Efficiency of Choroidal Thickness Monitoring to Prevent Topiramate Induced Acute Angle Closure Glaucoma

Abstract

The aim of this study is to investigate early findings of the choroidal effusion induced by topiramate use which is thought to be responsible for bilateral acute angle closure glaucoma. Enhanced depth imaging (EDİ) spectral domain optical coherence tomography (SD-OCT) recordings of 34 patients who has been used topiramate for the prophylaxis of migraines, before and after 2 weeks of drug use were retrospectively investigated. Alterations in subfoveal choroidal layer thicknesses and peripapillary retinal nerve fiber layer (RNFL) thickness were measured manually by two masked observers. The mean measurements of subfoveal choroidal layer thickness were 315.67±80.98 µm before use of the drug and 314.89±76.40 µm in 2nd week of drug use. However, this slight decrease was not statistically significant. The mean peripapillary RNFL thickness was 104.47±10.48 µm before use of the drug, and significant thinning was found only in the temporal quadrant during follow-up after use of the drug (p=0.008). No subclinical subfoveal choroidal effusions were encountered using EDİ SD-OCT in patients after 2 weeks of topiramate use. Further studies are needed to find out the cause of bilateral ciliochoroidal effusion related with topiramate use.

Keywords

• Choroidal effusion, topiramate, acute angle closure glaucoma, optical coherence tomography

Efficiency of Choroidal Thickness Monitoring to Prevent Topiramate Induced Acute Angle Closure Glaucoma

Abstract

Bu çalışmamızın amacı bilateral akut açı kapanması glokomu gelişiminden sorumlu olduğu düşünülen topiramatın neden olduğu koroidal effüzyona ait erken bulguları araştırmaktır. Migren profilaksisi için topiramat kullanan 34 hastanın, ilaç alımından önce ve 2 hafta sonra alınan enhanced depth imaging (EDİ) spektral optic koherens tomografi (S-OKT) kayıtları retrospektif olarak incelendi. Subfoveal koroidal tabaka ve peripapiller retinal sinir lifi tabakasındaki kalınlık değişimleri birbirine kör iki gözlemci tarafından manuel olarak ölçüldü. Subfoveal koroidal tabaka kalınlıklarının ortalaması ilaç kullanımından önce 315.67 ± 80.98 µm ve ilaç kullanımının 2. haftasında 314.89 ± 76.40 µm idi. Ancak bu hafif azalma istatistiksel olarak anlamlı değildi. Retina sinir lifi tabakası kalınlıklarının ortalaması ilaç kullanımından önce 104.47 ± 10.48 µm idi ve ilaç kullanımı sonrasındaki izlemde sadece temporal kadranda anlamlı bir incelme bulundu (P = 0.008). Topiramatın 2 haftalık kullanımı sonrasında EDİ S–OKT ile subklinik subfoveal koroidal effüzyona rastlanmamıştır. Topiramat kullanımı ile ilişkili olan bilateral siliokoroidal effüzyonun sebebini ortaya çıkarmak için ileri çalışmalara ihtiyaç vardır

Keywords

• Koroidal effüzyon, topiramat, akut açı kapanması glokomu, optik koherens tomografi

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