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Topiramate-induced acute bilateral angle closure and myopia: pathophysiology and treatment controversies.
MedLine Citation:
PMID:  21058272     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Christopher van Issum; Nikolaos Mavrakanas; James S Schutz; Tarek Shaarawy
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of ophthalmology     Volume:  21     ISSN:  1724-6016     ISO Abbreviation:  Eur J Ophthalmol     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110772     Medline TA:  Eur J Ophthalmol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  404-9     Citation Subset:  IM    
Affiliation:
Glaucoma Sector, Ophthalmology Department, Geneva University Hospitals, Geneva - Switzerland.
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