Presumed topiramate-induced bilateral acute angle-closure glaucoma

PURPOSE: We describe a case of bilateral angle closure glaucoma associated with oral topiramate therapy. METHODS: Interventional case report, Case report with echographic illustrat ion, RESULTS: A 51-year-old man developed bilateral acute angle-closure glaucoma 2 weeks after beginning topiramate therapy for bipolar affective disorder, Laser peripheral iridotomy was performed in the right eye without resoluti on of the acute attack. Echography revealed lens thickening and ciliochoroi dal detachments in both eyes. Visual acuity, intraocular pressure, and ante rior and posterior segment anatomy normalized 2 weeks after cessation of to piramate therapy. CONCLUSION: Topiramate, a new sulfa-derivative antiepileptic medication, ma y cause idiosyncratic ciliochoroidal detachments and ciliary body edema lea ding to anterior displacement of the lens-iris diaphragm, lens thickening, and acute angle-closure glaucoma, (Am J Ophthalmol 2001;132:112-114. (C) 20 01 by Elsevier Science Inc, All rights reserved.).