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From the Neuro-Ophthalmology Unit (Drs. Miller, Girkin, and Perry, and M. Endres) and the Department of Neurology (Drs. Miller and Girkin, and S.R. Paul), the Johns Hopkins Medical Institutions, Baltimore, and the Maryland Center for Eye Care (Dr. Johnson), University of Maryland, Baltimore.
Address correspondence and reprint requests to Dr. N.R. Miller, Maumenee B-109, The Wilmer Eye Institute, 600 North Wolfe Street, Baltimore, MD 21287-9204.
BACKGROUND: Vigabatrin is an antiepileptic drug that, although relatively well tolerated, is associated with visual field constriction and other visual disturbances of unclear origin.
METHODS: We performed a complete neuroophthalmologic examination and electrophysiologic studies on 39 patients receiving vigabatrin and on 11 control patients.
RESULTS: Nearly 50% of patients receiving vigabatrin had constricted visual fields compared with control patients. Some of the vigabatrin patients also had reduced visual acuity and abnormal color vision. In addition, most vigabatrin patients had abnormal electroretinographic results, the severity of which correlated strongly with the degree of visual field constriction.
CONCLUSIONS: Vigabatrin can cause electrophysiologic evidence of retinal dysfunction and clinically detectable disturbances of visual sensory function.
Key words: Seizures—Vigabatrin—Visual fields—Perimetry—Electroretinogram—
-Aminobutyric acid.
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