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Visual field defects associated with vigabatrin therapy.

M C Lawden1, T Eke, C Degg

  • 1Department of Neurology, Leicester Royal Infirmary, Leicester, UK.

Journal of Neurology, Neurosurgery, and Psychiatry
|November 24, 1999
PubMed
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Vigabatrin, an anticonvulsant, is linked to a high rate of peripheral visual field defects. This vision loss, possibly due to retinal toxicity, can persist even after discontinuing vigabatrin treatment.

Area of Science:

  • Ophthalmology
  • Neurology
  • Pharmacology

Background:

  • Vigabatrin is an anticonvulsant medication used to treat epilepsy.
  • Potential neuro-ophthalmic side effects of vigabatrin require investigation.

Purpose of the Study:

  • To determine the prevalence of visual field defects in patients using vigabatrin.
  • To characterize the specific visual dysfunctions associated with vigabatrin treatment.

Main Methods:

  • Neuro-ophthalmic evaluation of 33 patients on vigabatrin and 16 controls.
  • Static perimetry using Humphrey field analyser.
  • Ophthalmic examination, blood tests, brain MRI, Visual Evoked Responses (VERs), Electro-oculograms (EOGs), and Electroretinograms (ERGs).

Main Results:

Related Experiment Videos

  • 52% of vigabatrin patients had abnormal visual fields; 39% had definite bilateral defects possibly linked to vigabatrin.
  • Defects showed concentric peripheral field loss with temporal and macular sparing.
  • Electro-oculogram (EOG) Arden Index reduced, improving post-vigabatrin cessation; multifocal ERGs abnormal peripherally.

Conclusions:

  • Vigabatrin treatment is associated with a high prevalence of peripheral visual field defects.
  • The visual field defects appear to result from retinal toxicity caused by vigabatrin.
  • These defects may persist even after the drug is withdrawn.