Abstract
BackgroundTo test the nature of the ocular side effects induced by topiramate (TPM) whether dose dependent or idiosyncratic, and to test various predictors that might influence the occurrence of those side effects.MethodsTwenty patients treated with TPM were included in this study. Patients underwent ophthalmic assessment before and after 4 weeks of treatment by stable doses of oral TPM. We examined non-cycloplegic refraction (RF) in diopters, best corrected visual acuity (BCVA), intraocular pressure (IOP) in mmHg, and anterior chamber depth (ACD) in mm.ResultsThere were no statistically significant differences between baseline and follow-up assessments in all tested ophthalmological parameters including errors of RF, ACD, IOP, and the BCVA. One case suffered from painful drop of vision in both eyes with elevated IOP and decreased ACD, and evident myopic shift 1 week after treatment with small dose of TPM. There was no significant effect of age, TPM dose, disease, and gender on all tested variables.ConclusionTPM can induce idiosyncratic, but not dose dependent, ocular side effects, namely myopic shifts and angle closure glaucoma. Those side effects were not disease, age, or gender dependent. However, ethnicity might play a role in induction of those side effects.
Highlights
Later in the previous century, in 1996, topiramate (TPM) was approved by the Food and Drug Administration (FDA) for treatment of epilepsy
The most common ocular adverse effect of TPM is a ciliochoroidal effusion syndrome which can cause a spectrum of clinical manifestations ranging from TPM-induced myopic shift (TiMS) up to bilateral TPM-induced angle closure glaucoma (TiACG)
The best corrected visual acuity (BCVA) dropped from 0.7 to 0.1 in both eyes, the RF changed from − 1.50 D to − 6.00 D in the right eye and from − 1.75 D to − 5.50 D in the left eye, the intraocular pressure (IOP) was elevated from 16 to 27 mmHg in both eyes, and the anterior chamber depth (ACD) decreased from 3.6 to 3.1 mm in both eyes
Summary
Later in the previous century, in 1996, topiramate (TPM) was approved by the Food and Drug Administration (FDA) for treatment of epilepsy. Many ocular adverse effects of TPM have been described including acute angle closure glaucoma, ocular pain and headache, red eye, mydriasis, acute onset myopia, uveitis, and choroidal effusion [3]. The most common ocular adverse effect of TPM is a ciliochoroidal effusion syndrome which can cause a spectrum of clinical manifestations ranging from TPM-induced myopic shift (TiMS) up to bilateral TPM-induced angle closure glaucoma (TiACG). To test the nature of the ocular side effects induced by topiramate (TPM) whether dose dependent or idiosyncratic, and to test various predictors that might influence the occurrence of those side effects
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