TY - JOUR
T1 - Topiramate-Associated Acute, Bilateral, Secondary Angle-Closure Glaucoma
AU - Fraunfelder, F. W.
AU - Fraunfelder, F. T.
AU - Keates, Edwin U.
N1 - Funding Information:
Supported, in part, by an unrestricted grant from Research to Prevent Blindness, New York, New York, and by the National Registry of Drug-Induced Ocular Side Effects, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.
PY - 2004/1
Y1 - 2004/1
N2 - Purpose: To evaluate spontaneous reports of ocular side effects associated with topiramate use. Design: Retrospective case series. Methods: One hundred fifteen case reports, primarily of a specific ocular syndrome (acute secondary angle-closure glaucoma), were collected from spontaneous reporting systems: the Drug Safety section of Ortho-McNeil Pharmaceuticals, Inc. (Raritan, NJ), the Food and Drug Administration (Rockville, MD), the World Health Organization (Uppsala, Sweden), the National Registry of Drug-Induced Side Effects (Casey Eye Institute, Oregon Health & Science University, Portland, Oregon), and the world literature. Main Outcome Measures: The data were evaluated using the World Health Organization Causality Assessment Guide to the certainty of a suspected adverse drug reaction. Results: Eighty-six cases of acute-onset glaucoma (83 bilateral and 3 unilateral), 17 cases of acute bilateral myopia (up to 8.75 diopters), 9 cases of suprachoroidal effusions, 3 cases of periorbital edema, and 4 cases of scleritis were reported. In those cases for which management was reported, 38% had laser or surgical peripheral iridectomy (21 cases). Conclusions: In the "certain" category of the World Health Organization classification system, the following are caused by topiramate therapy: abnormal vision, acute secondary angle-closure glaucoma, acute myopia, and suprachoroidal effusions. All findings are reversible if recognized early and if the drug is discontinued. The first presenting symptom of acute secondary angle-closure glaucoma in many patients was blurring of vision. Peripheral iridectomy is ineffective for this type of angle-closure glaucoma.
AB - Purpose: To evaluate spontaneous reports of ocular side effects associated with topiramate use. Design: Retrospective case series. Methods: One hundred fifteen case reports, primarily of a specific ocular syndrome (acute secondary angle-closure glaucoma), were collected from spontaneous reporting systems: the Drug Safety section of Ortho-McNeil Pharmaceuticals, Inc. (Raritan, NJ), the Food and Drug Administration (Rockville, MD), the World Health Organization (Uppsala, Sweden), the National Registry of Drug-Induced Side Effects (Casey Eye Institute, Oregon Health & Science University, Portland, Oregon), and the world literature. Main Outcome Measures: The data were evaluated using the World Health Organization Causality Assessment Guide to the certainty of a suspected adverse drug reaction. Results: Eighty-six cases of acute-onset glaucoma (83 bilateral and 3 unilateral), 17 cases of acute bilateral myopia (up to 8.75 diopters), 9 cases of suprachoroidal effusions, 3 cases of periorbital edema, and 4 cases of scleritis were reported. In those cases for which management was reported, 38% had laser or surgical peripheral iridectomy (21 cases). Conclusions: In the "certain" category of the World Health Organization classification system, the following are caused by topiramate therapy: abnormal vision, acute secondary angle-closure glaucoma, acute myopia, and suprachoroidal effusions. All findings are reversible if recognized early and if the drug is discontinued. The first presenting symptom of acute secondary angle-closure glaucoma in many patients was blurring of vision. Peripheral iridectomy is ineffective for this type of angle-closure glaucoma.
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U2 - 10.1016/j.ophtha.2003.04.004
DO - 10.1016/j.ophtha.2003.04.004
M3 - Article
C2 - 14711721
AN - SCOPUS:0348048864
SN - 0161-6420
VL - 111
SP - 109
EP - 111
JO - Ophthalmology
JF - Ophthalmology
IS - 1
ER -