Topiramate-induced acute glaucoma

Vahdani, Kaveh; Easto, Rachel; Shah, Aadarsh; Habib, Nabil E

doi:10.1136/practneurol-2015-001363

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Section: Resultsunclassified

Topiramate-induced acute angle closure: A systematic review of case reports and case series

Owaifeer

¹

,

AlSultan

²

,

Badawi

³

2022

Indian Journal of Ophthalmology

4

0

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Topiramate-induced acute angle closure (TiAAC) is a potentially vision-threatening side effect of topiramate (TPM) use. The purpose of this article is to review demographic characteristics, clinical features, and management options of TiAAC. A systematic literature search of all reported cases and case series of TiAAC was conducted in the following search engines: PubMed, Web of Science, Google Scholar, Elsevier, and EBSCO. Seventy-three publications describing 77 cases were included. 58 (75.3%) patients were female, and the mean age was 34.88 ± 11.21 years (range, 7–57). The most commonly reported indication of TPM use was migraine headache (59.7%), and the mean duration from starting treatment until the onset of angle closure was 14.1 ± 31.5 days. All cases were managed by immediate cessation of TPM and topical therapy. In addition, systemic medications (carbonic anhydrase inhibitors, hyperosmotic agents, and steroids) were used in 51 patients (66.2%). A laser and/or surgical intervention was performed in 10 patients (13%). After commencement of treatment, the mean duration until the resolution of TiAAC was 3.9 ± 3.6 days (range, 1–18). The findings of our study present a summary of the current body of evidence provided by case reports and case series on TiAAC. In conclusion, the onset of angle closure following TPM use peaks at 2 weeks after initiating treatment, and in most cases, successful management can be achieved by discontinuing TPM and initiating appropriate medical therapy.

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“…5 Most usual adverse reactions are weight loss and nervous disorders, with ocular injury being uncommon. 2 Acute angle-closure glaucoma is an infrequent injurious effect of topiramate 6,7 and emerges about 7 and 12.8 days of the administration, 2,3,6 but of the described ocular adverse effects of topiramate, angle-closure acute glaucoma (ACAG) is the most common (58.3-74.8% of cases), 2 provoking: 4,5 • Abnormal vision • Blurred vision due to myopization.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2019

AOVS

0

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Topiramate, a sulfamate-substituted monosaccharide, is an anti-convulsive used primarily for treating epilepsy, depression, and neuropathic pain and as prophylactic treatment for migraine. Most usual adverse reactions are nervous disorders and weight loss, with the ocular compromise being uncommon. Acute angle-closure glaucoma is an infrequent injurious effect of topiramate, but of the described ocular adverse effects of topiramate, angle-closure acute glaucoma (ACAG) is the most common (58.3-74.8% of cases), provoking abnormal vision, acute intraocular pressure elevation, acute myopia, microcystic corneal edema, shallow anterior chamber, circumciliary congestion, retinal striae, macular folds, choroidal detachments, and ciliochroidal detachments. It emerges about 7 and 12.8 days of administration. If not treated properly, it can lead to irreversible damage to the patient's vision, such as blindness.

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“…5 Most usual adverse reactions are weight loss and nervous disorders, with ocular injury being uncommon. 2 Acute angle-closure glaucoma is an infrequent injurious effect of topiramate 6,7 and emerges about 7 and 12.8 days of the administration, 2,3,6 but of the described ocular adverse effects of topiramate, angle-closure acute glaucoma (ACAG) is the most common (58.3-74.8% of cases), 2 provoking: 4,5 • Abnormal vision • Headaches provoked by acute intraocular pressure (IOP) increase within 2 weeks from starting treatment or when modifying dose.…”

Section: Case Reportmentioning

confidence: 99%

“…5 Physicians should alert patients to the potential manifestations of acute glaucoma before begging topiramate, especially as the symptoms may easily be mistakenly associated to migraine (a particular problem if the topiramate is to treat migraine), probably procrastinating stopping of the drug and causing irreversible damage. 4,6…”

Section: Case Reportmentioning

confidence: 99%

Acute angle-closure glaucoma caused by topiramate–a drug complication that can lead to blindness

Duarte¹,

Duarte²

2019

AOVS

0

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Topiramate, a sulfamate-substituted monosaccharide, is an anti-convulsive used primarily for treating epilepsy, depression, and neuropathic pain and as prophylactic treatment for migraine. Most usual adverse reactions are nervous disorders and weight loss, with the ocular compromise being uncommon. Acute angle-closure glaucoma is an infrequent injurious effect of topiramate, but of the described ocular adverse effects of topiramate, angle-closure acute glaucoma (ACAG) is the most common (58.3-74.8% of cases), provoking abnormal vision, acute intraocular pressure elevation, acute myopia, microcystic corneal edema, shallow anterior chamber, circumciliary congestion, retinal striae, macular folds, choroidal detachments, and ciliochroidal detachments. It emerges about 7 and 12.8 days of administration. If not treated properly, it can lead to irreversible damage to the patient's vision, such as blindness.

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Topiramate-induced acute glaucoma

Cited by 3 publications

References 3 publications

Topiramate-induced acute angle closure: A systematic review of case reports and case series

Topiramate-induced acute angle closure: A systematic review of case reports and case series

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Acute angle-closure glaucoma caused by topiramate–a drug complication that can lead to blindness

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