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Argon laser peripheral iridoplasty for bilateral acute angle-closure secondary to topiramate-induced uveal effusion

Poster Details

First Author: F.Sousa Neves PORTUGAL

Co Author(s):    J. Braga   D. Meira   J. Sequeira   R. Varandas           

Abstract Details


To report a case of bilateral acute angle closure secondary to uveal effusion treated successfully by argon laser peripheral iridoplasty (ALPI).


Department of Ophthalmology of Centro Hospitalar Vila Nova de Gaia/Espinho


Patient submitted to full ophthalmological evaluation with B-scan ultrasonography and ultrasound biomicroscopy (UBM) and detailed therapeutic approach to cease a topiramate-induced bilateral acute angle closure. Goldmann applanation tonometry was used for intraocular pressure (IOP) measurements.


A 53-year old female presented bilateral acute vision loss (20/400), photophobia and ocular pain. Biomicroscopic evaluation revealed conjunctival injection, corneal edema, non reactive mid-dilated pupils and shallow anterior chamber with 360º iridocorneal contact, suggestive of anterior displacement of iris-lens diaphragm. IOP was 50 mmHg OU. B-scan ultrasonography and UBM showed ciliochoroidal effusions. Patient had initiated oral topiramate 7 days before describing ocular “discomfort” since the beginning of the treatment. Topiramate was immediately discontinued. Intravenous, oral and topical therapies were given. However, IOP did not decrease and ALIP was performed in the inferior 180º with relieve of the angle closure attack.


Argon laser peripheral iridoplasty should be considered in the treatment options for topiramate-induced acute angle closure if conventional therapies did not relieve the attack.

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