Statin-Induced Diplopia: A Rare Side Effect
Total Views: 121 | Total Downloads: 78
Keywords:statin; diplopia; dyslipidemia; HMG-CoA reductase; neurology
Statin is one of the most effective medication to date in treating dyslipidemia. Moreover, statin is the most available in health clinics due to its cost-effectiveness. However, statin must be used with caution due to its severe rare side effects. Ocular disorder secondary to statin is rarely reported. In this case, statin-induced lateral gaze diplopia, worst on the left lateral gaze, was noted in a middle-aged Malay man. He had underlying dyslipidemia and was started on simvastatin 20mg at night three days before developing diplopia. He was otherwise well and had no other medical illnesses. There were no other neurological signs and abnormal ocular signs. Investigations were done and revealed no other abnormalities. The patient's symptom resolved gradually over eight weeks after discontinuation of the statin. Thus, this case highlights the important key point of anticipating this severe rare side effect of statin, which may be irreversible.
MOH. Clinical Practice Guidelines: Management of Dyslipidaemia 2017 (5th Edition). Ministry of Health Malaysia. 2017;17(July):1–107.
Stroes, E. S., Thompson, P. D., Corsini, A., Vladutiu, G. D., Raal, F. J., Ray, K. K., ... & Wiklund, O. (2015). Statin-associated muscle symptoms: impact on statin therapy. European Atherosclerosis Society consensus panel statement on assessment, aetiology and management. European heart journal, 36(17), 1012-1022.
Thapar, M., Russo, M. W., & Bonkovsky, H. L. (2013). Statins and liver injury. Gastroenterology & hepatology, 9(9), 605.
Mizranita, V., & Pratisto, E. H. (2015). Statin-associated ocular disorders: the FDA and ADRAC data. International journal of clinical pharmacy, 37(5), 844-850.
Fraunfelder, F. W., & Richards, A. B. (2008). Diplopia, blepharoptosis, and ophthalmoplegia and 3 hydroxy 3 methyl glutaryl CoA reductase inhibitor use. Ophthalmology, 115(12), 2282-2285.
Mason, R. P., Walter, M. F., & Jacob, R. F. (2004). Effects of HMG CoA reductase inhibitors on endothelial function: role of microdomains and oxidative stress. Circulation, 109(21 supply 1), 2-34.
Alves, M., Miranda, A., Narciso, M. R., Mieiro, L., & Fonseca, T. (2015). Diplopia: a diagnostic challenge with common and rare etiologies. The American journal of case reports, 16, 220.
Subramanian P., Lee M. S., Eggenberger E., Volpe N. J., Liu G. T., Bruce B. B. (2014). NIH Public Access, 120, 1–13.
Zhou, L. Y., Liu, T. J., & Li, X. M. (2016). Adult reference values of the computerized diplopia test. International journal of ophthalmology, 9(11), 1646.
Lareb bijwerkingen centrum. Statins and diplopia. 2016.
How to Cite
Copyright (c) 2021 Syed Mohideen F.B. et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.
The copyright of this article will be vested to author(s) and granted the journal right of first publication with the work simultaneously licensed under the Creative Commons Attribution 4.0 International (CC BY 4.0) license, unless otherwise stated.