Play all audios:
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. The important clinical point
is that discontinuation of the drug leads to resolution of the symptoms. In some reports, resolution has possibly been hastened following the administration of IV methylprednisolone.2, 3
REFERENCES * Severn PS, Symes R, Rajendram R, Pal B . Topiramate maculopathy secondary to dose titration: first reported case. _Eye_ 2015; 29: 982–984. Article CAS Google Scholar * Kozner
P, Simonova K, Brozek B, Singh K . Late acute myopia syndrome induced by combination of sulphonamide drugs. _J Glaucoma_ 2014; 23: e119–e121. Article Google Scholar * 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. Article CAS Google Scholar Download
references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Medical Retina Service, Moorfields Eye Hospital, London, EC1V 2PD, UK R J Symes, P S Severn, R Rajendram & B Pal Authors * R J
Symes View author publications You can also search for this author inPubMed Google Scholar * P S Severn View author publications You can also search for this author inPubMed Google Scholar *
R Rajendram View author publications You can also search for this author inPubMed Google Scholar * B Pal View author publications You can also search for this author inPubMed Google Scholar
CORRESPONDING AUTHOR Correspondence to P S Severn. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no conflict of interest. RIGHTS AND PERMISSIONS Reprints 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 Download citation * Published: 16 October 2015 * Issue Date: January 2016 * DOI: https://doi.org/10.1038/eye.2015.196 SHARE THIS ARTICLE Anyone
you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the
Springer Nature SharedIt content-sharing initiative