Mechrgui Monia, Kanani Suleman
Ophthalmology, Primary Health Care Corporation (PHCC), Doha, QAT.
Internal Medicine, Primary Health Care Corporation (PHCC), Doha, QAT.
Cureus. 2022 Aug 28;14(8):e28513. doi: 10.7759/cureus.28513. eCollection 2022 Aug.
Topiramate (TPM) is a sulfonamide drug with multiple modes of action. It inhibits carbonic anhydrase, blocks sodium channels, enhances potassium channels, and stimulates postsynaptic gamma-aminobutyric acid (GABA) receptors. Pharmacists Joe Gardocki and Bruce Maryanoff synthesized TPM for the first time in 1979. The FDA did not approve it for medical use in the US until 1996. Around 2004, it was authorized for the prevention of migraine headaches. TPM, like any medication, has several side effects. Common aftermaths include weight loss, diarrhea, dizziness, sleepiness, fatigue, and coordination issues. Some people may experience mental health issues like memory problems, confusion, and speech or language difficulties. The most well-known ocular side effects of TPM are choroidal effusion syndrome, angle-closure glaucoma, and myopic shift. Aside from these, other ophthalmic adverse effects may arise in some people, including retinal problems, uveitis, visual field defects, myokymia, and neuro-ophthalmology complications. If such complications are not identified and treated promptly, they can be severe and vision-threatening, potentially leading to permanent blindness. TPM's application as a standalone and adjunctive therapy has increased over time. In 2019, more than 10 million prescriptions of TPM were issued. Due to its extensive use, medical professionals and patients must be aware of its potential repercussions, especially ophthalmic issues. The current review paper likewise makes a step in this direction. This article's primary purpose is to educate readers by providing a comprehensive assessment of the research on TPM's ocular side effects. All the information has been collected via a thorough search of the Google Search Engine and PubMed.
托吡酯（TPM）是一种具有多种作用模式的磺胺类药物。它能抑制碳酸酐酶、阻断钠通道、增强钾通道，并刺激突触后γ-氨基丁酸（GABA）受体。药剂师乔·加多茨基和布鲁斯·马里亚诺夫于1979年首次合成了TPM。直到1996年，美国食品药品监督管理局（FDA）才批准其在美国用于医疗用途。2004年左右，它被批准用于预防偏头痛。与任何药物一样，TPM也有几种副作用。常见的后果包括体重减轻、腹泻、头晕、嗜睡、疲劳和协调问题。一些人可能会出现心理健康问题，如记忆问题、困惑以及言语或语言困难。TPM最著名的眼部副作用是脉络膜渗漏综合征、闭角型青光眼和近视性移位。除此之外，一些人可能还会出现其他眼部不良反应，包括视网膜问题、葡萄膜炎、视野缺损、肌纤维颤搐和神经眼科并发症。如果这些并发症没有得到及时识别和治疗，可能会很严重并威胁视力，甚至可能导致永久性失明。随着时间的推移，TPM作为单一疗法和辅助疗法的应用有所增加。2019年，TPM的处方量超过1000万份。由于其广泛使用，医疗专业人员和患者必须意识到其潜在影响，尤其是眼部问题。当前的综述论文也朝着这个方向迈出了一步。本文的主要目的是通过对TPM眼部副作用研究的全面评估来教育读者。所有信息均通过对谷歌搜索引擎和PubMed的全面搜索收集而来。
