Choroidal Drainage in the Management of Acute Angle Closure After Topiramate Toxicity

PURPOSE: To report the role of choroidal drainage in patient with acute bilateral angle closure secondary to cilio-choroidal effusion with Topiramate. DESIGN: Interventional case report. METHODS: Two weeks after commencing tablet Topiramate (Sulfamate derivative) for management of epilepsy, a patient developed bilateral acute angle closure secondary to cilio-choroidal effusion with lenticulo-corneal touches for which choroidal drainage was performed in 1 eye. RESULTS: After choroidal drainage, anterior chamber deepened, corneal edema resolved, choroidals started resolving, and intraocular pressure was controlled without medication. CONCLUSIONS: In patients presenting with acute angle closure secondary to Topiramate toxicity, choroidal drainage if indicated, is a safe and effective interventional procedure.