First case of topiramate-induced acute bilateral transient myopia in Saudi Arabia: case report and literature review

Abstract Background Acute transient myopia with shallowing of the anterior chamber is a rare idiosyncratic response to many systemic and topical medications, including topiramate. Several such cases have been reported in the past as a chronic complication, but are less frequently reported as a bilat...

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Main Authors: Rawan Albalawi, Moustafa Alhashemi, Raseel Aljthalin
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Neurology
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Online Access:https://doi.org/10.1186/s12883-025-04089-5
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author Rawan Albalawi
Moustafa Alhashemi
Raseel Aljthalin
author_facet Rawan Albalawi
Moustafa Alhashemi
Raseel Aljthalin
author_sort Rawan Albalawi
collection DOAJ
description Abstract Background Acute transient myopia with shallowing of the anterior chamber is a rare idiosyncratic response to many systemic and topical medications, including topiramate. Several such cases have been reported in the past as a chronic complication, but are less frequently reported as a bilateral acute myopia. We report a case of acute transient myopia due to Topiramate – a drug used for epilepsy and migraine prophylaxis. Case presentation A 22 years old male recently diagnosed with epilepsy started on topiramate for 8 days after which he developed sudden drop in vision bilaterally. He was diagnosed with acute transient bilateral myopia based clinical findings and exclusion. The medication was stopped immediately and the patient showed significant improvement after the 2nd day from the discontinuation. Literature review A review of 9 studies, which included 16 cases for topiramate induced acute myopia encompassing 18 patients revealed a predominance of females (12). Symptoms included sudden myopia, anterior chamber shallowing, ciliochoroidal effusion, and elevated intraocular pressure. Notably, discontinuation of topiramate resulted in symptom reversal. These findings underscore the need for awareness of acute bilateral myopia secondary to topiramate as a rare adverse effect across diverse patient demographics and dosages. Conclusion This case and the existing literature emphasize the significance of educating patients and the necessity for immediate discontinuation of the drug when ocular symptoms happen. This case also outlines the importance of interdisciplinary collaboration in addressing the adverse effects linked to neurological medications such as topiramate. We present an additional case that illustrates the ophthalmic complications associated with topiramate.
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spelling doaj-art-02b5906a909d4fdda1710cb917e28cd22025-08-20T02:41:34ZengBMCBMC Neurology1471-23772025-03-012511810.1186/s12883-025-04089-5First case of topiramate-induced acute bilateral transient myopia in Saudi Arabia: case report and literature reviewRawan Albalawi0Moustafa Alhashemi1Raseel Aljthalin2Department of Adult Neurology, Prince Sultan Military Medical CityDepartment of internal medicine, Aleppo university hospitalDepartment of Adult Neurology, Prince Sultan Military Medical CityAbstract Background Acute transient myopia with shallowing of the anterior chamber is a rare idiosyncratic response to many systemic and topical medications, including topiramate. Several such cases have been reported in the past as a chronic complication, but are less frequently reported as a bilateral acute myopia. We report a case of acute transient myopia due to Topiramate – a drug used for epilepsy and migraine prophylaxis. Case presentation A 22 years old male recently diagnosed with epilepsy started on topiramate for 8 days after which he developed sudden drop in vision bilaterally. He was diagnosed with acute transient bilateral myopia based clinical findings and exclusion. The medication was stopped immediately and the patient showed significant improvement after the 2nd day from the discontinuation. Literature review A review of 9 studies, which included 16 cases for topiramate induced acute myopia encompassing 18 patients revealed a predominance of females (12). Symptoms included sudden myopia, anterior chamber shallowing, ciliochoroidal effusion, and elevated intraocular pressure. Notably, discontinuation of topiramate resulted in symptom reversal. These findings underscore the need for awareness of acute bilateral myopia secondary to topiramate as a rare adverse effect across diverse patient demographics and dosages. Conclusion This case and the existing literature emphasize the significance of educating patients and the necessity for immediate discontinuation of the drug when ocular symptoms happen. This case also outlines the importance of interdisciplinary collaboration in addressing the adverse effects linked to neurological medications such as topiramate. We present an additional case that illustrates the ophthalmic complications associated with topiramate.https://doi.org/10.1186/s12883-025-04089-5TopiramateMyopiaEpilepsieCiliochoroidal effusionNeurological medicationsBlurred vision
spellingShingle Rawan Albalawi
Moustafa Alhashemi
Raseel Aljthalin
First case of topiramate-induced acute bilateral transient myopia in Saudi Arabia: case report and literature review
BMC Neurology
Topiramate
Myopia
Epilepsie
Ciliochoroidal effusion
Neurological medications
Blurred vision
title First case of topiramate-induced acute bilateral transient myopia in Saudi Arabia: case report and literature review
title_full First case of topiramate-induced acute bilateral transient myopia in Saudi Arabia: case report and literature review
title_fullStr First case of topiramate-induced acute bilateral transient myopia in Saudi Arabia: case report and literature review
title_full_unstemmed First case of topiramate-induced acute bilateral transient myopia in Saudi Arabia: case report and literature review
title_short First case of topiramate-induced acute bilateral transient myopia in Saudi Arabia: case report and literature review
title_sort first case of topiramate induced acute bilateral transient myopia in saudi arabia case report and literature review
topic Topiramate
Myopia
Epilepsie
Ciliochoroidal effusion
Neurological medications
Blurred vision
url https://doi.org/10.1186/s12883-025-04089-5
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AT moustafaalhashemi firstcaseoftopiramateinducedacutebilateraltransientmyopiainsaudiarabiacasereportandliteraturereview
AT raseelaljthalin firstcaseoftopiramateinducedacutebilateraltransientmyopiainsaudiarabiacasereportandliteraturereview