托吡酯诱发急性近视和闭角型青光眼的机制。
Mechanism of topiramate-induced acute-onset myopia and angle closure glaucoma.
作者信息
Craig Jamie E, Ong Terrence J, Louis Damien L, Wells Jane M
机构信息
Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.
出版信息
Am J Ophthalmol. 2004 Jan;137(1):193-5. doi: 10.1016/s0002-9394(03)00774-8.
DESIGN
Interventional case report.
METHODS
In an institutional practice setting, two women, aged 25 and 45, developed acute myopia after starting topiramate for epilepsy. One patient also developed bilateral angle closure glaucoma.
RESULTS
Topiramate was discontinued. Anterior chamber shallowing was noted in both patients at presentation. Ultrasonography showed ciliochoroidal effusion. Baseline measurements of anterior chamber depth and lens thickness were obtained.
CONCLUSIONS
Topiramate may be associated with ciliochoroidal effusion with forward displacement of the lens-iris diaphragm and anterior chamber shallowing, resulting in acute myopia and angle-closure glaucoma. Increased lens thickness contributes only minimally (9%-16%) to anterior chamber shallowing.
设计
介入性病例报告。
方法
在一个机构性医疗实践环境中，两名分别为25岁和45岁的女性在开始使用托吡酯治疗癫痫后出现急性近视。其中一名患者还发生了双侧闭角型青光眼。
结果
停用托吡酯。两名患者就诊时均发现前房变浅。超声检查显示睫状体脉络膜积液。获得了前房深度和晶状体厚度的基线测量值。
结论
托吡酯可能与睫状体脉络膜积液相关，伴有晶状体-虹膜隔向前移位和前房变浅，导致急性近视和闭角型青光眼。晶状体厚度增加对前房变浅的影响极小（9%-16%）。
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