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Topiramate-induced angle closure with acute myopia, macular striae
S Natesh1, S K Rajashekhara, A S D Rao
1Departments of Vitreoretina, Glaucoma and Cataract and Refractive Surgery Narayana Nethralaya, Bangalore, India.
Oman Journal of Ophthalmology
|July 8, 2010
Summary
Topiramate can cause acute myopia, angle closure, and macular striae, even at low doses. Optical Coherence Tomography (OCT) documented these topiramate side effects and their resolution.
Area of Science:
- Ophthalmology
- Neurology
Background:
- Topiramate, a sulfamate-substituted monosaccharide, is prescribed for seizures and migraine prophylaxis.
- Ocular side effects associated with topiramate include bilateral angle closure, acute myopia, and macular striae.
Observation:
- A young adult presented with acute myopia, angle closure, and macular striae.
- Ultrasound biomicroscopy (UBM) was used to diagnose the shallow anterior chamber, ruling out other potential causes.
Findings:
- This case report details topiramate-induced acute myopia with angle closure and macular striae.
- It is the first report to document striae formation from low-dose topiramate using Optical Coherence Tomography (OCT).
- The resolution of these striae was also visualized by OCT.
Implications:
- This study highlights the potential for topiramate to cause significant ocular side effects, even at lower therapeutic doses.
- OCT imaging is valuable for diagnosing and monitoring topiramate-induced macular striae.
- Ophthalmologists should consider topiramate as a potential cause of acute myopia and angle closure in patients.
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