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Updated: Sep 5, 2025

Electroretinogram Recording for Infants and Children under Anesthesia to Achieve Optimal Dark Adaptation and International Standards
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Ocular examinations, findings, and toxicity in children taking vigabatrin

Yvette Schein1, Keith D Miller2, Ying Han3

  • 1Division of Ophthalmology, Children's Hospital of Philadelphia, Pennsylvania.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|July 11, 2022
PubMed

Insights

Vigabatrin-related ocular toxicity is rare in children, with only 0.7% showing definite toxicity. Ocular comorbidities and limited examinations complicate screening, making its value unclear for pediatric patients on vigabatrin.

Area of Science:

  • Ophthalmology
  • Pediatric Neurology
  • Pharmacovigilance

Background:

  • Vigabatrin, an antiepileptic drug, is linked to ocular toxicity.
  • Ophthalmic monitoring is recommended, but its value and feasibility in children lack consensus.

Purpose of the Study:

  • To assess ophthalmic findings in children treated with vigabatrin.
  • To determine the incidence of vigabatrin-related ocular toxicity in a pediatric cohort.
  • To evaluate the utility of regular screening and ancillary testing for ocular toxicity in children.

Main Methods:

  • Retrospective review of medical records of children with ophthalmic assessments.
  • Analysis of funduscopic examinations, visual field (VF) tests, electroretinograms (ERG), and optical coherence tomography (OCT).
  • Categorization of abnormalities as definite, possible, or not attributable to vigabatrin.

Main Results:

  • 284 children underwent 1,281 ophthalmic assessments.
  • Definite vigabatrin-related ocular toxicity was found in 0.7% of children (2/284), identified via ERG.
  • Possible toxicity (optic atrophy) was noted in 1.4% (4/284).

Conclusions:

  • The incidence of vigabatrin-related ocular toxicity in children is low.
  • Ocular and neurologic comorbidities, along with examination limitations, challenge toxicity identification.
  • The clinical utility of routine screening for vigabatrin-induced ocular toxicity in children remains uncertain.
Abstract

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