ABSTRACT
CASE REPORT: We describe a 42 year-old patient who developed acute myopia and closed-angle glaucoma one week after beginning treatment with topiramate. Ultrasound biomicroscopy revealed a bilateral angle closure and choroidal effusion. The clinical findings resolved with withdrawal of the topiramate. DISCUSSION: Topiramate may cause acute myopia and closure angle glaucoma in some patients due to a choroidal effusion. Ultrasound biomicroscopy seems to be a useful tool for monitoring the progression of the clinical lesions and their resolution when the drug is withdrawn.
Subject(s)
Anti-Obesity Agents/adverse effects , Antidepressive Agents/adverse effects , Fructose/analogs & derivatives , Glaucoma, Angle-Closure/chemically induced , Adult , Female , Fructose/adverse effects , Glaucoma, Angle-Closure/diagnostic imaging , Humans , Microscopy, Acoustic , Myopia/chemically induced , TopiramateABSTRACT
Caso clínico: Se presenta el caso de una mujer de 42 años que desarrolló un cuadro de miopía aguda y glaucoma de ángulo cerrado bilateral una semana después del inicio del tratamiento con topiramato. La biomicroscopía ultrasónica (BMU) reveló que la paciente presentaba un ángulo cerrado y una efusión coroidea bilateral. Con la retirada del fármaco se resolvió el cuadro. Discusión: El topiramato puede desencadenar miopía aguda y glaucoma de ángulo cerrado en algunos pacientes debido a una efusión coroidea. La realización de la BMU parece ser una herramienta útil para observar la evolución del cuadro y su resolución tras la suspensión del fármaco(AU)
Case report: We describe a 42 year-old patient who developed acute myopia and closed-angle glaucoma one week after beginning treatment with topiramate. Ultrasound biomicroscopy revealed a bilateral angle closure and choroidal effusion. The clinical findings resolved with withdrawal of the topiramate. Discussion: Topiramate may cause acute myopia and closure angle glaucoma in some patients due to a choroidal effusion. Ultrasound biomicroscopy seems to be a useful tool for monitoring the progression of the clinical lesions and their resolution when the drug is withdrawn(AU)
Subject(s)
Humans , Glaucoma, Angle-Closure/chemically induced , Glaucoma, Angle-Closure/diagnosis , Glaucoma, Angle-Closure/etiology , Glaucoma, Angle-Closure/pathology , Myopia/chemically induced , Monosaccharides/adverse effects , Monosaccharides , Glaucoma, Angle-Closure/drug therapy , Glaucoma, Angle-Closure/complications , Glaucoma, Angle-Closure/prevention & control , Myopia/complications , Myopia/diagnosis , Myopia/etiology , Myopia/pathology , Monosaccharides/pharmacology , Monosaccharides/toxicityABSTRACT
PURPOSE: To asses the prevalence of fluorescein angiographic features in bilateral and multifocal Congenital Hypertrophy of the Retinal Pigment Epithelium (CHRPE) in patients with a diagnosis of familial adenomatous polyposis. METHODS: We performed prospective angiographic and clinical examination of 49 CHPRE lesions in 15 patients. RESULTS: About 77.5% of CHRPE lesions were close to retinal vessels. The retinal vascular changes observed overlying and surrounding the CHRPE were: capillary non-perfusion with an area greater than 0.5 disc diameters (41%), capillary microaneurysms (4%), chorioretinal anastomoses (6.2%), attenuation of retinal vessels (4%), choriocapillary vessels inside the lacunae (6.2%) and in the depigmented marginal halo (18.4%). Depigmented streaks in contact with one or both edges of the CHRPE were observed in 79.6% of the lesions. About 9.6% of the lesions were not seen on ophthalmoscopy and could only be detected by angiography. CONCLUSIONS: Even though the diagnosis of CHRPE is clinical, fluorescein angiography may be useful in confirming the diagnosis, as well as detecting additional lesions not seen by means of ophthalmoscopic examination.
