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Memantine-Associated Corneal Endothelial Dysfunction

Matthew T. Feng, MD1; Francis W. Price Jr, MD1; Yuri McKee, MD1; Marianne O. Price, PhD2
[+] Author Affiliations
1Price Vision Group, Indianapolis, Indiana
2Cornea Research Foundation of America, Indianapolis, Indiana
JAMA Ophthalmol. 2015;133(10):1218-1220. doi:10.1001/jamaophthalmol.2015.2476.
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This case report describes corneal endothelial dysfunction in a patient being treated with memantine for Alzheimer disease.

Alzheimer disease (AD) is the most common type of dementia and a growing public health concern. Its estimated prevalence in the United States is 5.2 million cases and is projected to exceed 13 million cases by 2050.1 With no cure available, therapy is palliative via modulation of acetylcholine and glutamate. Current treatment patterns favor cholinesterase inhibitors and N-methyl-d-aspartate (NMDA) receptor antagonists, respectively.2

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Figure 1.
Diagram Juxtaposing the Adamantanes

The chemical structures of amantadine (A) and its congener memantine (B), which possesses additional methyl groups (red) at the 3- and 5-carbon positions. NH2 indicates amine group.

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Figure 2.
Optical Coherence Tomographic Images of the Patient’s Right Eye Showing 3 Consecutive Descemet Membrane Endothelial Keratoplasty Grafts From Unrelated Donors

A-C, While the patient was being treated with memantine, all grafts were diffusely detached (arrowheads) on their respective second postoperative days. Multiple air injections failed prior to memantine washout. D, After memantine washout and intracameral air injection, the third graft (C) attached and edema resolved in the recipient (D).

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