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Related Experiment Videos

Visual field defect during therapy with valproic-acid.

C Tilz1, Y Wang-Tilz, A Jünemann

  • 1Department of Neurology 1, Krankenhaus Barmherzige Brüder Linz, Austria. christian.tilz@bblinz.at

European Journal of Neurology
|July 31, 2007
PubMed
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Valproic acid (VPA), an antiepileptic drug, can rarely cause concentric visual field defects. This case highlights the importance of monitoring vision during long-term VPA therapy due to potential metabolic dysfunction.

Area of Science:

  • Ophthalmology
  • Neurology
  • Pharmacology

Background:

  • Antiepileptic drugs (AEDs) are known to cause visual field defects, with vigabatrin being a prominent example.
  • The mechanisms by which AEDs affect vision vary, involving both gamma-aminobutyric acid (GABA)-ergic and non-GABA-ergic pathways.

Observation:

  • A 22-year-old female patient developed bilateral concentric visual field defects during long-term valproic acid (VPA) therapy.
  • Clinical examination revealed VPA-related metabolic dysfunction.
  • Electroretinography showed reduced B-waves, confirming visual pathway dysfunction.

Findings:

  • Automated and manual perimetry confirmed bilateral concentric visual field defects in the patient.
  • The findings suggest a link between long-term VPA treatment and the observed visual impairment.

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Implications:

  • This case underscores that valproic acid, though rarely, can induce concentric visual field defects.
  • Ophthalmologists and neurologists should consider VPA as a potential cause of visual field defects in patients undergoing long-term treatment.
  • Routine visual field monitoring may be warranted for patients on long-term VPA therapy.