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Published on: September 20, 2024
Visual and ocular outcome in children after prenatal exposure to antiepileptic drugs
K T Fahnehjelm1, K Wide, J Ygge
1Department of Clinical Sciences, Karolinska Institute, Huddinge University Hospital, Sweden. kristina.fahnehjelm@klinvet.ki.se
Insights
Antiepileptic drug (AED) treatment during pregnancy, particularly monotherapy, appears safe for fetal eye development. This study found no major ophthalmological abnormalities in children exposed to well-controlled AEDs.
Area of Science:
- Ophthalmology
- Neurology
- Teratology
Background:
- Epilepsy affects women of childbearing age.
- Antiepileptic drugs (AEDs) are often necessary during pregnancy.
- Concerns exist regarding potential teratogenic effects of AEDs on fetal development, including ocular structures.
Purpose of the Study:
- To investigate the incidence of structural and functional ophthalmological abnormalities in offspring of women with epilepsy treated with antiepileptic drugs (AEDs) during pregnancy.
- To assess the safety of well-controlled AED treatment on ocular development.
- To compare ophthalmological outcomes in children exposed to AEDs versus controls.
Main Methods:
- Prospective study including 43 children prenatally exposed to AEDs and 47 controls.
- Blinded ophthalmological examinations were conducted.
- Fundus photography was utilized to assess ocular structures.
Main Results:
- No major eye anomalies were detected in the AED-exposed group, except for one child with nystagmus and low vision.
- Exposed children exhibited slightly lower visual acuity in the eye with the lowest acuity (p < 0.05).
- No other significant ophthalmological differences were observed between exposed and control groups.
Conclusions:
- Well-controlled antiepileptic drug (AED) treatment during pregnancy, especially monotherapy, does not appear to cause major adverse effects on eye development.
- The findings support the safety of carefully managed AED regimens for pregnant women with epilepsy.
- Further research may explore subtle visual function differences.
Purpose:
To prospectively study the incidence of structural and/or functional ophthalmological abnormalities in the offspring to an unselected population of women with epilepsy, subjected to a well controlled antiepileptic drug (AED) treatment during pregnancy.
Methods:
Forty-three children prenatally exposed to antiepileptic drugs and 47 controls were included. Blinded ophthalmological examinations including fundus photography were performed at a median age of 7 years and 4 months.
Results:
No major eye anomalies were found except in one child in the exposed group who had nystagmus and low vision. The visual acuity was lower in the eye with lowest acuity among the exposed children (p < 0.05). No other significant difference was found between the two groups.
Conclusion:
The results suggest that a well-controlled treatment with AEDs, preferably monotherapy, during pregnancy does not have any major adverse effects on the development of the eye and ophthalmological functions.
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