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Updated: Aug 15, 2026
08:30
Glaucoma-inducing Procedure in an In Vivo Rat Model and Whole-mount Retina Preparation
Published on: March 12, 2016
Topiramate-associated acute, bilateral, secondary angle-closure glaucoma
F W Fraunfelder1, F T Fraunfelder, Edwin U Keates
1The Casey Eye Institute, Oregon Health & Science University, Portland, Oregon 97201, USA. fraunfer@ohsu.edu
Ophthalmology
|January 9, 2004
Summary
Topiramate can cause serious ocular side effects, including acute glaucoma and myopia. Early recognition and drug discontinuation are key for reversible vision abnormalities.
Area of Science:
- Ophthalmology
- Pharmacovigilance
- Drug Safety
Background:
- Topiramate is an anticonvulsant and migraine prophylactic medication.
- Ocular side effects associated with topiramate have been reported.
- Spontaneous reporting systems are crucial for identifying adverse drug reactions.
Purpose of the Study:
- To evaluate spontaneous reports of ocular side effects linked to topiramate use.
- To identify specific ocular syndromes associated with topiramate.
Main Methods:
- Retrospective case series analysis of 115 case reports.
- Data collected from multiple spontaneous reporting systems and literature.
- Causality assessment using the World Health Organization Causality Assessment Guide.
Main Results:
- Eighty-six cases of acute-onset glaucoma (83 bilateral).
- Seventeen cases of acute bilateral myopia (up to 8.75 diopters).
- Nine cases of suprachoroidal effusions, with other reported effects including periorbital edema and scleritis.
Conclusions:
- Topiramate therapy is causally linked to abnormal vision, acute secondary angle-closure glaucoma, acute myopia, and suprachoroidal effusions.
- These ocular conditions are reversible with early recognition and drug discontinuation.
- Blurring of vision may be the initial symptom of acute secondary angle-closure glaucoma; peripheral iridectomy is ineffective for this condition.
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