title: Mechanism of topiramate-induced acute-onset myopia and angle closure glaucoma.
abstract: 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.
authors.affiliation: Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia. jamie.craig@flinders.edu.au
authors.forename: Jamie E
authors.initials: JE
authors.lastname: Craig
authors.forename: Terrence J
authors.initials: TJ
authors.lastname: Ong
authors.forename: Damien L
authors.initials: DL
authors.lastname: Louis
authors.forename: Jane M
authors.initials: JM
authors.lastname: Wells
mesh_terms: 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
chemical_list: D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose