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Topiramate-associated acute, bilateral, angle-closure glaucoma: case report
Lucas Barasnevicius Quagliato1, Kleyton Barella, José Maria Abreu Neto
1Fundação João Penido Burnier, Campinas (SP) - Brazil. lucasquagliato@yahoo.com.br
Arquivos Brasileiros De Oftalmologia
|July 2, 2013
Summary
Topiramate can cause acute bilateral angle-closure glaucoma, a rare side effect. Prompt treatment, including medication and laser iridotomy, led to full recovery after discontinuing topiramate.
Area of Science:
- Ophthalmology
- Pharmacology
Background:
- Topiramate is an anticonvulsant and migraine prophylactic medication.
- Acute angle-closure glaucoma is a medical emergency characterized by a sudden increase in intraocular pressure.
Observation:
- A 55-year-old woman developed bilateral acute angle-closure glaucoma one week after initiating topiramate therapy.
- Symptoms included blurry vision, ocular pain, and conjunctival injection with elevated intraocular pressure (48 mmHg).
Findings:
- The condition was attributed to topiramate-induced uveal effusion and lens forward displacement.
- Treatment involved topical and systemic medications, intravenous mannitol, and YAG laser iridotomy.
- Discontinuation of topiramate and medical intervention resulted in complete recovery within one week.
Implications:
- This case highlights a rare but serious adverse effect of topiramate.
- Ophthalmologists should consider topiramate as a potential cause of acute angle-closure glaucoma in patients presenting with these symptoms.
- Early recognition and management are crucial for preserving vision.
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