Table 1 Demographic and clinical of the patients
Patient | Study | Age | Gender | Country of origin and date of publishing | Indication of use of topamax | Dose and duration | Symptoms | Ophthalmological examination | Action | Prognosis |
|---|---|---|---|---|---|---|---|---|---|---|
1 | Craig et al. [3] | 25, 45 | Female, Female | Australia (2004) | Epilepsy | not defined | acute myopia | Anterior chamber shallowing was noted in both patients at presentation. Ultrasonography showed ciliochoroidal effusion | not defined | not defined |
2 | Cereza et al. [6] | 19, 34, 40, 42, 23, 15, 67 | Female /Female /Female /Male /Male /Male /Female/ Male | n/a (2005) | Psychiatric Causes /Migraine The Last Female | 50 Mg 1 day, 25 Mg 5 days, 100 30 days, 50 Mg 2 days, 25 Mg 1 day, 50 Mg 5 days | myopia | not mentioned | Immediate discontinuation of Topamax | back to normal after 1, 7, 3, 24, 1, 2 days |
3 | Desai et al. [2] | 36 | Female | India (2006) | Migraine | 25 mg/day for 10 days | sudden painless, blurring of vision in both eyes | BCVA was 20/20 and N6 in either eye with − 1.50 Dioptres Spherical (DSph) and − 1.00 DCyl at 160 degrees in right eye and − 2.0 DSph and − 0.75 DCyl at 20 degrees in left eye. Her intraocular pressures were 17 mm Hg by applanation in each eye. | discontinued | diagnosed before progression to glaucoma |
4 | Izambart et al. [7] | 44 | Female | France (2007) | Migraine | not defined | acute myopia, bilateral angle-closure glaucoma | Intraocular pressure was 31 mmHg right and 32 mmHg left, myopia was 4 diopters | Topiramate was interrupted and general and local hypotensive treatment begun and rapidly stopped after improvement. Iridotomy was also performed. | Fifteen days later, complete resolution was observed on ophthalmologic examination: anterior chambers were deep, myopia fully regressed, intraocular pressure returned to normal, and the visual field was complete. |
5 | Cruciani et al. [8] | not identified | Not Identified | Italy (2009) | Epilepsy | not defined | myopia, bilateral acute angle closure glaucoma | Complete ophtalmological examination was carried out along with ultrabiomicroscopy of the anterior segment and confocal microscopic study of the corneal endothelium | monitored for 2 weeks then discontinued | not defined |
6 | Kumar et al. [9] | 25 | Female | n/a (2011) | Migraine | not defined | acute headache and decreased vision following use of topiramate for treatment of migraine | 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. | discontinuation of topiramate and conservative treatment with topical steroids and cycloplegics in both eyes. | The symptoms resolved on the discontinuation of topiramat |
7 | Gualtieri et al. [10] | 22 | Female | America (2012) | Migraine | 100 Mg for 6 days | severe visual acuity deterioration of sudden onset in both eyes, regardless of distance (far or near), during the span of 1 day. | Best-corrected visual acuity (BCVA) in the right eye was hand motion and in the left eye was counting fingers Fundus biomicroscopy disclosed a maculopathy with macular striae and a cellophane-like reflex | Immediate discontinuation of Topamax | Three days after suspension of Topomax and steroid therapy the patient's BCVA was 6/6 in both eyes |
8 | Gazieva et al. [11] | 41 | Female | Scandinavia (2013) | Migraine | 25 Mg for 10 days increase to 50 Mg for 2 days for total of 12 days | blurred vision on both eyes | was increased to 50 mg for the last 2 days. On examination, the visual acuity was 0.04 in both eyes without correction, Slit-lamp examination revealed bilateral narrowing of anterior chamber with forward displacement of lens-iris diaphragm. Examination with A scan measurements revealed shallow anterior chamber, thickening of lens and normal axial length on both eyes. The intraocular pressure was measured to 20 mm Hg in the right eye and 23 mm Hg in the left eye. Gonioscopy confirmed narrow angles | Topiramate therapy was immediately discontinued, and the patient received systemic therapy with acetazolamide 250 mg twice a day | resolved after 1 week |
9 | Medagama et al. [12] | 35 | Female | Sri Lankan (2014) | Migraine | not defined | drop in vision bilaterally | not defined | discontinuation of the drug, | improvement after 3 days and full recovery after 10 days |
10 | This study | 23 | Male | Saudi Arabia (2024) | Epilepsy | 50mg 7 days, 100 mg 1 day | acute bilateral myopia | bilateral choroidal effusion and hyperemic disc. CTA showed patent anterior and posterior circulation | Immediate discontinuation of Topamax | ophthalmology assessment after 2 weeks showed resolution of the previously noticed choroidal effusion. |