title: Topiramate-Induced Changes in Anterior Chamber Angle and Choroidal Thickness.
abstract: OBJECTIVE
  To investigate the acute effects of topiramate on the anterior chamber angle (ACA) and choroidal thickness in patients with migraine.
  
  
  METHODS
  This prospective study included 15 eyes of 15 patients with migraine who have been scheduled to start topiramate therapy. All patients underwent complete ophthalmic examination including measurement of the ACA and choroidal thickness using a spectral domain optical coherence tomography device (Optovue Inc.) and refractive status evaluation with an autorefractokeratometer (KR-8100; Topcon) at the baseline and 1 week after starting therapy. The patients were asked to report any pain or discomfort in their eyes during therapy at the follow-up visit.
  
  
  RESULTS
  None of the patients experienced pain or discomfort in their eyes. The mean ACA significantly decreased at the first week of the therapy compared with the baseline levels (40.34±7.06° and 36.89±6.87°, respectively) (P=0.001). However, the mean choroidal thickness increased from 277.33±95.60 μm at the baseline to 323.40±84.50 μm at the first week (P=0.01). There was a nonsignificant increase in the mean refractive error (from -0.25±0.54 diopter [D] at the baseline to -0.38±0.49 D after 1 week) (P=0.06).
  
  
  CONCLUSIONS
  Topiramate can acutely decrease the ACA and increase the choroidal thickness. Because these effects may be asymptomatic, patients with migraine who start this therapy should be warned to be closely followed up by an ophthalmologist.
authors.affiliation: Department of Ophthalmology (A.K.), Baskent University, School of Medicine, Konya, Turkey; Department of Ophthalmology (B.E.K.), Selcuk University Faculty of Medicine, Konya, Turkey; and Department of Neurology (G.C.), Baskent University, School of Medicine, Konya, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Karalezli
authors.forename: Bengu Ekinci
authors.initials: BE
authors.lastname: Koktekir
authors.forename: Guner
authors.initials: G
authors.lastname: Celik
mesh_terms: D000328:Adult; D000867:Anterior Chamber / Q000187:drug effects*; D002829:Choroid / Q000187:drug effects*; D005260:Female; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy; D018696:Neuroprotective Agents / Q000009:adverse effects*; D010865:Pilot Projects; D011446:Prospective Studies; D012030:Refractive Errors / Q000139:chemically induced; D041623:Tomography, Optical Coherence; D000077236:Topiramate; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose