Anterior segment optical coherence tomography documentation of a case of topiramate induced acute angle closure (original) (raw)
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Secondary Bilateral Angle Closure Glaucoma due to Topiramate
2011
Copyright © 2011 Miguel Paciuc-Beja et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We examined a 39-year-old female with severe headache and blurred vision. She was on topiramate, 50mg once a day for one week because of migraine. Periorbital edema, chemosis, myopia, high intraocular pressures, and shallow anterior chambers were present at the initial examination. Iridocorneal angles were closed, ultrasound showed choroidal effusions. We stopped topiramate and started antiglaucoma treatment. After one week the intraocular pressure was 10mmHg in both eyes without treatment. A new ultrasound showed no choroidal effusions. Topiramate has been associated with acute secondary angle closure glaucoma as an idiosyncratic reaction to the drug. Physicians prescribing topiramate need to alert patients of this potential sig...
Oxford Medical Case Reports, 2018
This work reports on a clinical case of a female who presented with headache, bilateral eye pain and vision loss. Intraocular pressures were 40 mm Hg in the right eye and 45 mm Hg in the left eye. Optical Coherence Tomography examination shows the iridocorneal angle was collapsed and macular striae were also observed. The patient had been on topiramate due to migraines 7 days before presentation. Diagnosis for topiramate-induced acute angle closure was made in both eyes. The patient showed improvement in symptoms a few days after treatment initiation and images confirmed that the iridocorneal angle had been enlarged and macular striae had disappeared.
Topiramate-induced bilateral acute angle closure glaucoma and myopic shift
International Journal of Basic & Clinical Pharmacology, 2014
Topiramate (TPM) shows idiosyncratic adverse reaction of peripheral ciliochoroidal effusion leading to acute angle closure glaucoma (AACG), which should be diagnosed and managed at the earliest to prevent irreversible visual loss. We report, a case of TPM-induced bilateral AACG and myopic shift, which was reversed by omitting TPM and administering antiglaucoma medications.
A Rare Case of Unilateral Progressive Cataract in a Young Patient Receiving Topiramate
Case Reports in Ophthalmology, 2020
This case report presents an instance of unilateral cataract formation and its rapid progression following topiramate-induced bilateral acute angle closure. An 18-year-old female diagnosed with acute angle closure in both eyes had started treatment on the previous day at another healthcare facility. The patient presented with complaints of pain, sudden diminution of vision, excessive watering, and photophobia (both eyes) and reported the use of topiramate for headache for 10 days. There was no past history of decreased vision, trauma, uveitis, or use of steroids. Topiramate-induced bilateral secondary angle closure attack was the presumptive diagnosis. Topiramate use was stopped, and antiglaucoma drugs, topical cycloplegic, and topical steroids were started. On 1-day follow-up, clearer cornea and peripheral anterior capsular lenticular opacity of the right eye were observed. Gonioscopy showed closed angles. Anterior segment optical coherence tomography showed forward movement of the...
Bilateral Acute Angle-Closure Glaucoma Following Treatment with Topiramate for Headache
Neurology and Therapy, 2013
Introduction: This case report adds supportive evidence to the development of acute angleclosure glaucoma (AACG), a rare but serious adverse effect following the use of topiramate (TPM) for a severe headache. Case Report: A 25-year-old female reported with severe headache, suspected to be migraine, and was started on TPM 25 mg/day on the first day. However, she presented at the emergency clinic of a hospital with sudden blurring of vision and colored halos 5 days after stopping the drug, i.e., day 8. She was subjected to ophthalmic examination and was diagnosed with AACG. The intraocular pressure (IOP) was found to be elevated and she was hence started on acetazolamide 500 mg instantly, maintained on tablet acetazolamide 250 mg four times a day (QID), pilocarpine 2% eye drops QID, travoprost 0.004% once a day (OD), and dorzolamide 2% eye drops three times a day (TID). After a week's treatment, there was rapid improvement with return of IOP to normal. Conclusion: TPM-induced AACG is a rare serious adverse event leading to blindness but is preventable, when diagnosed early and by instituting appropriate treatment.
Topiramate Associated Bilateral Acute Angle Closure Glaucoma And Myopia
The Internet Journal of Ophthalmology and Visual Science
Topiramate, an oral sulphamate medication, is primarily licensed for treating epilepsy, though it is increasingly being used for treating migraine1. Studies have also established its role in treating cocaine addiction2. Topiramate is thought to potentiate the activity of GABA (-aminobutyric acid) neurotransmitter by blocking the glutamate receptors3. It also has a weak carbonic anhydrase inhibitory activity. We describe a case of acute myopia and angle closure glaucoma secondary to topiramate, used for the treatment of migraine.
Topiramate and asymptomatic ocular angle narrowing: a prospective pilot study
Eye, 2009
Purpose To investigate whether subclinical ciliochoroidal effusion and resulting asymptomatic angle narrowing occurs in patients taking topiramate, by ultrasound biomicroscopy (UBM). Methods Chinese patients aged 18-75 years for whom topiramate was indicated were recruited. Examinations including UBM were performed before and 4 weeks after commencement of topiramate. Results In this pilot of 20 eyes of 20 patients, there were no statistically significant changes in the angle parameters noted on gonioscopy or UBM, including anterior chamber depth, angle-opening distance at 500 lm, trabecular ciliary process distance, trabecular-iris angle, and scleral thickness. Conclusion Short-term use of topiramate does not induce asymptomatic angle narrowing.
Topiramate-induced Acute Transient Myopia and Angle Narrowing
Journal of the College of Physicians and Surgeons Pakistan, 2021
Sulphamate drugs, widely prescribed for various systemic conditions, are reported to have rare ocular adverse-effects, usually within weeks of initiation of treatment. Medical and drug history in such cases are of pivotal importance in reaching a proper diagnosis. This study reports three cases, which developed topiramate-induced ocular side effects. In one of the cases, although the angles were narrow in both eyes, yet intra-ocular pressure (IOP) was not high. Also, in the third case, there were no macular striae. Topiramate was immediately withheld and all cases were improved without any permanent ocular damage.
Clinical Ophthalmology, 2014
This is a case report describing recurrent intermittent acute angle closure episodes in the setting of topiramate use in a female suffering from migraines. Despite laser peripheral iridotomy placement for the pupillary block component, and the discontinuation of topiramate, the acute angle closure did not resolve in the left eye with chronic angle closure and the patient required urgent trabeculectomy. The right eye responded to laser peripheral iridotomy immediately and further improved after the cessation of topiramate. While secondary angle closure glaucoma due to topiramate use has been widely reported, its effects in patients with underlying primary angle closure glaucoma have not been discussed. Our report highlights the importance of recognizing the often multifactorial etiology of angle closure glaucoma to help guide clinical management.