Samaneh Farnia - Psychiatry and Behavioral Sciences Research Center, Addiction Institute and Department of Psychiatry, Mazandaran University of Medical Sciences, Sari, Iran
Hamid Bazyari - Student Research Committee, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
Hanieh Ahmadi - Department of ophthalmology, School of medicine, Mazandaran University of Medical Sciences, Sari, Iran
Nasim Tabrizi - Department of Neurology, School of medicine,Mazandaran University of Medical Sciences, Sari, Iran
Athena sharifi_razavi - Department of Neurology, School of medicine,Mazandaran University of Medical Sciences, Sari, Iran
Narjes Hendouei - Department of Pharmacotherapy, Faculty of Pharmacy and Psychiatry and Behavioral Sciences Research Center, Addiction Institute, MazandaranUniversity of Medical Sciences, Sari, Iran

Exposure to selective serotonin reuptake inhibitors causes pupillary dilator muscle stimulation, active mydriasis, rapid rise in the level of the intraocular pressure (IOP), damage to the optic nerve at the back of the eye, and ultimately leads to acute angle closure glaucoma. The aim of this study was to assess the effects of sertraline on the levels of IOP and cup-to-disc ratio (CDR) in patients with anxiety disorders or mixed anxiety and depressive disorder or major depressive under daily treatment with sertraline and without underlying eye disease for three months. In this study,۳۰ eligible patients in the sertraline group and ۳۰ healthy volunteers in the control group include the study and were referred to an ophthalmologist. Ophthalmologic examinations were assessed at the baseline and on the first and third months of the study. The average daily dose of sertraline was ۹۵±۲.۵ mg.During the study, the IOP changes in the sertraline and control groups were ۰.۲۶±۰.۴۳ and ۰.۰۰±۰.۰۰ mmHg (p<۰.۰۰۱, p=NS) respectively and the CDR changes in sertraline and control groups were ۰.۰۳±۰.۰۵ and -۰.۰۱±۰.۰۵ (p=۰.۰۰۲, p=۰.۰۳) respectively. There was a significant difference in the IOP and CDR increasement between two groups ([F (۱.۷, ۱۰۴.۲) = ۳.۷, p = ۰.۰۳] and [F (۲, ۱۱۶) = ۸.۳, p < ۰.۰۰۱] respectively). In the present study, although changes in the IOP and CDR  levels in the sertraline group were significant and was equal the daily change in the persons without glaucoma or patients with normal-tension glaucoma, but the slight and continuous increase in the IOP level associated with changes in pupil size and CDR, especially in patients at risk of glaucoma in the long term, can cause a disruption in hydrodynamic homeostasis. More studies with longer duration and different dosage of sertraline need to confirm our results.

Selective serotonin, reuptake inhibitors, intraocular pressure, cup-to-disc ratio