Amantadine-induced bilateral corneal edema: A case report and literature review

We report a case of amantadine-induced bilateral corneal edema that was initially suspected as herpes simplex keratitis in a 47-year-old female patient taking amantadine for neurological disease. The patient presented with progressive bilateral blurred vision for 2 months and was referred for corneal transplantation. Examination revealed bilateral corneal edema with Descemet’s membrane folds. Increased pachymetry showed as 744 µm in the right eye and 588 µm in the left eye. Comprehensive medication review identified amantadine use (100 mg twice daily) for 14 months. Following amantadine discontinuation, complete resolution of corneal edema occurred within 1 month, with visual acuity improving from counting fingers to 20/30 bilaterally. At 24-month follow-up, vision remained stable with normal corneal thickness. This case emphasizes the importance of comprehensive medication history in evaluating bilateral corneal edema to prevent unnecessary corneal transplantation, as amantadine-induced corneal edema is reversible when recognized promptly.