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Topimirate, other drugs can be precipitating factors for acute angle closure
LAS VEGAS — Cold relief medications or sulfa drugs can be the cause of acute angle closure in patients who do not have typical risk factors for the condition, a glaucoma specialist said here.
“Don’t be surprised if someone comes in with bilateral acute angle closure who doesn’t make sense. They are young. They are not hyperopic,” said Ronald L. Gross, MD, at the Ocular Surgery News Symposium, Glaucoma: Improving Your Odds.
“The treatment is to stop the drug, and in fact [pupil] dilation will be of more benefit to the patient than constriction,” he said.
Use of topimirate for the treatment of headaches and migraines has increased, Dr. Gross said. Topimirate is a risk factor for acute angle closure because it is sulfa drug, and “all sulfa drugs have the potential to precipitate acute angle closure,” he said.
Other precipitating factors for acute angle closure include dim illumination and the use of anticholinergics, adrenergics and pseudoephedrine, he added.