Topiramate induced bilateral angle-closure glaucoma

ABSTRACT

To describe a case of acute angle-closure glaucoma associated with oral topiramate [Topamax, Aria Daroo] therapy Two weeks after initiation of oral topiramate therapy for epilepsy, a 35-year-old woman presented with blurred vision and headache. Intraocular pressure in both eyes was significantly elevated and her visual acuity was 20/30 Ocular Uterque [OU]. Bilateral conjunctival chemosis, shallow anterior chamber and mild corneal edema were observed. Topiramate therapy was discontinued. Topical therapy was initiated in both eyes with betamethasone, atropine and timolol. Symptoms and signs including vision accuracy, refraction and intraocular pressure resolved over the next 2 weeks. Topiramate therapy may be associated with ciliochoroidal effusion resulting in angle-closure glaucoma; therefore, patients on such therapy should be carefully monitored