Department of Ophthalmology, Meram Faculty of Medicine, Selçuk University, Konya, Turkey.
Curr Eye Res. 2011 Jan;36(1):47-52. doi: 10.3109/02713683.2010.529540.
To determine the changes in refractive error, and the cornea, anterior chamber, and retina induced by topiramate.
The study included 76 eyes of 38 patients that began to use topiramate due to migraine. Following ophthalmological examination, all of the patients underwent central corneal thickness (CCT), anterior chamber volume (ACV), anterior chamber depth (ACD), and anterior chamber angle (ACA) measurement using a Scheimpflug camera, as well as macular thickness, retinal and retinal nerve fiber layer thickness (RNFLT) measurements using optical coherence tomography (OCT). These procedures were repeated 15, 30, and 90 days after the initiation of topiramate therapy.
The median refractive error value showed a statistically significant increase from -0.25 diopters (D) to -0.62 D at the 90th day follow-up (P < 0.001). Mean CCT was 570.56 µm before treatment and increased to 573.69 µm at the 15th day follow-up, 575.31 µm at the 30th day follow-up, and 574.56 µm at the 90th day follow-up; however, these changes were not statistically significant. Mean ACV, ACD, and ACA did not exhibit statistically significant changes. Mean retinal thickness (RT) increased during the treatment from 263.46 µm to 271.60 µm, which was not statistically significant. The initial mean RNFLT was 100.56 ± 15.36 µm and significantly increased to 110.2 ± 8.41 µm and 111.03 ± 14.59 µm at the 30th and 90th day follow-ups, respectively (P = 0.01 and P = 0.004, respectively).
During the 3-month follow-up of patients using topiramate 50 mg d(-1) significant myopic shift and an increase in RNFLT were observed. Further studies are warranted in order to assess the effects of topiramate when used long term and at higher doses.
确定托吡酯引起的屈光不正以及角膜、前房和视网膜的变化。
本研究纳入了 38 例因偏头痛开始使用托吡酯的患者的 76 只眼。眼科检查后，所有患者均使用 Scheimpflug 相机测量中央角膜厚度（CCT）、前房容积（ACV）、前房深度（ACD）和前房角（ACA），并使用光学相干断层扫描（OCT）测量黄斑厚度、视网膜和视网膜神经纤维层厚度（RNFLT）。在开始托吡酯治疗后 15、30 和 90 天重复这些程序。
中位屈光度值从治疗前的-0.25 屈光度（D）显著增加到 90 天随访时的-0.62 D（P < 0.001）。治疗前平均 CCT 为 570.56 µm，随访 15 天时增加至 573.69 µm，随访 30 天时增加至 575.31 µm，随访 90 天时增加至 574.56 µm，但这些变化无统计学意义。平均 ACV、ACD 和 ACA 无统计学显著变化。治疗期间平均视网膜厚度（RT）从 263.46 µm 增加至 271.60 µm，但无统计学意义。初始平均 RNFLT 为 100.56 ± 15.36 µm，随访 30 天和 90 天时分别显著增加至 110.2 ± 8.41 µm 和 111.03 ± 14.59 µm（P = 0.01 和 P = 0.004）。
在使用托吡酯 50 mg/d 的 3 个月随访期间，观察到明显的近视漂移和 RNFLT 增加。需要进一步研究以评估长期和高剂量使用托吡酯的影响。
