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Abstract #8121 Published in IGR 4-3
Bilateral acute angle closure glaucoma following topiramate treatment
Nemet A; Nesher R; Almog Y; Assia EHarefuah 2002; 141: 597-599, 667
The authors describe a case of bilateral acute angle-closure glaucoma associated with oral topiramate therapy. A 64-year-old woman developed bilateral acute angle-closure glaucoma two weeks after starting topiramate therapy for peripheral diabetic neuropathy. Topical and systemic anti-glaucomatous treatment were given and laser peripheral iridotomies performed and, the intraocular pressure was were stabilized. However, the anterior chambers remained very shallow and peripheral ciliochoroidal detachment was observed and confirmed echographically. Assuming that the mechanism of acute bilateral simultaneous angle-closure glaucoma differs from the common pupillary block, and is related to external cause, the topiramate therapy was discontinued, and the patient was treated with cycloplegic agent and steroids. Gradual deepening of the anterior chamber and resolution of the choroidal edema were accompanied by improvement of visual acuity and corneal clarity. The presumed mechanism of drug-related acute bilateral angle-closure glaucoma is choroidal effusion and detachment associated with forward budging of the iris-lens diaphragm. This, in turn, causes a shallow anterior chamber and blockage of the ocular draining system. LA: Hebrew
A. Nemet, MD, Department of Ophthalmology, Meir Hospital, Sapir Medical Center, Kfar Sava, Israel
Classification:
9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
