Rapid Reolution of Topiramate-induced Angle-cloure Glaucoma With Methylpredniolone and Mannitol

Purpoe Topiramate-induced angle-cloure glaucoma (TiACG) i believed to be related to it ulfonamide moiety. Although the exact mechanim i unknown, the time coure and contellation of ymptom are conitent with a poible inflammatory pathophyiologic condition. Deign Interventional cae report. Method We report the clinical outcome of a cae of TiACG that wa aociated with an extreme intraocular preure elevation of >60 mm Hg that wa treated with the combination of ytemic mannitol and methylpredniolone. Reult The combination of the two ytemic medication reulted in the reolution of the attack with a much more rapid time coure than i een typically for extreme cae of TiACG. Mannitol treatment alone did not lower the intraocular preure after 90 minute, although improvement wa noted four hour after methylpredniolone. Concluion For evere cae of TiACG that are aociated with very high intraocular preure, the combination of mannitol and methylpredniolone can induce a rapid improvement. Inflammation may be a component of TiACG.