[Topiramate associated bilateral acute angle closure glaucoma and myopia]

Topiramate, is an oral Sulfonamide medication that was primarily licensed for treating epilepsy, though increasingly used for treating migraine. In recent years there have been several reports of its association with bilateral acute angle closure glaucoma and or myopia. We introduce a rare case of simultaneous bilateral acute angle closure glaucoma and myopia following topiramate usage. A 43 years-old woman, who referred to Amiralmomenin hospital with bilateral painful visual loss following prescription of topiramate. Her best corrected visual acuity was one meter counting finger in both eyes. Intraocular pressure was 60 mm Hg OD and 54 mm Hg OS with ciliary injection. There were corneal edema, shallow anterior chamber and closed angles on gonioscopy in both eyes. Abnormal findings were normalized within 2 weeks after discontinuation of topiramate and starting antiglaucoma medication. Topiramate can caused acute bilateral angle- closure glaucoma and myopia, which is usually reversible and its intraocular pressure is controlled promptly by discontinuing drug. Patients who started Topiramate therapy need to be informed of this potential risk especially within first few weeks after starting or increasing dose of the drug

[Frequency and severity of retinopathy of prematurity: singleton versus multiple-births]

To determine the frequency and severity of retinopathy of prematurity [ROP] among singleton and multiple-birth neonates referred to Farabi Eye Hospital, Tehran-Iran. We reviewed the records of 99 consecutive neonates from multiple-gestation pregnancies including 68 twins, 26 triplets and 5 quadruplets who were screened for ROP during 2002-2004. The frequency, severity and risk factors of ROP were determined. The results were compared with a group of singletons who did not differ from the multiple-birth group regarding birth weight, gestational age, oxygen therapy, respiratory distress syndrome, transfusion, sepsis, phototherapy and gender. ROP was present in 12.1% of multiple-birth neonates compared to 15.1% in singletons [P=0.53]. Threshold ROP was present in 6.1% of multiple-birth neonates and 7.1% of singletons [P=0.62]. ROP was detected in 60% of quadruplets vs 9.6% of twins and triplets with threshold disease in 40% of quadruplets compared to 4.2% in twins and triplets. Logistic regression analysis revealed no statistically significant differences in frequency and severity of ROP among subgroups of multiple-gestation pregnancies [P= 0.79]. The higher frequency of ROP among multiple-birth neonates is due to lower birth weight and gestational age but there is no significant difference between multiple-births and singletons in terms of frequency and stages of ROP. Screening for ROP in multiple pregnancy births may be conducted according to the same standard protocols as for singletons