Diaz-Cespedes R A, Toro-Giraldo D, Olate-Perez A, Hervas-Ontiveros A, Garcia-Delpech S, Udaondo-Mirete P
Servicio de Oftalmología, Hospital de Manises, Valencia, España.
Servicio de Oftalmología, Hospital Clínico Universitario de Valencia, Valencia, España.
Arch Soc Esp Oftalmol (Engl Ed). 2019 Aug;94(8):391-395. doi: 10.1016/j.oftal.2019.01.004. Epub 2019 Feb 7.
A 45 year-old man with bilateral acute angle-closure and myopia after starting treatment with topiramate, secondary to alcohol and heroin dependence. Using Visante® OCT (Optical Coherence Tomography) and B-scan Ultrasound he was diagnosed with bilateral ciliochoroidal effusion as the pathophysiological mechanism. Topiramate was stopped and ocular hypotensive therapy with a topical cycloplegic and corticosteroids were started, resolving ciliochoroidal effusion syndrome. Visante® OCT and B-scan Ultrasound are useful tools for the diagnosis and follow-up of patients with acute angle-closure and myopia due to topiramate. As a result of broad spectrum of indications for topiramate, physicians and ophthalmologists should be aware of the possible ophthalmological manifestations attributable to this drug.
一名45岁男性，在开始使用托吡酯治疗后出现双侧急性闭角型青光眼和近视，继发于酒精和海洛因依赖。使用Visante®光学相干断层扫描（OCT）和B超检查，诊断其双侧睫状脉络膜积液为病理生理机制。停用托吡酯，并开始使用局部睫状肌麻痹剂和皮质类固醇进行降眼压治疗，睫状脉络膜积液综合征得以缓解。Visante® OCT和B超检查是诊断和随访托吡酯所致急性闭角型青光眼和近视患者的有用工具。由于托吡酯适应证广泛，内科医生和眼科医生应意识到该药物可能引起的眼科表现。
