%0 Journal Article
%T Acute bilateral simultaneous angle closure glaucoma after topiramate administration: a case report
%A Kakarla V Chalam
%A Tina Tillis
%A Farhana Syed
%A Swati Agarwal
%A Vikram S Brar
%J Journal of Medical Case Reports
%D 2008
%I BioMed Central
%R 10.1186/1752-1947-2-1
%X A 34 year-old woman developed bilateral severe visual loss 2 days after doubling the dosage of topiramate. Her best-corrected visual acuity (BCVA) was counting fingers in both eyes (OU). Intraocular pressures were 49 mm and 51 mm of Hg in right and left eyes respectively, with conjunctival chemosis, corneal edema, shallow anterior chamber and closed angles on gonioscopy. B-scan ultrasound revealed annular peripheral choroidal effusions in both eyes.Intraocular pressures and anterior chamber depth were normalized after discontinuation of topiramate and initiation of antiglaucoma therapy. Two weeks later, visual acuities improved to 20/25 in the right eye and 20/40 in the left eye. B-scan ultrasound showed resolution of choroidal effusion. Topiramate, an oral sulpha-derivative medication is known to cause ciliochoroidal effusions, which lead to forward rotation of the ciliary body and displacement of the lens-iris diaphragm, with resultant acute angle closure glaucoma and myopic shift.Banta et al [1] reported the first case of topiramate (Topomax; Ortho-McNeil) induced acute-angle closure glaucoma in a 51-year-old man who recently initiated the medication for mood-stabilization. Topiramate, a sulfamate derivative, is primarily used in the management of seizure disorders, however has also demonstrated efficacy in the treatment of bipolar disease and migraine. In the case of migraine, the symptoms of elevated intraocular pressure secondary to angle closure may mimic those of the primary condition, thus it is important to be aware of this association as the symptoms typically resolve with cessation of the medication and management of the intraocular pressure. We present a case of bilateral acute angle closure glaucoma occurring within 10 days of initiating therapy with topiramate for symptoms related to migraine.A 34-year-old woman with migraine, hypertension and hypothyroidism presented with acute bilateral severe visual loss after increasing her dose of topiramate from
%U http://www.jmedicalcasereports.com/content/2/1/1