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Acute bilateral simultaneous angle closure glaucoma after topiramate administration: a case report
Kakarla V Chalam1, Tina Tillis, Farhana Syed
1Department of Ophthalmology, University of Florida-Jacksonville, Jacksonville, USA. kchalam@jax.ufl.edu
Journal of Medical Case Reports
|January 10, 2008
Summary
Oral topiramate can cause severe acute angle closure glaucoma, leading to vision loss. Prompt discontinuation of topiramate and glaucoma treatment can restore vision and normalize eye pressure.
Area of Science:
- Ophthalmology
- Pharmacology
Background:
- Topiramate, an oral medication, has been linked to ocular side effects.
- Severe acute bilateral angle closure glaucoma with complete visual loss is a rare but serious complication.
Purpose of the Study:
- To report a case of acute angle closure glaucoma induced by oral topiramate.
- To highlight the mechanism and management of topiramate-induced glaucoma.
Main Methods:
- A case presentation of a 34-year-old woman with sudden vision loss after topiramate dosage increase.
- Clinical examination including visual acuity, intraocular pressure measurement, gonioscopy, and B-scan ultrasound.
- Management involved drug discontinuation and medical/surgical glaucoma therapy.
Main Results:
- The patient presented with severe visual loss, elevated intraocular pressures, and signs of angle closure.
- B-scan ultrasound revealed annular peripheral choroidal effusions.
- Discontinuation of topiramate and glaucoma treatment led to normalization of intraocular pressure and significant visual recovery.
Conclusions:
- Topiramate can induce ciliochoroidal effusions, leading to acute angle closure glaucoma.
- Early recognition and management are crucial for visual recovery.
- This case underscores the importance of considering medication side effects in patients presenting with acute visual changes.
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