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Secondary Bilateral Angle Closure Glaucoma due to Topiramate
Miguel Paciuc-Beja1, Myriam Retchkiman-Bret, Cecilio Francisco Velasco-Barona
1Eye Clinic, Denver Health and Hospital Authority, Davis Pavillion, Colorado, 777 Bannock Street, Denver, CO 80204, USA.
Case Reports in Ophthalmological Medicine
|May 19, 2012
Summary
Topiramate can cause acute secondary angle closure glaucoma, a rare side effect. Prompt discontinuation and treatment can reverse this serious vision-threatening condition.
Area of Science:
- Ophthalmology
- Neurology
- Pharmacology
Background:
- Topiramate is an anticonvulsant and migraine prophylactic medication.
- It is known to have various side effects, including ocular manifestations.
Observation:
- A 39-year-old female presented with severe headache and blurred vision after one week of topiramate use.
- Clinical examination revealed periorbital edema, chemosis, myopia, elevated intraocular pressures, and shallow anterior chambers.
- Ocular ultrasound demonstrated choroidal effusions.
Findings:
- The patient was diagnosed with acute secondary angle closure glaucoma.
- Discontinuation of topiramate and initiation of antiglaucoma treatment led to normalization of intraocular pressure and resolution of choroidal effusions within one week.
- This suggests an idiosyncratic reaction to topiramate.
Implications:
- Topiramate can induce acute secondary angle closure glaucoma through an idiosyncratic mechanism.
- Ophthalmologists and neurologists should be aware of this potential sight-threatening adverse drug reaction.
- Patient education regarding this risk is crucial for early detection and management.
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