Sir,
We agree with Kozner et al that the maculopathy reported in our case1 likely represents a mild form of the idiosyncratic reaction causing choroidal effusion, induced myopia, and angle-closure glaucoma that has been reported with topiramate and other sulfur-containing medications. In these cases, it is a consistently reported feature that the reaction generally occurs within days following commencement of the drug or an increase in dose.2 In Kosner’s case,3 the reaction occurred 3 days after discontinuing topiramate and a sulfur-containing antibiotic, but the patient had commenced the medication 10 days prior to presentation. It is therefore difficult to be sure of the precise trigger in this case.
References
Severn PS, Symes R, Rajendram R, Pal B . Topiramate maculopathy secondary to dose titration: first reported case. Eye 2015; 29: 982–984.
Kozner P, Simonova K, Brozek B, Singh K . Late acute myopia syndrome induced by combination of sulphonamide drugs. J Glaucoma 2014; 23: e119–e121.
Abtahi MA, Abtahi SH, Fazel F, Roomizadeh P, Etemadifar M, Jenab K, Akbari M . Topiramate and the vision: a systematic review. Clin Ophthalmol 2012; 6: 117–131.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Symes, R., Severn, P., Rajendram, R. et al. Response to ‘Comment on Topiramate maculopathy secondary to dose titration: first reported case’. Eye 30, 166 (2016). https://doi.org/10.1038/eye.2015.196
Published:
Issue Date:
DOI: https://doi.org/10.1038/eye.2015.196