FP499

An evidence based pathogenesis exploration in Topiramate induced transient glaucoma and High myopia

Aim: To measure ACD and LT by A-scan and AS morpholgy by AS-OCT 
Case history: A 22 year old female presented with bilateral gross visual reduction and eye pain since one day following Topiramate administration. Distant visual acuity was counting fingers at 2 meters with -6.00 D of myopia. Corneal epithelial edema with Van Herricks grade 1 noted. On rebound tonometery, 50 and 56 mm Hg IOP recorded. Signs of uveitis and vitritis observed with chemosis. Scleral spur visualized on gonioscopy.  Pre and post treatment ACD and LT were 2.10 and 3.88 mm, and 3.40 and 3.40 mm measured by A-scan respectively. AS-OCT showed CCT of 615 microns and iris bombe with improved AOD and TISA post treatment. B-scan showed retino-choroidal complex thickening and widened tenon’s space. With cycloplegic, steroids and Topiramate cessation, refractive status and IOP stabilized within a week.
Conclusion: Increased fluid accumulation causing iris bombe and lenticular myopia possibly explains the pathogenesis.