Choroidal Drainage in the Management of Acute Angle Closure After Topiramate Toxicity

Abstract

Purpose To report the role of choroidal drainage in patient with acute bilateral angle closure secondary to cilio-choroidal effusion with Topiramate. Design Interventional case report. Methods Two weeks after commencing tablet Topiramate (Sulfamate derivative) for management of epilepsy, a patient developed bilateral acute angle closure secondary to cilio-choroidal effusion with lenticulo-corneal touches for which choroidal drainage was performed in 1 eye. Results After choroidal drainage, anterior chamber deepened, corneal edema resolved, choroidals started resolving, and intraocular pressure was controlled without medication. Conclusions In patients presenting with acute angle closure secondary to Topiramate toxicity, choroidal drainage if indicated, is a safe and effective interventional procedure.