advertisement
Abstract #13859 Published in IGR 8-2
Blood-brain barrier disruption associated with topiramate-induced angle-closure glaucoma of acute onset
Viet Tran H; Ravinet E; Schnyder C; Reichhart M; Guex-Crosier YKlinische Monatsblätter für Augenheilkunde 2006; 223: 425-427
BACKGROUND: Topiramate (Topamax®) is an anti-epileptic drug of the sulfamate group used secondarily for bipolar disease. HISTORY AND SIGNS: One week after initiation of topiramate treatment for a bipolar disorder, a 57-year-old man presented with blurred vision. Clinical examination revealed a bilateral conjunctivitis, areflexic mydriasis, severe anterior chamber shallowing, with a myopic shift and vitritis. THERAPY AND OUTCOME: A spinal tap revealed an increased protein content of 1581 mg/L on cerebrospinal fluid (CSF) analysis, being compatible with a rupture of the blood-brain barrier (BBB). UBM exposed bilateral ciliochoroidal effusions with secondary angle-closure. Topiramate was promptly discontinued, whereas visual acuity, intraocular pressure (IOP), and anterior and posterior segments anatomy normalized within one week. One month later, bilateral iris atrophy was present. CONCLUSION: The presence of BBB disruption with increased protein content in CSF with simultaneous blood ocular barrier breakdown may suggest a common inflammatory mechanism. LA: German.
Dr. H. Viet Tran, Jules Gonin University Eye Hospital, Lausanne, Switzerland
Classification:
9.3.10 Other (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
