Bilateral acute onset myopia and angle closure glaucoma after oral topiramate: a case report.
OBJECTIVE
Describe bilateral acute onset myopia and angle-closure glaucoma as ocular adverse effects of topiramate.


METHODS
A 23 year-old woman developed bilateral severe blurred vision seven days after initiating therapy with topiramate. Her visual acuity was counting fingers in both eyes. Intraocular pressures were 33 mmHg and 32 mmHg in the right and left eyes, respectively, with conjunctival chemosis, corneal edema, shallow anterior chambers, and closed angles. Her refraction was -7.50 diopters in both eyes. The symptoms and clinical findings resolved completely upon discontinuation of topiramate and, administration of antiglaucoma drugs.


CONCLUSIONS
Topiramate use can result in acute bilateral angle-closure glaucoma and myopia, which are usually reversible upon cessation of the drug. Visual outcome is usually good and the episode resolves within a few weeks. Thus, it is important for clinicians to recognize these conditions and educate patients about these serious adverse effects when prescribing topiramate.
Boonyaleephan
Sumalee
S
Department of Ophthalmology, Faculty of Medicine, Srinakharinwirot, University, 62 Moo 7 Rangsit-Nakhonnayok Rd, Ongkarak, Nakhon Nayok 26120, Thailand. nujane8@hotmail.com
D000086:Acetazolamide / Q000627:therapeutic use; D000208:Acute Disease; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D003451:Cryoprotective Agents / Q000627:therapeutic use; D005260:Female; D005632:Fructose / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D015812:Glaucoma, Angle-Closure / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy; D005990:Glycerol / Q000627:therapeutic use; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D009216:Myopia / Q000139:chemically induced / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D012307:Risk Factors; D013999:Timolol / Q000627:therapeutic use; D000077236:Topiramate
D000927:Anticonvulsants; D000959:Antihypertensive Agents; D003451:Cryoprotective Agents; D000077236:Topiramate; D005632:Fructose; D013999:Timolol; D000086:Acetazolamide; D005990:Glycerol