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Does vigabatrin treatment for infantile spasms cause visual field defects? An international multicentre study

Raili Riikonen1, Zvonka Rener-Primec, Lionel Carmant

  • 1Children's Hospital, Kuopio University Hospital, Kuopio, Finland.

Developmental Medicine and Child Neurology
|August 23, 2014
PubMed

Insights

Vigabatrin treatment in infancy was associated with visual field defects (VFDs) in 34% of school-aged children. The risk of VFDs increased significantly with longer treatment durations, highlighting the need for careful risk-benefit assessment.

Area of Science:

  • Ophthalmology
  • Pediatric Neurology
  • Pharmacology

Background:

  • Infantile spasms are a severe epilepsy syndrome in infants.
  • Vigabatrin is an effective anti-seizure medication for infantile spasms.
  • Potential long-term visual side effects of vigabatrin require investigation.

Purpose of the Study:

  • To assess the prevalence and severity of visual field defects (VFDs) in school-aged children previously treated with vigabatrin for infantile spasms.
  • To determine the relationship between vigabatrin treatment duration and the occurrence of VFDs.

Main Methods:

  • A cohort of 35 children treated for infantile spasms in infancy underwent comprehensive visual field testing (static and kinetic perimetry).
  • Etiologies of infantile spasms included tuberous sclerosis, other symptomatic causes, and cryptogenic cases.
  • Children were stratified into groups based on vigabatrin treatment duration (<1 year, 1-2 years, >2 years).

Main Results:

  • 34% of children (11/32) exhibited vigabatrin-attributed VFDs.
  • VFD prevalence increased with treatment duration: 9% (<1 year), 30% (1-2 years), and 63% (>2 years).
  • Six out of 10 children with tuberous sclerosis developed VFDs, indicating a higher risk in this subgroup.

Conclusions:

  • Vigabatrin treatment for infantile spasms is associated with a significant risk of developing VFDs in school-aged children.
  • The duration of vigabatrin therapy is a critical factor influencing the likelihood and severity of VFDs.
  • A careful evaluation of the risk-benefit profile is essential when considering vigabatrin treatment, particularly for extended periods.
Abstract

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