Macular folds: an unusual association in topiramate toxicity

Clinical & Experimental Optometry : Journal of the Australian Optometrical Association
Mukesh KumarAnshuman Garnaik

Abstract

We report two uncommon cases of acute onset myopia with macular folds following use of topiramate. A 25-year-old woman, with no prior history of glasses, taking topiramate for recurrent headaches, presented with decreased vision. On examination, she was found to have a refractive error of -5.00 DS in both eyes and intraocular pressure of 10 mmHg and 6 mmHg in the right and left eyes, respectively. She had closed angles on gonioscopy, ciliary effusion on ultrasonic biomicroscopy with inner limiting membrane folds in the macula in both eyes. She was on anti-glaucoma medication when she presented to us. A 20-year-old woman presented with acute headache and decreased vision following use of topiramate for treatment of migraine. On examination, her intraocular pressure was 25 mmHg in both eyes with closed angles on gonioscopy, a refractive error of -4.50 DS and prominent macular folds with no fluid in both eyes. There was complete resolution of macular folds and angle-closure attack after discontinuation of topiramate and conservative treatment with topical steroids and cycloplegics in both eyes. Topiramate toxicity may present with macular folds associated with angle-closure glaucoma. Folds in the inner limiting membrane might give...Continue Reading

References

Dec 10, 2002·Archives of Ophthalmology·Naohiro IkedaOsamu Mimura
Apr 3, 2003·Journal of Glaucoma·Harry A QuigleyNathan G Congdon
Jan 1, 2004·American Journal of Ophthalmology·Jamie E CraigJane M Wells
Jan 9, 2004·Ophthalmology·F W FraunfelderEdwin U Keates
Dec 20, 2007·Optometry and Vision Science : Official Publication of the American Academy of Optometry·Christian P Guier
Mar 19, 2011·Archivos de la Sociedad Española de Oftalmología·E DorronzoroJ A Gegúndez-Fernández

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Citations

Sep 28, 2012·International Ophthalmology·William Gualtieri, Jan Janula
Oct 31, 2012·Clinical & Experimental Optometry : Journal of the Australian Optometrical Association·Seyed-Hossein AbtahiZahra-Alsadat Abtahi
Jun 5, 2015·Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie·Nathaniel SearsRishi P Singh
May 7, 2015·Journal of Glaucoma·Rory M MurphyLouis R Pasquale

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