Topiramate-Associated Acute, Bilateral, Secondary Angle-Closure Glaucoma

F. W. Fraunfelder, Frederick (Fritz) Fraunfelder, Edwin U. Keates

Research output: Contribution to journalArticle

202 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)109-111
Number of pages3
JournalOphthalmology
Volume111
Issue number1
DOIs
StatePublished - Jan 2004

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Angle Closure Glaucoma
Iridectomy
Myopia
Drug-Related Side Effects and Adverse Reactions
Pharmaceutical Preparations
Scleritis
Case Management
United States Food and Drug Administration
Sweden
Causality
Glaucoma
Registries
Edema
Lasers
Outcome Assessment (Health Care)
Safety
topiramate
Health
Therapeutics

ASJC Scopus subject areas

  • Ophthalmology

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Topiramate-Associated Acute, Bilateral, Secondary Angle-Closure Glaucoma. / Fraunfelder, F. W.; Fraunfelder, Frederick (Fritz); Keates, Edwin U.

In: Ophthalmology, Vol. 111, No. 1, 01.2004, p. 109-111.

Research output: Contribution to journalArticle

Fraunfelder, F. W. ; Fraunfelder, Frederick (Fritz) ; Keates, Edwin U. / Topiramate-Associated Acute, Bilateral, Secondary Angle-Closure Glaucoma. In: Ophthalmology. 2004 ; Vol. 111, No. 1. pp. 109-111.
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