Topiramate-Associated Secondary Angle-Closure Glaucoma: A Case Series

Thambi, Lopa; Kapcala, Leonard P.; Chambers, Wiley A.; Nourjah, Parivash; Beitz, Julie; Chen, Min; Lu, Susan

doi:10.1001/archopht.120.8.1108

Cited by 53 publications

(28 citation statements)

References 1 publication

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“…[22] Many patients with topiramateinduced glaucoma had blurred vision as the initial symptom. [22,[53][54][55] Fraunfelder and Fraunfelder [22] have proposed a series of recommendations to manage topiramate-induced glaucoma:…”

Section: Topiramatementioning

confidence: 99%

Ocular Adverse Effects of Common Psychotropic Agents

Richa¹,

Yazbek²

2010

CNS Drugs

170

143

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All psychotropic medications have the potential to induce numerous and diverse unwanted ocular effects. Visual adverse effects can be divided into seven major categories: eyelid and keratoconjunctival disorders; uveal tract disorders; accommodation interference; angle-closure glaucoma; cataract/pigmentary deposits in the lens and cornea; retinopathy; and other disorders. The disorders of the eyelid and of the keratoconjunctiva are mainly related to phenothiazines and lithium. Chlorpromazine, at high dosages, can commonly cause abnormal pigmentation of the eyelids, interpalpebral conjunctiva and cornea. It can also cause a more worrisome but rarer visual impairment, namely corneal oedema. Lithium can rarely lead to a bothersome eye irritation by affecting sodium transport. Uveal tract problems are mainly associated with tricyclic antidepressants (TCAs), typical antipsychotics, topiramate and selective serotonin reuptake inhibitors (SSRIs). TCAs, typical antipsychotics and SSRIs can all cause mydriasis that is often transient and with no major consequences, but that can promote closure of angles in susceptible patients. Topiramate has been frequently associated with a number of significant ocular symptoms including acquired myopia and angle-closure glaucoma. Problems with accommodation are related to TCAs and to low-potency antipsychotics. TCAs cause transient blurred vision in up to one-third of patients. Angle-closure glaucoma is a serious condition that has been mainly associated with TCAs, low-potency antipsychotics, topiramate and, to a lesser extent, SSRIs. When patients with narrow angles are given TCAs, they all appear to experience induction of glaucomatous attacks. Antipsychotics and SSRIs may lead to an added risk of developing angle-closure glaucoma, but only in predisposed eyes. Topiramate can lead to an allergic-type reaction whereby structures of the lens and ciliary body are displaced, which results in angle-closure glaucoma. Cataractous changes can result from antipsychotics, mainly from high dosages of chlorpromazine or thioridazine. These two drugs, when used at high dosages and for prolonged periods, frequently cause lenticular opacifications. Retinopathy has been shown to be related to high dosages of typical antipsychotics, mainly chlorpromazine and thioridazine. The frequency of occurrence of retinal effects seems to be proportional to the total amount of drug used over a long period of time. Other visual problems of special concern are the ocular dystonias, other eye movement disorders, and decreased ability to perceive colours and to discriminate contrast. Ocular dystonias can occur with antipsychotics (especially high-potency ones), carbamazepine (especially in polytherapy), topiramate and, rarely, with SSRIs. Disturbance in various eye movements is frequently seen with benzodiazepines, antiepileptic drugs and lithium. Impairment in the perception of colours and the discrimination of contrasts has been shown to occur not uncommonly with carbamazepine and lorazepam. Thus, typical antipsycho...

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Section: Topiramatementioning

confidence: 99%

Ocular Adverse Effects of Common Psychotropic Agents

Richa¹,

Yazbek²

2010

CNS Drugs

170

143

View full text Add to dashboard Cite

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“…Seven patients sustained permanent vision loss. 48,49,78,79 Ecstasy (3, 4-methylenedioxymethamphetamine) Ecstasy, a synthetic amphetamine derivate, and marijuana was implicated as the cause of recurrent bilateral ACAG in a 29-year-old woman. 80 Ecstasy increases the release of monoamine neurotransmitters and inhibits the uptake of serotonin from the synaptic gap that can lead to mydriasis and ACAG in predisposed persons.…”

Section: Anticonvulsantsmentioning

confidence: 99%

Non-steroidal drug-induced glaucoma

Razeghinejad

Pro

Katz

2011

Eye

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Numerous systemically used drugs are involved in drug-induced glaucoma. Most reported cases of non-steroidal drug-induced glaucoma are closed-angle glaucoma (CAG). Indeed, many routinely used drugs that have sympathomimetic or parasympatholytic properties can cause pupillary block CAG in individuals with narrow iridocorneal angle. The resulting acute glaucoma occurs much more commonly unilaterally and only rarely bilaterally. CAG secondary to sulfa drugs is a bilateral non-pupillary block type and is due to forward movement of iris-lens diaphragm, which occurs in individuals with narrow or open iridocorneal angle. A few agents, including antineoplastics, may induce open-angle glaucoma. In conclusion, the majority of cases with glaucoma secondary to non-steroidal medications are of the pupillary block closed-angle type and preventable if the at-risk patients are recognized and treated prophylactically.

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“…8,[10][11][12]14 Fakat olguların büyük bölümünde etkin tedavinin topiramat kullanımının sonlandırılması, kortikosteroid ve sikloplejik ajanlar ile sağlandığı kanaati yaygındır. [13][14][15][16][17][18] Biz de olgumuzda bu tedavi seçeneklerinden topikal antiglokomotoz damla, intravenöz hiperozmotik ajan, oral asetazolamid, lazer periferik iridotomiyi denememize rağmen etkili sonucu topiramat kullanımının kesilmesi, destekleyici olarak topikal kortikosteroid ve sikloplejik ajanların tedaviye eklenmesi ile elde ettik.…”

Section: Discussionunclassified

Topiramat Kullanımının Tetiklediği Miyopik Kayma ve Bilateral Sekonder Kapalı Açılı Glokom

...

2012

Tjo

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Topiramate-Associated Secondary Angle-Closure Glaucoma: A Case Series

Cited by 53 publications

References 1 publication

Ocular Adverse Effects of Common Psychotropic Agents

Ocular Adverse Effects of Common Psychotropic Agents

Non-steroidal drug-induced glaucoma

Topiramat Kullanımının Tetiklediği Miyopik Kayma ve Bilateral Sekonder Kapalı Açılı Glokom

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