Methyl-Sulfonyl-Methane (MSM)-Induced Acute Angle Closure. Issue 4 (April 2015)

• Record Type: Journal Article
• Authors: Hwang, Jeremy C.; Khine, Kay T.; Lee, Jennifer C.; Boyer, David S.; Francis, Brian A.
• Is Part Of: Journal of glaucoma. Volume 24:Issue 4(2015:Apr./May)
• Publication Date: 2015-04
• Subjects: Glaucoma -- Periodicals; 617.741005
• DOI: 10.1097/IJG.0000000000000027
• Languages: English
• ISSNs: 1057-0829

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Purpose:</title> <p>To report the first case of presumed bilateral acute angle closure (AAC) secondary to ingestion of the dietary supplement, methyl-sulfonyl-methane (MSM).</p> </sec> <sec> <title>Patient:</title> <p>A 35-year-old woman presented with bilateral AAC 1 week after starting multiple dietary supplements, one of which contained MSM. Ultrasound biomicroscopy demonstrated bilateral anterior rotation of the iris-lens diaphragm, ciliary body edema, and choroidal effusion. Four days after discontinuation of the supplements, her angle closure and uveal effusion resolved, and her best-corrected vision recovered to 20/20 bilaterally.</p> </sec> <sec> <title>Discussion:</title> <p>Sulfa-based drugs have been reported to cause AAC, choroidal effusion, and ciliary body edema. In our patient, the coincidence of bilateral AAC with choroidal and ciliary body effusion that began 1 week after starting dietary supplements was suspicious for drug-induced AAC. The dietary supplement Basic Detox Nutrients contains MSM, the only constituent in the patient's medication list with a sulfonyl moiety. Given the similarities in chemical structure and clinical presentation, we postulate that MSM induces AAC in a manner similar to mechanisms previously described for other sulfa-based drugs.</p> </sec> <sec> <title>Conclusions:</title> <p>As MSM continues to be used and studied for its anti-inflammatory and antioxidative properties, investigators and marketers will need to be cognizant of its potential to cause AAC and provide proper warning to consumers.</p> </sec> </abstract>