Turkish Abstract Abstract PDF Similar Articles Mail to Author

¹M.D. Professor, 19 Mayıs University Faculty of Medicine Department of Ophthalmology, Samsun/TURKEY
²M.D., 19 Mayıs University Faculty of Medicine Department of Ophthalmology, Samsun/TURKEY Fourty years-old female had acute pain and blurred vision in both eyes during 3 days and she had admitted to hospital and treated as acute glaucoma crisis. We learned that she had gone to neurology staff a week ago because of she had severe headache,nausea, vomiting complaints since a week. She was on oral topiramat (Xamate), paroksetin (Paxore), etodolak (Dolarit), frovatriptan (Migrex), metoklopramid (Metpamid) for migraine since five days prior to the onset of ocular symptoms. On examination, her visual acuity was counter finger at 1 meter in both eyes (OU), intraocular pressure (IOP) was 14 mmHg OU. There was conjunctival hyperemia, severe corneal edema, very shallow anterior chamber, exudative membrane, atrophic iris, severe posterior synechia and blurred lens. In USG, there was demonstrable choroidal effusion and peripheral choroidal detachment in the both eyes. It was diagnosed that, bilateral simultaneous acute angle closure, choroidal effusion and uveitis may be caused by drug toxicity and all used systemic medications were discontinued. Systemic and topical steroids, oral acetazolamide, topical dorzolamide+timolol and cycloplegics were administered. After one week treatment, anterior segment findings were gradually improved. After 8 months follow-up, the visual acuity was 10/10 and IOP was 14 mmHg (with medication) in OU. Topimarate and paroxetine, each other were caused bilateral simultaneous acute angle closure glaucoma. Their use with together, they may be lead to severe clinic findings and irreversible damage. Keywords : Bilateral angle closure glaucoma, topiramate, paroxetine, frovatriptan, uveitis, anterior segment ischemia