Dorzolamide Induced Giant Cell Thrombocytopenia: A Case Report Of An Hitherto Unreported Condition

To report a case of topical Dorzolamide induced Giant Cell Thrombocytopenia: a hitherto unreported condition

in litreture

a tertiary level referral centre in eastern india

Methods: Carbonic anhydrase inhibitors are frequently prescribed in topical and oral forms in various types of glaucoma.

Dorzolamide eyedrops are frequently associated with ocular side effects but systemic side effects are rare with its

use.We report a case of Dorzolamide induced Giant Cell Thrombocytopenia in a patient with post uveitic angle closure

glaucoma.After discontinuation of Dorzolamide eyedrop, the thrombocytopenia reversed.

Results: To establish a casual relationship between the thrombocytopenia and Eyedrop Dorzolamide , the Naranjo

Algorithm or ADR probability score was computed as follows and the total score in our case is 7 , which implies that

there is Probable/ Very Likely causuality between topical Dorzolamide and Giant Cell Thrombocytopenia. [16]

• TOTAL ADR PROBABILITY SCORE- 7;

Probable. The reaction (1) followed a reasonable temporal sequence after a drug, (2) followed a recognized response to

the suspected drug, (3) was confirmed by withdrawal but not by exposure to the drug, and (4) could not be reasonably

explained by the known characteristics of the patient’s clinical state.

Conclusions: In conclusion, this case report highlights the potential side effects of Dorzolamide eyedrops due to

systemic absorption. Dorzolamide induced Giant Cell Thrombocytopenia is rare but can occur in patients being treated

with it. This thrombocytopenia can occur without any systemic manifestations as happened in our case. Patients should

be made aware of this potential complication and should be screened by Haemograms at regular intervals on follow up.

Also , regular punctal occlusion should be taught to the patients when they are started on dorzolamide topical

formulations as with any other Glaucoma drops . We suggest a complete haemogram every 6 months of topical carbonic

anhydrase inhibitor use.

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