Topiramate has been associated with ocular issues, including glaucoma:
Adverse reactions
- Topiramate, both in its immediate-release (Topamax) and extended-release (Qudexy XR) forms, has been linked to increased intraocular pressure and myopia, which are known risk factors for glaucoma
Warnings and precautions
- Caution is advised when prescribing topiramate to patients with increased ocular pressure, as it may exacerbate visual impairment and myopia
Clinical evidence
- A retrospective case series reported 86 cases of acute-onset glaucoma (83 bilateral and 3 unilateral) associated with topiramate use. The first presenting symptom in many patients was blurring of vision. All findings were reversible if recognized early and if the drug was discontinued
- The National Registry of Drug-Induced Ocular Side Effects has identified topiramate as a cause of angle-closure glaucoma
In conclusion, topiramate has been associated with ocular issues, including increased intraocular pressure and angle-closure glaucoma. Caution is advised when prescribing this medication to patients with increased ocular pressure.