DÜŞÜK DOZ TOPİRAMAT KULLANIMI SONRASI GELİŞEN BİLATERAL AKUT DAR AÇILI GLOKOM VE MİYOPİ

Giriş: Topiramat, epilepsi tedavisinde ve migren profilaksisinde etkili olduğu gösterilen sülfamat sübstitüsyonlu monosakkarid türevi bir ajandır. Bu ilacın kullanımı sırasında özellikle ilk iki hafta içerisinde akut myopi ile birlikte açı kapanması glokomu krizi gelişebilir.
Anahtar Kelimeler:

Glokom, migren, miyopi, topiramat

BILATERAL ACUTE ANGLE CLOSURE GLAUCOMA AND MYOPIA INDUCED BY LOW DOSAGE TOPIRAMATE

day) for prophylaxis of migraine without aura. The patient was found to have significant conjunctival hyperemia, shallow anterior chamber, and bulging iris in both eyes. Grade 1 acute angle was detected in both eyes during gonioscopic examination. There was no pupillary block and intraocular pressure was 40 mmHg in both eyes. Refraction values were measured at -7.00 and -8.00 in the right and left eye, respectively. The patient’s visual acuity was at 0.1 to 0.2. Topiramate treatment was promptly discontinued, topical antiglaucomatous treatment was initiated, and laser peripheral iridotomy was performed on each eye. Intraocular pressure has declined to normal limits, refractive values were zero in both eyes and patient’s visual acuity has restored at follow-up period at 10 days after treatment. Conclusion- Side effects associated with topiramate treatments are known to disappear without long-term damage when the discontinuation of therapy and effective interventions are started early. Therefore, patients and their physicians should be alert for symptoms associated with acute secondary angle closure glaucoma and myopia

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