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Related Experiment Videos

Topiramate-induced bilateral angle-closure glaucoma.

Jaime Levy1, Ronit Yagev, Alena Petrova

  • 1Department of Ophthalmology, Soroka University Medical Center, Beer-Sheva, Israel. ljaime@bgu.ac.il

Canadian Journal of Ophthalmology. Journal Canadien D'Ophtalmologie
|June 13, 2006
PubMed
Summary

Topiramate, a medication for depression, can cause acute angle-closure glaucoma. This serious eye condition is typically reversible upon discontinuing the drug, highlighting the need for patient awareness.

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Area of Science:

  • Ophthalmology
  • Pharmacology

Background:

  • Topiramate is an anticonvulsant and migraine prophylaxis medication also prescribed for depression.
  • Acute angle-closure glaucoma is a medical emergency characterized by a sudden increase in intraocular pressure.

Observation:

  • A 35-year-old woman developed acute bilateral angle-closure glaucoma one week after initiating oral topiramate therapy.
  • Clinical examination revealed extremely high intraocular pressures (57 mm Hg OD, 56 mm Hg OS), bilateral shallow anterior chambers, and closed angles.
  • Ocular ultrasound demonstrated ciliochoroidal detachment, a forward lens shift, and swollen ciliary processes.

Findings:

  • Discontinuation of topiramate therapy was followed by a rapid decrease in intraocular pressure.
  • Antiglaucoma treatment was initiated and subsequently tapered.

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  • Within five days, anterior chambers deepened, and intraocular pressures normalized without ongoing medication.

    • Implications:

    • Topiramate use is associated with a risk of inducing acute bilateral angle-closure glaucoma.
    • Early recognition and drug cessation are crucial for reversing this adverse ocular event.
    • Informing patients about this potential side effect of topiramate is essential for safe prescribing practices.