Comment on ‘Topiramate maculopathy secondary to dose titration: first reported case’

Sir,

It was with much interest that we read the recent article by Severn et al¹ regarding the first documented report of topiramate maculopathy secondary to an increase in dose. In contrary, in 2014 we shared our experience of acute myopia syndrome secondary to topiramate discontinuation, a dose decrease.² Therefore, we assume that an increase as well as decrease of dosing may have a common physiological mechanism through which both ocular adverse effects are mediated.

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