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Abstract #27212 Published in IGR 12-4
Acute bilateral angle-closure glaucoma induced by topiramate: Contribution of Visante((registered trademark)) OCT
Tahiri Joutei Hassani R; Dupont Monod S; Oukacha G; Mantout F; Benrabah R; Heron E; Baudouin CJournal Français d'Ophtalmologie 2010; 33: 307-311
Introduction: Topiramate, a sulfamate-substituted monosaccharide classically used as an antiepileptic medication, has been widely used since its recent indication for migraine prophylaxis. We report the case of a 68-year-old woman who developed bilateral acute glaucoma following topiramate migraine prophylaxis. Observation: A 68-year-old woman presented in the emergency department for ocular pain, redness, and bilateral reduced visual acuity associated with nausea and vomiting. Initial examination found a bilateral corneal edema with shallow anterior chambers and closed iridocorneal angles. Intraocular pressure was 40 mmHg in the right eye and 45 mmHg in the left eye. Ultrasound biomicroscopy diagnosed ciliochoroidal detachment and swollen ciliary processes with closed angles, which was also objectified using the Visante((registered trademark)) OCT. Topiramate treatment was interrupted and a local and general hypotonic treatment was started. After 4 days, examination showed deeper anterior chambers and normal intraocular pressures. Visante((registered trademark)) OCT and ocular echography follow-up examinations were normal, and Indoramin was prescribed for migraine prophylaxis with no relapse after 10 months. Conclusion: Bilateral acute angle-closure glaucoma is a possible complication of topiramate. Physicians and patients starting this therapy should be aware of this underestimated risk. (copyright) 2010 Elsevier Masson SAS. All rights reserved. LA: French
C. Baudouin. Service d'ophtalmologie III, Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France. baudouin@quinze-vingts.fr
Classification:
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
11.15 Other drugs in relation to glaucoma (Part of: 11 Medical treatment)
9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
