topiramate and Choroid-Diseases

To report two cases of ciliochoroidal effusion after the usage of topiramate.. Two middle-aged women experienced sudden onset of acute glaucoma and acquired myopia after taking topiramate. Ultrasound biomicroscopy demonstrated bilateral ciliochoroidal effusion and angle closure. The A-scan ultrasonography revealed shallow anterior chamber and thick lens. After the treatment and drug withdrawal, intraocular pressure, refractive status and angle anatomy returned to normal and there was resolution of ciliochoroidal effusion. During the clinical course, the anterior chamber depth (ACD) increased from 2.02 to 3.30 mm (1.28 mm of changes) OD and from 1.94 to 3.36 mm (1.42 mm of changes) OS. The lens thickness (LT) became thinner from 4.53 to 4.31 mm (0.22 mm of changes) OD and from 4.59 to 4.30 mm (0.29 mm of changes) OS in the first case. In the second case, the ACD increased from 2.33 to 3.07 mm (0.74 mm of changes) OD and from 2.30 to 3.05 mm (0.75 mm of changes) OS. The LT became thinner from 4.42 to 4.27 mm (0.15 mm of changes) OD and from 4.38 to 4.26 mm (0.12 mm of changes) OS. The forward displacement of the lens-iris diaphragm contributed more to the shallowness of the anterior chamber than the thickening of the lens itself (only accounting for 20%).. Topiramate-induced bilateral acute angle closure glaucoma and myopic shift was due to ciliochoroidal effusion which resulted in thicker lens and shallow anterior chamber. The later was mainly due to anterior displacement of the lens-iris diaphragm.

Topics: Anticonvulsants; Choroid Diseases; Female; Glaucoma, Angle-Closure; Humans; Hypoglycemic Agents; Middle Aged; Myopia; Topiramate

Topics: Acute Disease; Adult; Anticonvulsants; Antihypertensive Agents; Choroid Diseases; Ciliary Body; Drug Therapy, Combination; Female; Fructose; Glaucoma, Angle-Closure; Glucocorticoids; Humans; Intraocular Pressure; Microscopy, Acoustic; Mydriatics; Tonometry, Ocular; Topiramate; Uveal Diseases

To report the role of choroidal drainage in patient with acute bilateral angle closure secondary to cilio-choroidal effusion with Topiramate.. Interventional case report.. Two weeks after commencing tablet Topiramate (Sulfamate derivative) for management of epilepsy, a patient developed bilateral acute angle closure secondary to cilio-choroidal effusion with lenticulo-corneal touches for which choroidal drainage was performed in 1 eye.. After choroidal drainage, anterior chamber deepened, corneal edema resolved, choroidals started resolving, and intraocular pressure was controlled without medication.. In patients presenting with acute angle closure secondary to Topiramate toxicity, choroidal drainage if indicated, is a safe and effective interventional procedure.

Topics: Anticonvulsants; Choroid Diseases; Corneal Edema; Drainage; Epilepsy; Fructose; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Male; Microscopy, Acoustic; Middle Aged; Topiramate; Treatment Outcome; Ultrasonography

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.. 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.

Topics: Acute Disease; Adult; Anticonvulsants; Antihypertensive Agents; Choroid Diseases; Female; Fructose; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Microscopy, Acoustic; Topiramate

Topics: Anticonvulsants; Child, Preschool; Choroid Diseases; Ciliary Body; Exudates and Transudates; Female; Fructose; Glaucoma, Angle-Closure; Humans; Pupil Disorders; Topiramate; Ultrasonography; Uveal Diseases

We describe a case of bilateral angle-closure glaucoma associated with oral topiramate therapy.. Interventional case report. Case report with echographic illustration.. A 51-year-old man developed bilateral acute angle-closure glaucoma 2 weeks after beginning topiramate therapy for bipolar affective disorder. Laser peripheral iridotomy was performed in the right eye without resolution of the acute attack. Echography revealed lens thickening and ciliochoroidal detachments in both eyes. Visual acuity, intraocular pressure, and anterior and posterior segment anatomy normalized 2 weeks after cessation of topiramate therapy.. Topiramate, a new sulfa-derivative antiepileptic medication, may cause idiosyncratic ciliochoroidal detachments and ciliary body edema leading to anterior displacement of the lens-iris diaphragm, lens thickening, and acute angle-closure glaucoma.

Topics: Acute Disease; Administration, Oral; Anticonvulsants; Bipolar Disorder; Choroid Diseases; Fructose; Glaucoma, Angle-Closure; Humans; Intraocular Pressure; Male; Middle Aged; Topiramate; Ultrasonography; Visual Acuity