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OPHTHALMIC IMAGE
Year : 2020  |  Volume : 68  |  Issue : 9  |  Page : 1972

Batman in the anterior chamber: Retracting fibrin on anterior segment optical coherence tomography


Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India

Date of Web Publication20-Aug-2020

Correspondence Address:
Dr. Mudit Tyagi
Uveitis and Ocular Immunology Services, Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Banjara Hills, Hyderabad - 500 0034, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1243_20

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How to cite this article:
Reddy S, Tyagi M, Govindhari V. Batman in the anterior chamber: Retracting fibrin on anterior segment optical coherence tomography. Indian J Ophthalmol 2020;68:1972

How to cite this URL:
Reddy S, Tyagi M, Govindhari V. Batman in the anterior chamber: Retracting fibrin on anterior segment optical coherence tomography. Indian J Ophthalmol [serial online] 2020 [cited 2020 Sep 25];68:1972. Available from: http://www.ijo.in/text.asp?2020/68/9/1972/292513



A 45-year-old female developed a bilateral grade 4 anterior chamber (AC) inflammation after using topiramate 100 mg once daily for 1 week for her epilepsy. Her best-corrected visual acuity (BCVA) was counting fingers close to face (CFCF) in both eyes. Topiramate was discontinued [1] and she was started on intense topical steroids and cycloplegics. At 1 week, her BCVA improved to 20/60 and AC showed reduced reaction with retracting fibrin [Figure 1]a. An AS-OCT showed multiple hyperreflective dots [2] (cells) surrounded by a boundary of fused hyperreflective dots [Figure 1]b suggestive of enmeshed coagulum of fibrin (yellow arrow) in the shape of a bat.
Figure 1: (a) Diffuse slit lamp photograph showing fibrinous anterior uveitis, (b) AS-OCT showing retracting fibrin (yellow arrow) in the shape of a bat

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Our case demonstrates that topiramate cause drug-induced uveitis and angle closure.[1] Anterior segment OCT can be used in the documentation of AC reaction and can also aid in quantification along with existing slit lamp grading.[2]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Jabbarpoor Bonyadi MH, Soheilian R, Soheilian M. Topiramate-induced bilateral anterior uveitis associated with hypopyon formation. Ocular Immunol Inflamm 2011;19:86-8.  Back to cited text no. 1
    
2.
Li Y, Lowder C, Zhang X, Huang D. Anterior chamber cell grading by optical coherence tomography. Invest Ophthalmol Vis Sci 2013;54:258-65. Published 2013 Jan 9.  Back to cited text no. 2
    


    Figures

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