Evaluation of Ocular Side Effects in the Patients on Topiramate Therapy for Control of Migrainous Headache
Introduction: Topiramate, a sulfa-derivative monosaccharide, is an antiepileptic drug which is administered in the control of migraine. It is reported to cause various ocular side effects such as visual field defect and myopic shift. To investigate the alterations in refractive error, properties...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/7339/16263_CE[Ra1]_F(AK)_PF1(BMAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: Topiramate, a sulfa-derivative monosaccharide,
is an antiepileptic drug which is administered in the control
of migraine. It is reported to cause various ocular side effects
such as visual field defect and myopic shift. To investigate
the alterations in refractive error, properties of the cornea
and changes in the anterior chamber in patients that receive
Topiramate for migraine control.
Materials and Methods: This is a hospital-based, noninterventional, observational study that is conducted at Imam
Hossein Hospital, affiliated to Shahid Beheshti University of
Medical Sciences, Department of Neurology, in collaboration
with the department of Ophthalmology.
Thirty three consecutive patients with the diagnosis of migraine
that were candidate for Topiramate therapy were recruited.
Patients with history of ocular trauma or surgery, keratoconus,
glaucoma, congenital ocular malformations and any history
of unexplained visual loss were excluded. After thorough
ophthalmic examination, all the patients underwent central
corneal thickness (CCT) measurement, and Pentacam imaging
(Scheimpflug camera) at the baseline. Various parameters were
extracted and used for analysis. Anterior chamber volume (ACV),
anterior chamber depth (ACD), and anterior chamber angle
(ACA) measurement was performed. These measurements were
repeated on day 30th and 90th after the initiation of Topiramate
therapy. According to the normality tests, parameters with
normal distribution were analysed using the repeated measures
test and the remaining parameters (with non-normal distribution)
were analysed using the non-parametric k-sample test. A
p-value< 0.05 was considered statistically significant, according
to Bonferroni post hoc correction.
Results: There were 66 eyes of 33 patients under the diagnosis
of migrainous headache, that Topiramate was initiated for
headache control, included in the study. The mean value of
refractive error had a statistically significant myopic change,
from −0.23 diopters (D) at the baseline to −0.61 D at the 90th day
of follow-up period (p-value < 0.001). Mean CCT was 531.43 μm
at the baseline and increased to 534.72 μm at the 30th day, and
537.51 μm at the 90th day after the administration of Topiramate
(p-value=0.001). Mean value of other parameters, ACV, ACD,
and ACA, did not reveal statistically significant change.
Conclusion: Myopic shift and gradually increasing CCT in the
patients after Topiramate administration should be considered
before any refractive surgery. We found no gradual change in
the anterior chamber and angle parameters in our patients in
the 90 days of follow up. More studies with a longer duration
of follow-up are needed to elucidate dose-dependent ocular
manifestations. |
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| ISSN: | 2249-782X 0973-709X |