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Related Experiment Videos

Outer retinal dysfunction in patients treated with vigabatrin.

C F Arndt1, P Derambure, S Defoort-Dhellemmes

  • 1Service d'Explorations Fonctionnelles de la Vision, Lille, France. carndt@univ-lille2.fr

Neurology
|April 24, 1999
PubMed
Summary
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Vigabatrin treatment may cause early outer retinal dysfunction, detectable by electro-oculogram (EOG). EOG is a more sensitive and specific screening tool for vigabatrin-induced visual impairment than electroretinogram (ERG).

Area of Science:

  • Ophthalmology
  • Neuroscience
  • Pharmacology

Background:

  • Vigabatrin inhibits gamma-aminobutyric acid (GABA) transaminase, potentially affecting retinal pigment epithelium function.
  • Electro-oculogram (EOG) assesses photoreceptor and pigment epithelium function.
  • Electroretinogram (ERG) measures retinal electrical activity.

Purpose of the Study:

  • To prospectively evaluate early visual impairment in patients treated with vigabatrin.
  • To compare the sensitivity and specificity of EOG and ERG in detecting vigabatrin-induced visual changes.

Main Methods:

  • Twenty patients treated with vigabatrin underwent ophthalmologic and neurologic examinations.
  • Tests included static perimetry, EOG, and ERG.

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Main Results:

  • Reduced EOG Arden ratio in 14 of 20 patients, indicating outer retinal dysfunction.
  • Normal ERG a- and b-wave amplitudes, but absent oscillatory potentials in 10 patients.
  • Visual field constriction in 12 patients; 5 reported visual symptoms. Combination therapy with valproate worsened impairment.

Conclusions:

  • Evidence suggests vigabatrin can cause outer retinal dysfunction.
  • EOG is a more sensitive and specific diagnostic tool than ERG for screening vigabatrin-treated patients for visual impairment.