withdrawal [276 ]. 

A 52-year-old woman with Parkinson s disease who had taken amantadine for 6 years developed bilateral comeal edema for 2 months amantadine was withdrawn and the edema resolved amantadine was reintroduced and the corneal edema recurred amantadine was then permanently withdrawn and the comeal edema again resolved [277 ]. 

A 12-year-old girl took amantadine HCl 100 mg bd for 4 months and developed bilateral blurred vision which progressed. She had corneal edema and the central corneal thicknesses were 851 pm in the right eye and 886 pm in the left eye (reference range 509-613) [278 ]. 

A 39-year-old woman developed bilateral corneal edema after taking amantadine for 2 months [279 ]. Corneal thicknesses were 940 pm in the right eye and 802 pm in the left. There was diffuse stromal edema, folds in Des-cemet s membrane, and microcystic subepithe-lial edema. Specular microscopy showed significant pleomorphism and polymegathism with an endothelial cell count of 1504 cells in the right eye and 1596 in the left eye. 

Blanchard DL. Amantadine caused corneal edema. Cornea 1990 9(2) 181. 

Jeng BH, Galor A, Lee MS, Meisler DM, Hollyfield JG, Schoenfield L, McMahon JT, Langston RH. Amantadine-associated corneal edema potentially irreversible even after cessation of the medication. Ophthalmology 2008 115(9) 1540. ... 

Koenig SB, McDermott ML, Simons KB. Nonimmunologic graft failure after Desce-met s stripping automated endothelial keratoplasty (DSAEK) for presumed amantadine-induced corneal edema. Eye Contact Lens 2009 35(4) 209-11. 

Hughes B, Feiz V, Flynn SB, Brodsky MC. Reversible amantadine-induced corneal edema in an adolescent. Cornea 2004 23 (8) 823-4. 

Dubow JS, Rezak M, Berman AA. Reversible corneal edema associated with amantadine use an unrecognized problem. Mov Disord 2008 23(14) 2096-7. 

Esquenazi S. Bilateral reversible corneal edema associated with amantadine use. J Ocul Pharmacol Ther 2009 25(6) 567-70. 

Ghaffariyeh A, Honarpisheh N. Amantadine-associated corneal edema. Parkinsonism Relat Disord 2010 16(6) 427. 

Naumann GO, Schlotzer-Schrehardt U. Amantadine-associated corneal edema. Ophthalmology 2009 116(6) 1230-1. 

Santiago-Caban LA, Rivera E, Lopez-Beauchamp V. Bilateral corneal edema secondary to amantadine in the pediatric population a case report. Bol Asoc Med P R 2012 104(l) 69-76. 

Rarely, amantadine causes visual impairment due to corneal abrasions, local edema, and superficial keratitis (14). 

A 14-year-old boy with a tremor took amantadine and developed comeal edema. The corneal thickness was over 900 pm [274 ]. The edema rapidly resolved after withdrawal and the corneal thickness returned to normal. 

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