Mechanism of topiramate-induced acute-onset myopia and angle closure glaucoma.
METHODS
Interventional case report.


METHODS
In an institutional practice setting, two women, aged 25 and 45, developed acute myopia after starting topiramate for epilepsy. One patient also developed bilateral angle closure glaucoma.


RESULTS
Topiramate was discontinued. Anterior chamber shallowing was noted in both patients at presentation. Ultrasonography showed ciliochoroidal effusion. Baseline measurements of anterior chamber depth and lens thickness were obtained.


CONCLUSIONS
Topiramate may be associated with ciliochoroidal effusion with forward displacement of the lens-iris diaphragm and anterior chamber shallowing, resulting in acute myopia and angle-closure glaucoma. Increased lens thickness contributes only minimally (9%-16%) to anterior chamber shallowing.
Craig
Jamie E
JE
Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia. jamie.craig@flinders.edu.au
Ong
Terrence J
TJ
Louis
Damien L
DL
Wells
Jane M
JM
D000208:Acute Disease; D000328:Adult; D000867:Anterior Chamber / Q000000981:diagnostic imaging / Q000473:pathology; D000927:Anticonvulsants / Q000009:adverse effects*; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D005632:Fructose / Q000009:adverse effects* / Q000031:analogs & derivatives*; D015812:Glaucoma, Angle-Closure / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D008875:Middle Aged; D009216:Myopia / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D000077236:Topiramate; D014463:Ultrasonography
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose