If your patients have taken gabapentin to manage chronic pain or other conditions, they may have a higher chance of developing acute angle-closure glaucoma, Canadian researchers report. Their study found a significant occurrence of acute angle-closure glaucoma in patients who took gabapentin the year prior to the diagnosis. However, the investigation noted the association was not as apparent in current users.

Their study, published in the Journal of Glaucoma, looked at the association between the disease and the use of gabapentin and pregabalin, both commonly prescribed to treat peripheral neuropathy, fibromyalgia, trigeminal neuralgia, epilepsy and other chronic conditions. Previous research notes several possible ocular side effects of gabapentin use, including blurred vision, nystagmus, diplopia, visual field defects and electrophysiological changes, according to the study. This is the first study to investigate the association between gabapentin or pregabalin and the incidence of acute angle-closure glaucoma, researchers said.

The study included 1,307 adult patients who developed acute angle-closure glaucoma over a 10-year period, as well as 13,070 controls. The investigators reported they found no link to acute angle-closure glaucoma and pregabalin use either in the year prior to diagnoses or in patients who were currently taking the drug.

Research has mostly associated acute angle-closure glaucoma with tricyclic antidepressants, low-potency antipsychotics, topiramate and selective serotonin reuptake inhibitors, the researchers said in their study. They hypothesized the mechanism of acute angle-closure linked to gabapentin use is similar to topiramate with respect to ciliary body displacement.

While further research is needed to learn more about this association, the researchers feel clinicians and patients should be aware of the potential for angle-closure after taking gabapentin.

Browne M, Zakrzewski H, Carleton B, et al. Association of gabapentin or pregabaline use and incidence of acute angle-closure glaucoma. J Glaucoma. July 19, 2019. [Epub ahead of print].