Izambart C, Rocher F, Zur C, Chichmanian R M, Gastaud P
Service d'Ophtalmologie, CHU de Nice, Hôpital Saint Roch, Nice.
J Fr Ophtalmol. 2007 May;30(5):e11. doi: 10.1016/s0181-5512(07)89635-5.
Topiramate, an antiepileptic medication, has been widely used since its recent indication for migraine prophylaxis. We report a case of bilateral angle-closure glaucoma and acute myopia in a 44-year-old woman on oral topiramate therapy initiation for migraine prophylaxis. 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. This new case prompts discussion on current reports in the literature and French drug monitoring database cases in this context.
托吡酯是一种抗癫痫药物，自其最近被用于偏头痛预防以来已被广泛使用。我们报告了一例44岁女性在开始口服托吡酯预防偏头痛治疗后出现双侧闭角型青光眼和急性近视的病例。右眼眼压为31 mmHg，左眼眼压为32 mmHg，近视度数为4屈光度。停用托吡酯并开始进行全身和局部降压治疗，病情改善后迅速停药。同时也进行了虹膜切开术。15天后，眼科检查显示完全恢复：前房加深，近视完全消退，眼压恢复正常，视野完整。这一新病例促使我们对文献中的现有报告以及法国药物监测数据库中在此背景下的病例进行讨论。
