Foundation segmentation models such as the Segment Anything Model (SAM) exhibit strong zero-shot generalization through large-scale pretraining, but adapting them to domain-specific semantic segmentation remains challenging, particularly for thin structures (e.g., retinal vessels) and noisy modalities (e.g., SAR imagery). Full fine-tuning is computationally expensive and risks catastrophic forgetting. We propose \textbf{TopoLoRA-SAM}, a topology-aware and parameter-efficient adaptation framework for binary semantic segmentation. TopoLoRA-SAM injects Low-Rank Adaptation (LoRA) into the frozen ViT encoder, augmented with a lightweight spatial convolutional adapter and optional topology-aware supervision via differentiable clDice. We evaluate our approach on five benchmarks spanning retinal vessel segmentation (DRIVE, STARE, CHASE\_DB1), polyp segmentation (Kvasir-SEG), and SAR sea/land segmentation (SL-SSDD), comparing against U-Net, DeepLabV3+, SegFormer, and Mask2Former. TopoLoRA-SAM achieves the best retina-average Dice and the best overall average Dice across datasets, while training only \textbf{5.2\%} of model parameters ($\sim$4.9M). On the challenging CHASE\_DB1 dataset, our method substantially improves segmentation accuracy and robustness, demonstrating that topology-aware parameter-efficient adaptation can match or exceed fully fine-tuned specialist models. Code is available at : https://github.com/salimkhazem/Seglab.git