Topiramate-induced bilateral acute angle closure glaucoma and myopic shift


  • Rajnish Raj Department of Psychiatry, Government Medical College & Rajindra Hospital, Patiala, Punjab, India
  • Anuradha Raj Department of Ophthalmology, Himalayan Institute Medical Sciences, Jolly Grant, Dehradun, Uttarakhand, India


Topiramate, Acute angle closure glaucoma, Ciliochoroidal effusion, Young mania rating scale


Topiramate (TPM) shows idiosyncratic adverse reaction of peripheral ciliochoroidal effusion leading to acute angle closure glaucoma (AACG), which should be diagnosed and managed at the earliest to prevent irreversible visual loss. We report, a case of TPM-induced bilateral AACG and myopic shift, which was reversed by omitting TPM and administering antiglaucoma medications.



Shank RP, Gardocki JF, Streeter AJ, Maryanoff BE. An overview of the preclinical aspects of topiramate: pharmacology, pharmacokinetics, and mechanism of action. Epilepsia. 2000;41 Suppl 1:S3-9.

Marcotte D. Use of topiramate, a new anti-epileptic as a mood stabilizer. J Affect Disord. 1998;50(2-3):245-51.

Kirov G, Tredget J. Add-on topiramate reduces weight in overweight patients with affective disorders: a clinical case series. BMC Psychiatry. 2005;5:19.

Rhee DJ, Goldberg MJ, Parrish RK. Bilateral angle-closure glaucoma and ciliary body swelling from topiramate. Arch Ophthalmol. 2001;119(11):1721-3.

Chen TC, Chao CW, Sorkin JA. Topiramate induced myopic shift and angle closure glaucoma. Br J Ophthalmol. 2003;87(5):648-9.

Bovino JA, Marcus DF. The mechanism of transient myopia induced by sulfonamide therapy. Am J Ophthalmol. 1982;94(1):99-102.

Grinbaum A, Ashkenazi I, Gutman I, Blumenthal M. Suggested mechanism for acute transient myopia after sulfonamide treatment. Ann Ophthalmol. 1993;25(6):224-6.

Ikeda N, Ikeda T, Nagata M, Mimura O. Ciliochoroidal effusion syndrome induced by sulfa derivatives. Arch Ophthalmol. 2002;120(12):1775.

Sankar PS, Pasquale LR, Grosskreutz CL. Uveal effusion and secondary angle-closure glaucoma associated with topiramate use. Arch Ophthalmol. 2001;119(8):1210-1.

Sachi D, Vijaya L. Topiramate induced secondary angle closure glaucoma. J Postgrad Med. 2006;52(1):72-3.

Fraunfelder FW, Fraunfelder FT, Keates EU. Topiramate-associated acute, bilateral, secondary angle-closure glaucoma. Ophthalmology. 2004;111(1):109-11.

Rhee DJ, Ramos-Esteban JC, Nipper KS. Rapid resolution of topiramate-induced angle-closure glaucoma with methylprednisolone and mannitol. Am J Ophthalmol. 2006;141(6):1133-4.




How to Cite

Raj, R., & Raj, A. (2017). Topiramate-induced bilateral acute angle closure glaucoma and myopic shift. International Journal of Basic & Clinical Pharmacology, 3(3), 562–565. Retrieved from



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