Presumed topiramate-induced bilateral acute angle-closure glaucoma.
OBJECTIVE
We describe a case of bilateral angle-closure glaucoma associated with oral topiramate therapy.


METHODS
Interventional case report. Case report with echographic illustration.


RESULTS
A 51-year-old man developed bilateral acute angle-closure glaucoma 2 weeks after beginning topiramate therapy for bipolar affective disorder. Laser peripheral iridotomy was performed in the right eye without resolution of the acute attack. Echography revealed lens thickening and ciliochoroidal detachments in both eyes. Visual acuity, intraocular pressure, and anterior and posterior segment anatomy normalized 2 weeks after cessation of topiramate therapy.


CONCLUSIONS
Topiramate, a new sulfa-derivative antiepileptic medication, may cause idiosyncratic ciliochoroidal detachments and ciliary body edema leading to anterior displacement of the lens-iris diaphragm, lens thickening, and acute angle-closure glaucoma.
Banta
J T
JT
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida, USA.
Hoffman
K
K
Budenz
D L
DL
Ceballos
E
E
Greenfield
D S
DS
D000208:Acute Disease; D000284:Administration, Oral; D000927:Anticonvulsants / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000188:drug therapy; D015862:Choroid Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging; D005632:Fructose / Q000009:adverse effects* / Q000031:analogs & derivatives; D015812:Glaucoma, Angle-Closure / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D000077236:Topiramate; D014463:Ultrasonography; D014792:Visual Acuity
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose