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Published on: February 15, 2022
Mechanism of topiramate-induced acute-onset myopia and angle closure glaucoma
Jamie E Craig1, Terrence J Ong, Damien L Louis
1Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia. jamie.craig@flinders.edu.au
Design:
Interventional case report.
Methods:
In an institutional practice setting, two women, aged 25 and 45, developed acute myopia after starting topiramate for epilepsy. One patient also developed bilateral angle closure glaucoma.
Results:
Topiramate was discontinued. Anterior chamber shallowing was noted in both patients at presentation. Ultrasonography showed ciliochoroidal effusion. Baseline measurements of anterior chamber depth and lens thickness were obtained.
Conclusions:
Topiramate may be associated with ciliochoroidal effusion with forward displacement of the lens-iris diaphragm and anterior chamber shallowing, resulting in acute myopia and angle-closure glaucoma. Increased lens thickness contributes only minimally (9%-16%) to anterior chamber shallowing.
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