Sierra-Rodríguez M A, Rodríguez-Vicente L, Chavarri-García J J, Del Río-Mayor J L
Servicio de Oftalmología, Hospital San Pedro, Logroño, La Rioja, España.
Servicio de Oftalmología, Hospital San Pedro, Logroño, La Rioja, España.
Arch Soc Esp Oftalmol (Engl Ed). 2019 Mar;94(3):130-133. doi: 10.1016/j.oftal.2018.11.005. Epub 2018 Dec 24.
We report the case of a 29-year-old epileptic woman who had been on treatment with topiramate 25mg/day for 9 days. She was referred to the Emergency Department due to reduction in far visual acuity (VA) after increasing the dose to 50mg/day two days before. The ocular examination showed bilateral acute angle closure glaucoma (AACG) and macular striae in both eyes (AO) observed by Retinography and Optical Coherence Tomography (OCT). The AACG is a well-known side effect of topiramate, but the macular striae rarely accompanies it. Although macular striae have been previously described in other cases, very few document those using retinography and OCT images. Therefore, it is important to differentiate a case of AACG induced by topiramate from a case of primary AACG, since they differ in their clinical presentation, mechanism of action, and treatment. Mismanagement can have potentially serious consequences.
我们报告了一例29岁的癫痫女性病例，她服用托吡酯25毫克/天进行治疗，疗程为9天。两天前，她的剂量增加到50毫克/天，之后因远视力（VA）下降被转诊至急诊科。眼科检查显示双眼急性闭角型青光眼（AACG），通过视网膜造影和光学相干断层扫描（OCT）观察到双眼均有黄斑条纹（AO）。AACG是托吡酯众所周知的副作用，但黄斑条纹很少与之伴随出现。尽管黄斑条纹在之前的其他病例中已有描述，但很少有使用视网膜造影和OCT图像记录的情况。因此，区分托吡酯诱发的AACG病例和原发性AACG病例很重要，因为它们在临床表现、作用机制和治疗方面存在差异。管理不当可能会带来潜在的严重后果。
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