DaCosta Joanna, Younis Saad
Ophthalmology Department, Imperial College Healthcare NHS Trust, Western Eye Hospital, Whipps Cross University Hospital, London, UK; Barts Health NHS Trust, Whipps Cross University Hospital, London, UK.
Ophthalmology Department, Imperial College Healthcare NHS Trust, Western Eye Hospital, Whipps Cross University Hospital, London, UK.
Drug Healthc Patient Saf. 2016 Jun 8;8:59-63. doi: 10.2147/DHPS.S105962. eCollection 2016.
This report describes a case of reversible topiramate-induced maculopathy in a 32-year-old female patient with IgG4-related disease. The patient presented with decreased vision associated with anterior uveitis and cystoid macula edema, which was unresponsive to oral and topical steroids. Following topiramate cessation, both cystoid macula edema and vision improved. The ocular side effects of topiramate and putative pharmacological mechanisms for topiramate-induced maculopathy in the context of IgG4-related disease are discussed. This report highlights that neurologists and ophthalmologists should be aware that patients presenting with topiramate-associated maculopathy should be advised to discontinue topiramate promptly to prevent irreversible loss of vision.
本报告描述了一名32岁患有IgG4相关疾病的女性患者出现的托吡酯所致可逆性黄斑病变。该患者出现与前葡萄膜炎和黄斑囊样水肿相关的视力下降，口服和局部使用类固醇均无反应。停用托吡酯后，黄斑囊样水肿和视力均有所改善。本文讨论了托吡酯的眼部副作用以及在IgG4相关疾病背景下托吡酯所致黄斑病变的可能药理机制。本报告强调，神经科医生和眼科医生应意识到，对于出现托吡酯相关性黄斑病变的患者，应建议其立即停用托吡酯，以防止视力不可逆丧失。
