topiramate and Retinal-Diseases

We report the case of a 29-year-old epileptic woman who had been on treatment with topiramate 25mg/day for 9 days. She was referred to the Emergency Department due to reduction in far visual acuity (VA) after increasing the dose to 50mg/day two days before. The ocular examination showed bilateral acute angle closure glaucoma (AACG) and macular striae in both eyes (AO) observed by Retinography and Optical Coherence Tomography (OCT). The AACG is a well-known side effect of topiramate, but the macular striae rarely accompanies it. Although macular striae have been previously described in other cases, very few document those using retinography and OCT images. Therefore, it is important to differentiate a case of AACG induced by topiramate from a case of primary AACG, since they differ in their clinical presentation, mechanism of action, and treatment. Mismanagement can have potentially serious consequences.

Topics: Acute Disease; Adult; Anticonvulsants; Female; Glaucoma, Angle-Closure; Humans; Macula Lutea; Myopia; Retinal Diseases; Topiramate

Topics: Adult; Anticonvulsants; Fructose; Humans; Male; Migraine Disorders; Retinal Diseases; Tomography, Optical Coherence; Topiramate; Visual Acuity; Withholding Treatment

Topics: Anticonvulsants; Child; Fructose; Humans; Male; Myopia; Retinal Diseases; Tomography, Optical Coherence; Topiramate; Visual Acuity

The purpose of this study is to present the first case of a pure 'topiramate maculopathy' without acute glaucoma and/or myopia, which form the classical syndrome.. Interventional/observational case report.. Institutional University Teaching Hospital.. A 22-year-old American female, after taking 100 mg of topiramate (Topamax®) a day for 6 days because of a migraine attack, complained of severe visual acuity deterioration of sudden onset in both eyes, regardless of distance (far or near), during the span of 1 day. A complete ocular examination was carried out. Best-corrected visual acuity (BCVA) in the right eye was hand motion and in the left eye was counting fingers. Cycloplegic refraction and pinhole did not improve the visual acuity of patient's eyes. The anterior chamber depth was normal in both eyes. Tonometry was 14 mmHg in both eyes. Fundus biomicroscopy disclosed a maculopathy with macular striae and a cellophane-like reflex. Optical coherence tomography (OCT) showed an undulating profile with congruent retinal folds and choroidal layers plicae. INTERVENTIONAL/OBSERVATION PROCEDURE: Immediate discontinuation of Topamax and steroid therapy.. BCVA, cycloplegic refraction, tonometry, fundus photography, and OCT. Three days after suspension of Topomax and steroid therapy the patient's BCVA was 6/6 in both eyes. Tonometry was 14 mmHg in both eyes. Fundus appearance and OCT features were nearly normal. After 2 years of follow-up, the patient's BCVA, tonometry, macula, and OCT are stable in both eyes. In conclusion, an isolated (unassociated with glaucoma and/or induced myopia) acute maculopathy, previously known as being part of a rare syndrome, has been identified, described, and documented.

Topics: Anticonvulsants; Diagnosis, Differential; Female; Fluorescein Angiography; Fructose; Fundus Oculi; Humans; Macula Lutea; Migraine Disorders; Retinal Diseases; Tomography, Optical Coherence; Topiramate; Young Adult

A 23-year-old woman who was seen due to decreasing far visual acuity 24hours after starting treatment with topiramate. In the cycloplegic refraction, RE showed -4.25 and LE -4.50. Retinal striae could be seen in the macula of both eyes. The alterations ceased 48hours after the drug treatment was interrupted.. Drug induced acute myopia is an infrequent phenomenon, the aetiology of which is still not fully known.

Topics: Anticonvulsants; Female; Fructose; Humans; Macula Lutea; Migraine Disorders; Mydriatics; Myopia; Retinal Diseases; Topiramate; Young Adult

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

Topics: Acute Disease; Adolescent; Anticonvulsants; Fructose; Fundus Oculi; Humans; Male; Myopia; Retinal Diseases; Topiramate; Visual Acuity