Topiramate-induced bilateral angle-closure glaucoma.
METHODS
We present an interventional case report of a rare occurrence of acute angle-closure glaucoma in a 35-year-old woman presenting 1 week after start of oral topiramate therapy for depression. Intraocular pressure measured 57 mm Hg OD and 56 mm Hg OS, and bilateral shallow anterior chamber and closed angles were observed. Ultrasound disclosed ciliochoroidal detachment, a closed angle with a forward shift of the lens, and swollen ciliary processes. Topiramate treatment was stopped. Antiglaucoma treatment was started and quickly tapered. After 5 days, examination showed deep anterior chambers and normal intraocular pressures with no medication.


CONCLUSIONS
Topiramate use can result in acute bilateral angle-closure glaucoma, which is usually reversible if the drug is discontinued. Patients starting topiramate therapy need to be informed of this potential risk.
Levy
Jaime
J
Department of Ophthalmology, Soroka University Medical Center, Beer-Sheva, Israel. ljaime@bgu.ac.il
Yagev
Ronit
R
Petrova
Alena
A
Lifshitz
Tova
T
D000208:Acute Disease; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015862:Choroid Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging; D005260:Female; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives*; D015812:Glaucoma, Angle-Closure / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D033401:Microscopy, Acoustic; D000077236:Topiramate
D000927:Anticonvulsants; D000959:Antihypertensive Agents; D000077236:Topiramate; D005632:Fructose