Anterior segment optical coherence tomography documentation of a case of topiramate induced acute angle closure.
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Date
2014-05
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Abstract
We present a case report of a 31-year-old female patient
who presented to us with a 1 day history of acute bilateral
eye pain, blurred vision and headache. She was found
to have a myopic shift, raised intraocular pressure (IOP)
and shallow anterior chambers in both eyes. She had been
commenced on oral topiramate 1 week previously. A number
of investigations, including anterior segment optical coherence
tomography (AS-OCT) were done and a diagnosis of topiramate
induced bilateral acute angle closure (TiAAC) was made.
Topiramate was discontinued and she was managed with
topical and oral antiglaucoma medications, topical steroids
and cyclopegics. Her symptoms subsided dramatically at the
next follow-up. The AS-OCT documentation revealed lucidly
the improvement in her anterior chamber depth and anterior
chamber angle parameters. Her IOP decreased, her myopic
shift showed reversal and her AS-OCT fi ndings revealed gross
improvement in all the parameters angle opening distance,
trabecular iris space area and scleral spur angle. This case report
clearly shows with AS OCT documentation the changes which
occur in the anterior segment in a case of TiAAC.
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Keywords
Anterior segment optical coherence tomography, angle opening distance, angle recess area, myopic shift, shallow anterior chamber, topiramate induced bilateral acute, angle closure, trabecular iris space area
Citation
Mitra Arijit, Ramakrishnan R, Kader Mohideen Abdul. Anterior segment optical coherence tomography documentation of a case of topiramate induced acute angle closure. Indian Journal of Ophthalmology. 2014 May ; 62 (5): 619-622.