Presumed topiramate-induced maculopathy

The case of a patient who developed decreased vision while taking topiramate (TPM) for symptomatic epilepsy is described. Ophthalmological examination revealed findings suggestive of maculopathy. TPM was discontinued; however, vision failed to improve significantly over 6 months of follow-up. We hypothesize that the patient’s maculopathy was induced by TPM. TPM, like vigabatrin, may exert retinal toxicity causing persistent visual impairment.