topiramate and Blindness

A 46-year-old woman presented to the emergency department with progressive bilateral loss of vision followed by headache. She had been taking topiramate 25 mg daily for eight days before presentation. In the end, she was diagnosed with topiramate-induced acute glaucoma for which she received appropriate treatment.

Topics: Acute Disease; Blindness; Female; Fructose; Glaucoma, Angle-Closure; Headache; Humans; Middle Aged; Topiramate

We describe a 43-year-old patient who experienced visual loss 4 years after beginning antiepileptic therapy with topiramate. Ophthalmological and neurological examinations led to a preliminary diagnosis of bilateral toxic optic neuritis. Mitochondrial genome sequence analysis detected a Leber hereditary optic neuropathy 11778G>A mutation. The possibility that topiramate might favor a conversion disease, alerts physicians to seek a history of blindness in patients undergoing chronic antiepileptic therapy.

Topics: Adult; Anticonvulsants; Blindness; Epilepsy; Fructose; Humans; Male; Mutation; Optic Atrophy, Hereditary, Leber; Topiramate; Visual Fields

We describe 2 patients who developed ocular side effects during treatment with topiramate. One was a 16-year-old woman with generalized seizures who developed a homonymous hemianopia after using topiramate 125 mg per day for 12 weeks, and the other was a 24-year-old epileptic female who developed a bilateral maculopathy after using topiramate 150 mg per day for 8 weeks.. We identified two severe ocular adverse reactions from topiramate. Both reactions necessitated discontinuing the treatment, but the topiramate-associated maculopathy was irreversible.

Topics: Adolescent; Adult; Anticonvulsants; Blindness; Female; Fructose; Hemianopsia; Humans; Macula Lutea; Retinal Diseases; Topiramate; Visual Fields