Topiramate-Induced Acute Bilateral Angle Closure and Myopia: Pathophysiology and Treatment Controversies

Autor: Tarek Shaarawy, Nikolaos Mavrakanas, James Scott Schutz, Christopher Van Issum
Rok vydání: 2010
Předmět:
Adult
Male
Topiramate
medicine.medical_specialty
genetic structures
Visual Acuity/physiology
Fructose/adverse effects/analogs & derivatives
Visual Acuity
Glaucoma
Fructose
Glaucoma
Angle-Closure/chemically induced/drug therapy/physiopathology
Anterior Eye Segment
Ophthalmology
Myopia
Humans
Medicine
Intraocular Pressure/physiology
Closure (psychology)
Antihypertensive Agents
Intraocular Pressure
Ultrasonography
Anticonvulsants/adverse effects
Antihypertensive Agents/therapeutic use
business.industry
Ciliochoroidal effusion
General Medicine
medicine.disease
eye diseases
Pathophysiology
ddc:616.8
Surgery
Drug Combinations
Acute angle-closure glaucoma
Acute Disease
Anticonvulsants
sense organs
Anterior Eye Segment/physiopathology/ultrasonography
Glaucoma
Angle-Closure
business
Myopia/chemically induced/drug therapy/physiopathology
Tomography
Optical Coherence
medicine.drug
Zdroj: European Journal of Ophthalmology, Vol. 21, No 4 (2011 ) pp. 404-9
ISSN: 1724-6016
1120-6721
DOI: 10.5301/ejo.2010.5979
Popis: PurposeTO discuss the unusual features of topiramate-induced acute angle closure glaucoma, its pathophysiologic mechanisms, and treatment controversies, and to report the first anterior segment optical coherence tomography (OCT) of this condition.MethodsLiterature review and case report with OCT findings.ResultsTopiramate-induced angle closure is usually bilateral and associated with acute myopia; the ocular pressure is often not very highly elevated. Ciliochoroidal detachment with ciliary body anterior rotation is typically present and was demonstrated easily in our case with anterior segment OCT. Pilo-carpine exacerbates this condition and peripheral iridotomy is not indicated, nor is iridoplasty Treatment consists of replacing topiramate with appropriate medication, strong cycloplegia, and topical steroids.ConclusionsIt is important to recognize this form of acute secondary angle closure in order to treat it properly, avoiding harmful medication and unnecessary surgery.
Databáze: OpenAIRE
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