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Abstract #59320 Published in IGR 16-3
Bilateral Angle Closure Following Use of a Weight Loss Combination Agent Containing Topiramate
Grewal DS; Goldstein DA; Khatana AK; Tanna APJournal of Glaucoma 2015; 24: e132-e136
PURPOSE: To report a unique case of topiramate-induced bilateral angle closure following ingestion of a recently introduced weight loss medication containing topiramate, and to describe its management. METHODS: Case report of a 39-year-old, otherwise healthy woman who experienced decreased vision, bilateral acute angle closure, choroidal thickening as measured with enhanced depth optical coherence tomography imaging, bilateral suprachoroidal effusions, and induced myopia 1 week after starting a weight loss medication, Qysmia, composed of phentermine 3.75 mg and topiramate 23 mg. Treatment was initiated with high-dose intravenous methylprednisolone, intravenous mannitol, topical difluprednate ophthalmic emulsion, atropine sulfate, and the fixed combination of brimonidine and timolol. At the 2-week follow-up visit, vision, intraocular pressure, and angle anatomy had returned to normal and there was resolution of choroidal and ciliary body effusions on ultrasound biomicroscopy. CONCLUSIONS: Bilateral acute angle closure may develop after ingestion of weight loss drugs containing topiramate.
*Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL †Cincinnati Eye Institute, University of Cincinnati, Cincinnati, OH.
Full articleClassification:
9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
9.4.5.5 Other (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous)