Document Detail

Topiramate-induced acute bilateral angle closure and myopia: pathophysiology and treatment controversies.
MedLine Citation:
PMID:  21058272     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To discuss the unusual features of topiramate-induced acute angle closure glaucoma, its pathophysiologic mechanisms, and treatment controversies, and to report the first anterior segment optical coherence tomography (OCT) of this condition.
METHODS: Literature review and case report with OCT findings.
RESULTS: Topiramate-induced angle closure is usually bilateral and associated with acute myopia; the ocular pressure is often not very highly elevated. Ciliochoroidal detachment with ciliary body anterior rotation is typically present and was demonstrated easily in our case with anterior segment OCT. Pilocarpine exacerbates this condition and peripheral iridotomy is not indicated, nor is iridoplasty. Treatment consists of replacing topiramate with appropriate medication, strong cycloplegia, and topical steroids.
CONCLUSIONS: It is important to recognize this form of acute secondary angle closure in order to treat it properly, avoiding harmful medication and unnecessary surgery.
Christopher van Issum; Nikolaos Mavrakanas; James S Schutz; Tarek Shaarawy
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  European journal of ophthalmology     Volume:  21     ISSN:  1724-6016     ISO Abbreviation:  Eur J Ophthalmol     Publication Date:    2011 Jul-Aug
Date Detail:
Created Date:  2011-12-13     Completed Date:  2012-03-02     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  9110772     Medline TA:  Eur J Ophthalmol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  404-9     Citation Subset:  IM    
Glaucoma Sector, Ophthalmology Department, Geneva University Hospitals, Geneva, Switzerland.
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MeSH Terms
Acute Disease
Anterior Eye Segment / physiopathology*,  ultrasonography
Anticonvulsants / adverse effects*
Antihypertensive Agents / therapeutic use
Drug Combinations
Fructose / adverse effects,  analogs & derivatives*
Glaucoma, Angle-Closure / chemically induced,  drug therapy,  physiopathology*
Intraocular Pressure / physiology
Myopia / chemically induced,  drug therapy,  physiopathology*
Tomography, Optical Coherence
Visual Acuity / physiology
Reg. No./Substance:
0/Anticonvulsants; 0/Antihypertensive Agents; 0/Drug Combinations; 0H73WJJ391/topiramate; 30237-26-4/Fructose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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