Topiramate-Induced Angle Closure, Ophthalmology Case Reports and Grand Rounds from the University of Iowa Department of Ophthalmology & Visual Sciences Topiramate (brand name Topamax) is an anticonvulsant medication commonly prescribed for prophylaxis against migraine and epileptic seizures
Cycloplegia relaxes the cilary body and tighten the zonules, keeping the iris-lens diaphragm in check
1 ± 31
Given the timing of our patient's symptoms, occurring within two weeks of starting topiramate, and the Topiramate-induced acute angle closure (TiAAC) is a potentially vision-threatening side effect of to
All cases were managed by immediate cessation of TPM and topical therapy
Beyond cessation of Topamax, the acute IOP rise can also be addressed with anti-glaucoma medications
Topiramate, a sulfamate-substituted monosaccharide (Topamax, Ortho-McNeil Pharmaceuticals, Raritan, NJ), is structurally unrelated to any other Blocked drainage leads to increased pressure and eventually acute angle closure glaucoma
[ 4, 5] We report two cases of bilateral secondary angle closure glaucoma related to Presumed topiramate-induced bilateral acute angle-closure glaucoma
Bilateral angle-closure glaucoma and ciliary body swelling from topiramate
In one case, prompt discontinuation of topiramate prevented bilateral angle closure glaucoma
Its use may rarely be associated with the occurrence of secondary angle-closure glaucoma due to supraciliary effusion
the decision may not be as clear cut in a narrow-angle patient without history of angle closure
To our knowledge, case 1 is the first case in the Topamax (topiramate) is used off-label for weight loss in obesity treatment
3) After the resolution of an episode of acute angle-closure glaucoma, eyes should be assessed for degree of angle closure, the presence of peripheral anterior synechiae (PAS), degree of cataract, and optic disk and visual field damage
The usual symptoms are sudden, severe eye pain, a red eye and reduced or blurred vision
In the acute form, the IOP rises rapidly as a result of relatively sudden blockage of the trabecular meshwork ™ by the iris 1
In contrast to primary narrow angle glaucoma, which is rare under 40 years of age, secondary angle closure glaucoma associated with topiramate has been reported in pediatric patients as well as adults
Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with Topamax
Treatment Acute angle-closure glaucoma presents as a sudden onset of severe unilateral eye pain or a headache associated with blurred vision, rainbow-colored halos around bright lights, nausea, and vomiting
After the dose is increased, it is taken twice a day
Recently, it has also become a popular medication to Acute myopia and angle closure glaucoma are two of many adverse side effects of topiramate
Abstract
In addition, pilocarpine can cause anterior displacement of the lensiris diaphragm through rounding BY TONY THIEU, MD, MS, AND SARWAT SALIM, MD
In angle closure glaucoma, increased intraocular pressure is caused by impaired outflow facility secondary to appositional or synechial closure of the anterior chamber drainage angle Tonometry, Ocular
The risk of angle-closure glaucoma in patients younger than 50 years was twice as high in patients taking bupropion and more than 5 times higher in patients taking topiramate
3
One must ensure that the iridectomy is not blocked by lens material or vitreous
Some health conditions can also cause angle closure glaucoma: Cataracts
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Once his IOP was deemed appropriate, the patient was discharged and instructed angle closure glaucoma without pupillary block seen with anterior chamber narrowing after peripheral iridotomy
One medication to note is topiramate (Topamax, Janssen), used in the treatment and management of epilepsy and migraines and more recently for weight loss, along with many off-label uses
Both are discussed later in this chapter
1 After the acute attack is successfully treated with medication, the A case is reported of acute bilateral myopia and angle closure glaucoma in a 7-year-old patient from topiramate toxicity
The most essential treatment of topiramate-induced angle closure is early recognition and discontinuation of the offending medication
Medications such as topiramate and escitalopram that expand choroidal or ciliary body volume or increase zonular laxity and lens size can trigger angle closure in this way
Topiramate-induced angle closure Don’t assume prescribers know its ocular side effects
Presenting
The first presenting symptom of acute secondary angle-closure glaucoma in many patients was blurring of vision
Other measures, in
Learn more about why it’s used, whether it’s effective, and who should and shouldn’t take
Topiramate (Topamax; Ortho-McNeil Pharmaceutical, Raritan, NJ, USA) is an oral sulfamate medication used primarily for seizure treatment
Off
Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with Topamax
5 days
Low-lying choroidals may be seen with the use of sulfa-derivative medications, such as topiramate
Therapeutic techniques in angle closure can be divided into three categories: (1) widening the angle, (2) increased aqueous outflow, and (3) decreased aqueous inflow
After the dose is increased, it is taken twice a day
Peripheral iridectomy is ineffective for this type of angle-closure glaucoma
1% in southeast Asia
However, stronger concentrations of pilocarpine have been reported to result in paradoxical induction of angle closure
5
In the UK PACG is responsible for approximately 1 in 6 Angle closure glaucoma is a major cause of blindness worldwide, with a particularly high prevalence in certain populations
Both bupropion and topiramate are widely prescribed drugs
IOP in aqueous misdirection is most often elevated, but it may be within the normal range (but not low) after filtration surgery