Symptomatic and asymptomatic visual loss in patients taking vigabatrin.

Academic Article

Abstract

  • PURPOSE: To investigate the clinical, perimetric, and electrophysiologic findings in patients with visual field loss on long-term treatment with the antiepileptic medication vigabatrin. DESIGN: Consecutive observational case series. PARTICIPANTS: Forty-one consecutive subjects taking vigabatrin referred for screening ophthalmologic assessment were studied. Twelve subjects with evidence of peripheral visual field constriction are presented. METHODS: Twelve subjects with evidence of peripheral visual field constriction on 60-4 perimetry underwent central 30-2 and blue-on-yellow (B/Y) perimetry, as well as electroretinography (ERG), electro-oculography (EOG), and visual-evoked potential (VEP) testing. MAIN OUTCOME MEASURES: Visual acuity; fundus abnormalities; visual field loss; and ERG, EOG, or VEP abnormalities were the main outcome measures. RESULTS: Eight of the 12 subjects with constricted visual fields were asymptomatic. The central 30-2 perimetry demonstrated bilateral visual field constriction in 9 of 12 patients and the B/Y perimetry in 8 of 9 patients tested. Of the ten patients tested electrophysiologically, four had abnormal ERGs, five had abnormal EOGs, and three had delayed VEPs. CONCLUSIONS: The incidence of visual field constriction in patients taking vigabatrin may be higher, and asymptomatic visual field loss more common, than reported previously. The authors postulate a possible Muller cell dysfunction in the peripheral retina. Patients taking vigabatrin should have regular peripheral visual field examinations.
  • Authors

    Keywords

  • 4-Aminobutyrate Transaminase, Adult, Anticonvulsants, Electrooculography, Electroretinography, Enzyme Inhibitors, Evoked Potentials, Visual, Female, Humans, Male, Middle Aged, Vigabatrin, Vision Disorders, Visual Acuity, Visual Field Tests, Visual Fields, gamma-Aminobutyric Acid
  • Digital Object Identifier (doi)

    Author List

  • Daneshvar H; Racette L; Coupland SG; Kertes PJ; Guberman A; Zackon D
  • Start Page

  • 1792
  • End Page

  • 1798
  • Volume

  • 106
  • Issue

  • 9