Acute Angle-Closure Crisis Secondary to Topiramate-Induced Ciliochoroidal Effusion With Underlying Plateau Iris Configuration

2021 ◽  
pp. 875647932110357
Author(s):  
Steven R. Shen ◽  
Erin A. Boese ◽  
Courtney P. Clark ◽  
Xiaofei Man ◽  
Melisa Nika ◽  
...  
Keyword(s):  
Side Effect ◽  
Ciliary Body ◽  
Case Series ◽  
Ultrasound Biomicroscopy ◽  
Acute Angle ◽  
Migraine Prophylaxis ◽  
Angle Closure ◽  
Anatomical Feature ◽  
Ciliochoroidal Effusion ◽  
Acute Angle Closure

Objective: The development of ciliochoroidal effusions and secondary acute angle-closure crisis (AACC) is an uncommon side effect of topiramate, a common antiepileptic now FDA-approved for migraine prophylaxis. The mechanisms that underlie the development of ciliochoroidal effusions after topiramate use remain unclear. Materials and Methods: Ultrasound biomicroscopy (UBM) was also performed in all participants after stopping topiramate. Results: Six patient cases are presented with medication-induced AACC following the initiation or escalation of topiramate. Ciliochoroidal effusions were confirmed by gray-scale sonography in all patients at presentation. The images revealed either plateau iris configuration or atypical plateau iris configuration. Plateau iris configuration is defined by presence of an anteriorly rotated ciliary body processes and an absent posterior sulcus. Atypical plateau iris configuration refers to when the iris inserts directly into the ciliary body face. This case series, of medication-induced angle-closure crisis, suggests that plateau iris configuration is a shared anatomical feature in the development of topiramate-induced ciliochoroidal effusions.

scholarly journals Case Series of Stickler Syndrome Presenting with Acute Angle Closure

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Alexander Walters ◽  
Nathan Lambert ◽  
Seth Bricel ◽  
Thomas Hwang ◽  
Eliesa Ing ◽  
...  
Keyword(s):  
Case Series ◽  
Acute Angle ◽  
Angle Closure ◽  
Stickler Syndrome ◽  
Acute Angle Closure

A Rare Serious Ocular Side Effect of Topiramate: Bilateral Acute Angle Closure Glaucoma

2017 ◽  
Vol 3 (2) ◽  
pp. 255-257
Author(s):  
Dhruvkumar M. Patel ◽  
◽  
Mukundkumar V. Patel ◽  
Ajay V. Garg ◽  
◽  
...  
Keyword(s):  
Side Effect ◽  
Acute Angle ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Ocular Side ◽  
Acute Angle Closure ◽  
Ocular Side Effect ◽  
Acute Angle Closure Glaucoma

Utility of ultrasound biomicroscopy in the diagnosis of topiramate-associated ciliochoroidal effusions causing bilateral acute angle closure

2014 ◽  
Vol 42 (5) ◽  
pp. 500-501 ◽  
Author(s):  
Gustavo MSM Reis ◽  
Oliver CF Lau ◽  
Chameen Samarawickrama ◽  
Peter Heydon ◽  
Ivan Goldberg
Keyword(s):  
Ultrasound Biomicroscopy ◽  
Acute Angle ◽  
Angle Closure ◽  
Acute Angle Closure

scholarly journals Angiographic features of drug-induced bilateral angle closure and transient myopia with Ciliochoroidal effusion

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yong Koo Kang ◽  
Byeong Jae Son ◽  
Dong Ho Park ◽  
Jae Pil Shin
Keyword(s):  
Case Series ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Drug Induced ◽  
Idiosyncratic Reaction ◽  
Transient Myopia ◽  
Extravascular Fluid ◽  
Ciliochoroidal Effusion ◽  
Myopic Shift ◽  
Shallow Anterior Chamber

Abstract Background To report five cases of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion and to analyze angiographic findings of these cases. Methods This study is an observational case series. Five patients with acute drug-induced angle closure and transient myopia with ciliochoroidal effusion were examined by fluorescein angiography, indocyanine green angiography (ICGA) and ultrasound biomicroscopy (UBM). Results Five patients presented with bilateral visual loss and ocular pain after intake of topiramate, methazolamide, phendimetrazine tartrate or mefenamic acid. All patients showed elevated intraocular pressure (IOP) with shallow anterior chamber and myopic shift from − 0.5 to − 17.0 diopters (D). UBM showed ciliochoroidal effusions with diffuse thickening of the ciliary body in all cases. Rapid normalization of IOP and decrease of myopic shift occurred in all patients after discontinuing the suspected drugs. We classified the ICGA findings into 2 major signs (hypofluorescent dark spots, hyperfluorescent pinpoints) and 3 minor signs (diffuse choroidal hyperfluorescence, early hyperfluorescence of choroidal stromal vessel, and leakage and dilated retinal vessels). Conclusions The pathogenesis of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion may be idiosyncratic reaction of uveal tissue to systemic drugs. Accumulation of extravascular fluid in the ciliochoroidal layer had a major role in the pathogenesis. ICGA could be a useful method to examine the pathophysiology of this condition by imaging of the choroidal layer.

scholarly journals Circumscribed ciliochoroidal effusion presenting as an acute angle closure attack

2017 ◽  
Vol 12 (1) ◽  
pp. 117 ◽  
Author(s):  
RoslynKathryn Manrique Lipa ◽  
MaríaEugenia González Sánchez ◽  
CarlosAntonio Hijar Ordovas ◽  
AbelRojo Aragües ◽  
CarmenGarcia Borque
Keyword(s):  
Acute Angle ◽  
Angle Closure ◽  
Ciliochoroidal Effusion ◽  
Acute Angle Closure

scholarly journals Bilateral simultaneous acute angle closure caused by sulphonamide derivatives: A case series

2010 ◽  
Vol 58 (3) ◽  
pp. 248 ◽  
Author(s):  
Sirisha Senthil ◽  
Chandrasekhar Garudadri ◽  
HarshaB.L Rao ◽  
Rajat Maheshwari
Keyword(s):  
Case Series ◽  
Acute Angle ◽  
Angle Closure ◽  
Acute Angle Closure

scholarly journals Comparisons of clinical characteristics of lens-subluxated eye with or without acute angle closure: A retrospective study

2019 ◽  
Author(s):  
Hong-Yang Zhang ◽  
Hong-Liang Lin ◽  
Yong-Jie Qin ◽  
Yu-Lin Zhang ◽  
Yu-Qiao Zhang ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Clinical Characteristics ◽  
Anterior Segment ◽  
Ultrasound Biomicroscopy ◽  
Acute Angle ◽  
Angle Closure ◽  
Fellow Eye ◽  
Lens Extraction ◽  
Lens Subluxation ◽  
Acute Angle Closure

Abstract BackgroundTo compare clinical characteristics of lens subluxation between eyes with or without acute angle closure (AAC).MethodsThis is a retrospective and case control study. Thirty-four cases with lens subluxation were recruited from 2015 to 2017. Patients with acute angle closure were assigned to the AAC group (n=17 eyes) and those without AAC were in the non-AAC group (n=17 eyes). Quantitative anterior segment was evaluated by ultrasound biomicroscopy (UBM). Axial length (AL) was measured with IOL master. All patients underwent lens extraction surgery and were followed up for 6 months. ResultsThe history of blunt trauma was accounted for 11 (64.7%) cases in the AAC group and 14 (82.3%) cases in the non-AAC group. Nine (52.9%) patients in the AAC group had LPI or SPI treatment history, and high intraocular pressure was recurred. The UBM analysis showed that the average central ACD of affected eyes in the AAC group was 1.75 mm, which was significantly shallower than the fellow eyes (2.39 mm, P < 0.05) or both eyes in the non-AAC group (affected eye 3.24mm vs fellow eye 3.81mm). Lens vault and AOD500 also showed a remarkable difference between affected eye than fellow eye (P < 0.001) in the AAC group. The both eyes in the AAC group presented a shorter AL and shallower anterior chamber, comparing with those in the non-AAC group. Besides, the affected eyes in the AAC group presented significantly higher LV. ConclusionsThe crowded anterior chamber structure and shorter AL might be an anatomic basis for the eye with lens subluxation induced AAC. Quantitative evaluation of these ocular structures to identify zonular compromise, increased LV and shorter AL are valuable for the diagnosis of lens subluxation induced AAC.

scholarly journals Angiographic Features of Drug-Induced Bilateral Angle Closure and Transient Myopia with Ciliochoroidal Effusion

2019 ◽  
Author(s):  
Yong Koo Kang ◽  
Byeong Jae Son ◽  
Dong Ho Park ◽  
Jae Pil Shin
Keyword(s):  
Indocyanine Green ◽  
Indocyanine Green Angiography ◽  
Case Series ◽  
Ultrasound Biomicroscopy ◽  
Angle Closure ◽  
Drug Induced ◽  
Idiosyncratic Reaction ◽  
Transient Myopia ◽  
Ciliochoroidal Effusion ◽  
Myopic Shift

Abstract Background: To report five cases of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion and to analyze angiographic findings of these cases. Methods: This study is an observational case series. Five patients with acute drug-induced angle closure and transient myopia with ciliochoroidal effusion were examined by fluorescein angiography, indocyanine green angiography (ICGA) and ultrasound biomicroscopy (UBM). Results: Five patients presented with bilateral visual loss and ocular pain after intake of topiramate, methazolamide, phendimetrazine tartrate or mefenamic acid. All patients showed elevated intraocular pressure (IOP) with shallow anterior chamber and myopic shift from -0.5 to -17.0 diopters (D). UBM showed ciliochoroidal effusions with diffuse thickening of the ciliary body in all cases. Rapid normalization of IOP and decrease of myopic shift occurred in all patients after discontinuing the suspected drugs. We classified the ICGA findings into 2 major signs (hypofluorescent dark spots, hyperfluorescent pinpoints) and 3 minor signs (diffuse choroidal hyperfluorescence, early hyperfluorescence of choroidal stromal vessel, and leakage and dilated retinal vessels). Conclusions: The pathogenesis of acute drug-induced angle closure and transient myopia with ciliochoroidal effusion may be idiosyncratic reaction of uveal tissue to systemic drugs. Accumulation of extravascular fluid in the ciliochoroidal layer had a major role in the pathogenesis. ICGA could be a useful method to examine the pathophysiology of this condition by imaging of the choroidal layer. Keywords: Ciliochoroidal effusion; Drug-induced angle closure; Indocyanine green angiography; Transient myopia.

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