Low-dose topiramate and hydrochlorothiazide-associated early acute myopia and angle narrowing: A case report

Chao Wu; Hong Pan; Shijun Feng; Xiaokun Wang; Zhaoqiang Liu; Bojun Zhao

doi:10.3389/fmed.2023.1062160

Low-dose topiramate and hydrochlorothiazide-associated early acute myopia and angle narrowing: A case report

Front Med (Lausanne). 2023 Feb 8:10:1062160. doi: 10.3389/fmed.2023.1062160. eCollection 2023.

Authors

Chao Wu¹, Hong Pan², Shijun Feng¹, Xiaokun Wang¹, Zhaoqiang Liu², Bojun Zhao^{1

2}

Affiliations

¹ Department of Ophthalmology, Shandong Provincial Hospital, Shandong University, Jinan, China.
² Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

Abstract

Purpose: To report a unique case of topiramate and hydrochlorothiazide associated with acute myopia and angle narrowing.

Patients and methods: A 34-year-old Asian woman presented with prominent binocular visual acuity decrease 6 h after taking only one dose of 25 mg topiramate, 25 mg hydrochlorothiazide, and 22.4 mg fluoxetine to lose weight. She was subsequently diagnosed with acute bilateral myopia and angle narrowing and was started on topical therapy.

Results: Initial examination revealed a decreased visual acuity of 20/100 bilaterally, an elevated intraocular pressure of 23 mmHg in the right eye and 24 mmHg in the left eye, suprachoroidal effusions, and angle narrowing. After the discontinuation of these drugs and the use of IOP-lowering medication, the patient made full recovery.

Conclusion: We speculate that there is a drug-drug interaction between topiramate and hydrochlorothiazide that may lead to the angle narrowing in a short time and at a low dose. Timely discontinuation of the drug usually leads to complete recovery within days to weeks.

Keywords: angle narrowing; drug–drug interaction; hydrochlorothiazide; short time; topiramate.

Publication types

Case Reports