title: Anterior segment optical coherence tomography documentation of a case of topiramate induced acute angle closure.
abstract: We present a case report of a 31-year-old female patient who presented to us with a 1 day history of acute bilateral eye pain, blurred vision and headache. She was found to have a myopic shift, raised intraocular pressure (IOP) and shallow anterior chambers in both eyes. She had been commenced on oral topiramate 1 week previously. A number of investigations, including anterior segment optical coherence tomography (AS-OCT) were done and a diagnosis of topiramate induced bilateral acute angle closure (TiAAC) was made. Topiramate was discontinued and she was managed with topical and oral antiglaucoma medications, topical steroids and cyclopegics. Her symptoms subsided dramatically at the next follow-up. The AS-OCT documentation revealed lucidly the improvement in her anterior chamber depth and anterior chamber angle parameters. Her IOP decreased, her myopic shift showed reversal and her AS-OCT findings revealed gross improvement in all the parameters angle opening distance, trabecular iris space area and scleral spur angle. This case report clearly shows with AS OCT documentation the changes which occur in the anterior segment in a case of TiAAC.
authors.affiliation: Department of Glaucoma, Aravind-Ziess Centre for Excellence in Glaucoma, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
authors.forename: Arijit
authors.initials: A
authors.lastname: Mitra
authors.forename: R
authors.initials: R
authors.lastname: Ramakrishnan
authors.forename: Mohideen Abdul
authors.initials: MA
authors.lastname: Kader
mesh_terms: D000208:Acute Disease; D000328:Adult; D000869:Anterior Eye Segment / Q000187:drug effects / Q000473:pathology*; D004282:Documentation; D005260:Female; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives*; D015812:Glaucoma, Angle-Closure / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D006068:Gonioscopy; D006801:Humans; D007429:Intraocular Pressure; D018696:Neuroprotective Agents / Q000009:adverse effects; D041623:Tomography, Optical Coherence / Q000379:methods*; D000077236:Topiramate
chemical_list: D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose