Topiramate引起雙側急性隅角閉鎖及近視加深之病例報告及文獻回顧

Bilateral acute angle closure and myopic shift caused by topiramate – A case report and literature review

Topiramate是一種磺胺衍生藥物，被廣泛應用於癲癇控制，偏頭痛預防，三叉神經痛，躁鬱症，憂鬱症，甚至減重治療。續發性的急性隅角閉鎖型青光眼是topiramate的副作用之一。我們報告一位41歲的近視女性，在服用topiramate當作減肥藥物10天後產生雙側急性視力減退，並且合併眼壓上升，水晶體增厚，以及前房狹窄的案例。在立即停止服用topiramate並給予降眼壓藥物後，她的眼壓及視力完全回復。當患者兩眼同時發生急性隅角閉鎖及近視加深的情形，我們應該小心的詢問過往的用藥史，以排除藥物引起的可能性。

 

Topiramate is a sulfa-derivative drug, which was used in many diseases, including seizure, migraine prophylaxis, trigeminal neuralgia, bipolar disorders, depression and weight-loss. Secondary acute angle closure glaucoma is one of the side effects of topiramate. We presented a case of 41-year-old myopic woman with acute bilateral blurred vision after taking topiramate as weight-loss drugs for ten days. Elevated intraocular pressure (IOP), increased lens thickness (LT), and decreased anterior chamber depth (ACD) were noted. After immediate discontinuation of topiramate and given ocular hypotensive medication, her IOP returned to normal and vision recovered completely. Review of the medication record is crucial, especially when acute angle closure and myopia occurred simultaneously.