Topiramate and accommodation: Does topiramate cause accommodative dysfunction?

Abstract

Objective: To investigate the accommodation function in topiramate users.

Design: Case-control clinical study.

Participants: The participants included 16 controls and 22 patients using 100 mg/kg topiramate who were diagnosed with migraine according to the International Classification of Headache Disorders, second edition criteria.

Methods: One-minute dynamic measurements of refraction with accommodation stimuli of 0 D, 2 D, 2.5 D, 3 D, 4 D, and 5 D were obtained using the open field refractometer WAM-5500 in.

Results: In most of the accommodation stimuli ranges (0 D, 2.5 D, 3 D, and 5 D), topiramate users had a significantly higher accommodative lag compared with controls (p = 0.028, p = 0.014, p = 0.011, and p = 0.011, respectively). The most important causes of accommodative lag were found to be accommodation stimulus and inclusion in the topiramate group (p < 0.001, R² = 0.32, 95% CI 0.22-0.37 and 0.42-0.91, respectively). Multivariate linear regression analysis revealed that the 2 most important predictors of accommodative lag were accommodation stimulus and age (p < 0.001, r = 0.51, 95% CI 0.31-0.32 and 0.67-0.69, respectively) CONCLUSIONS: Even after adjustment for age, accommodative lag is greater across several accommodative stimulus levels in patients using topiramate, which may be related to visual symptoms in topiramate users.