Albalawi Rawan, Alhashemi Moustafa, Aljthalin Raseel
Department of Adult Neurology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Department of internal medicine, Aleppo university hospital, Aleppo, Syria.
BMC Neurol. 2025 Mar 19;25(1):113. doi: 10.1186/s12883-025-04089-5.
Acute transient myopia with shallowing of the anterior chamber is a rare idiosyncratic response to many systemic and topical medications, including topiramate. Several such cases have been reported in the past as a chronic complication, but are less frequently reported as a bilateral acute myopia. We report a case of acute transient myopia due to Topiramate - a drug used for epilepsy and migraine prophylaxis.
A 22 years old male recently diagnosed with epilepsy started on topiramate for 8 days after which he developed sudden drop in vision bilaterally. He was diagnosed with acute transient bilateral myopia based clinical findings and exclusion. The medication was stopped immediately and the patient showed significant improvement after the 2nd day from the discontinuation.
A review of 9 studies, which included 16 cases for topiramate induced acute myopia encompassing 18 patients revealed a predominance of females (12). Symptoms included sudden myopia, anterior chamber shallowing, ciliochoroidal effusion, and elevated intraocular pressure. Notably, discontinuation of topiramate resulted in symptom reversal. These findings underscore the need for awareness of acute bilateral myopia secondary to topiramate as a rare adverse effect across diverse patient demographics and dosages.
This case and the existing literature emphasize the significance of educating patients and the necessity for immediate discontinuation of the drug when ocular symptoms happen. This case also outlines the importance of interdisciplinary collaboration in addressing the adverse effects linked to neurological medications such as topiramate. We present an additional case that illustrates the ophthalmic complications associated with topiramate.
急性短暂性近视伴前房变浅是对包括托吡酯在内的许多全身和局部用药罕见的特异反应。过去曾有几例此类情况作为慢性并发症报道，但双侧急性近视的报道较少。我们报告一例因托吡酯引起的急性短暂性近视病例，托吡酯是一种用于预防癫痫和偏头痛的药物。
一名22岁男性最近被诊断为癫痫，开始服用托吡酯8天后，双侧视力突然下降。根据临床检查结果和排除其他因素，他被诊断为急性双侧短暂性近视。药物立即停用，停药后第2天患者视力有显著改善。
对9项研究进行回顾，其中包括16例托吡酯引起急性近视的病例，涉及18名患者，结果显示女性占多数（12例）。症状包括突然近视、前房变浅、睫状体脉络膜积液和眼压升高。值得注意的是，停用托吡酯后症状逆转。这些发现强调了对于托吡酯继发的急性双侧近视作为一种罕见不良反应，无论患者人口统计学特征和剂量如何，都需要提高认识。
该病例及现有文献强调了对患者进行教育的重要性，以及眼部症状出现时立即停药的必要性。该病例还概述了跨学科合作在处理与托吡酯等神经药物相关不良反应方面的重要性。我们展示了另一例说明与托吡酯相关眼科并发症的病例。
