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Patients treated with vigabatrin exhibit central visual function loss.

Emma J Roff Hilton1, Robert P Cubbidge, Sarah L Hosking

  • 1Neurosciences Research Institute, Aston University, and Queen Elizabeth Psychiatric Hospital, Birmingham, United Kingdom.

Epilepsia
|November 9, 2002
PubMed
Summary
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Vigabatrin (VGB) therapy can cause central vision problems in epilepsy patients. This study recommends specific visual function tests to monitor these potential side effects.

Area of Science:

  • Ophthalmology
  • Neurology
  • Pharmacology

Background:

  • Vigabatrin (VGB) is an antiepileptic drug (AED) used in epilepsy treatment.
  • Potential visual side effects associated with VGB therapy require investigation.
  • Central visual function assessment is crucial for patients undergoing VGB treatment.

Purpose of the Study:

  • To investigate visual function within the central 10 degrees of the retina in patients treated with VGB.
  • To identify an optimal clinical regimen for assessing central visual function in this patient group.

Main Methods:

  • A cohort of 12 epilepsy patients with mean age 38.6 years, treated with VGB (monotherapy or polytherapy), was studied.
  • Central visual function tests included high-contrast LogMAR visual acuity, short-wavelength automated perimetry (SWAP 10-2), spatial contrast sensitivity (CSV-1000), and Farnsworth-Munsell (FM) 100-hue colour discrimination.

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  • Tests were performed on each eye to evaluate visual function.

    • Main Results:

    • A mean cumulative VGB dose of 5,086 g was recorded.
    • Abnormalities were detected in SWAP 10-2 (14 eyes), FM 100-hue colour discrimination (9 eyes), and spatial contrast sensitivity (15 eyes).
    • Visual defects were more pronounced at higher spatial frequencies, with four patients exhibiting defects across all tested visual functions.

    Conclusions:

    • Vigabatrin (VGB) therapy is associated with visual function deficits in the central 10 degrees of the retina.
    • A recommended assessment battery includes SWAP 10-2 and spatial contrast sensitivity testing.
    • These tests are vital for monitoring central visual function in patients receiving VGB.