Utility of ultrasound biomicroscopy in the diagnosis of topiramate-associated ciliochoroidal effusions causing bilateral acute angle closure

摘要

Since the introduction of high-frequency ultrasound biomicroscopy (UBM) by Pavlin et al. in the early 1990s, we have improved the determination of mechanisms underlying angle closure.1 Uniquely, UBM enables high-resolution visualization of the ciliary body2; it is invaluable in detecting tumours, cysts, oedema, and forward rotation of the ciliary body as a cause for anterior displacement of the iris root and secondary appositional angle closure.Perhaps related to the inconvenience of preparing a water bath, the time required for the examination, and the high dependence on operator skill for quality images and meaningful interpretation, it has been confined to research and large institutional settings.Our case report illustrates the utility of UBM to detect presumed topiramate-associated ciliochoroidal effusion (CCE) as the underlying cause for bilateral acute angle closure (AAC).