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[Severe ocular side effects with Topamax].

V M Asensio-Sánchez1, B Torreblanca-Agüera, S Martínez-Calvo

  • 1Hospital General, Medina del Campo, Valladolid, España. vasensio@hmdc.sacyl.es

Archivos De La Sociedad Espanola De Oftalmologia
|June 29, 2006
PubMed
Summary
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Topiramate can cause severe ocular side effects, including homonymous hemianopia and irreversible maculopathy. These adverse reactions necessitate treatment discontinuation.

Area of Science:

  • Ophthalmology
  • Neurology
  • Pharmacology

Background:

  • Topiramate is an anticonvulsant medication used for epilepsy and migraine prevention.
  • Ocular side effects are known but severe reactions are less common.

Observation:

  • Two cases of severe ocular adverse events during topiramate therapy are presented.
  • A 16-year-old female developed homonymous hemianopia.
  • A 24-year-old female developed bilateral maculopathy.

Findings:

  • Topiramate treatment led to significant visual field defects and retinal changes.
  • One patient experienced homonymous hemianopia after 12 weeks of treatment.
  • The other patient developed irreversible bilateral maculopathy after 8 weeks of treatment.

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Implications:

  • Clinicians should be vigilant for ocular toxicity in patients on topiramate.
  • Prompt recognition and discontinuation of topiramate are crucial.
  • Maculopathy associated with topiramate may result in permanent vision loss.