HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Data Supplement Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by McDonagh, J. Articles by Brodie, M.J. Search for Related Content PubMed PubMed Citation Articles by McDonagh, J. Articles by Brodie, M.J. Related Collections Retina Visual fields Antiepileptic drugs

Peripheral retinal dysfunction in patients taking vigabatrin

From the Tennent Institute of Ophthalmology (J. McDonagh, and Drs. Dolan, Parks, Dutton, and Keating), Gartnavel General Hospital; and Epilepsy Unit (Drs. Stephen, Sills, and Brodie, and K. Kelly), University Department of Medicine and Therapeutics, Western Infirmary, Glasgow, Scotland.

Address correspondence and reprint requests to Dr. S. Parks, ElectroDiagnostic Imaging Unit, Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow G12 0YN, Scotland; e-mail: s.w.parks{at}clinmed.gla.ac.uk

Objective: To assess the wide-field multifocal electroretinogram (WF-mfERG) for assessment of retinal function in vigabatrin-treated patients.

Methods: Thirty-two adults who had taken vigabatrin for at least 3 years for localization-related epilepsy underwent WF-mfERG, ERG, logMar visual acuity and color vision evaluation, Humphrey visual field analysis (static perimetry), and funduscopy. The group was matched with a cohort of patients who had never received vigabatrin. Results were compared with a normative data set (120 drug-free controls) with respect to potential bilateral abnormalities in response timing.

Results: There were no significant differences between groups in visual acuity or color vision testing. Of the vigabatrin patients, 19 (59%) had bilateral visual field defects compared to none of the controls. Using WF-mfERG, all patients on vigabatrin with visual field defects showed abnormalities (100% sensitivity) and only 2 of the 13 patients without a field defect showed retinal abnormalities (86% specificity).

Conclusions: WF-mfERG may be useful for detecting retinal pathology in patients taking vigabatrin. The majority of previous reports based on subjective testing may have underestimated the prevalence of peripheral retinal toxicity related to the drug.

Received November 13, 2002. Accepted in final form August 21, 2003.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the December 23 issue to find the title link for this article.

This article has been cited by other articles:

				R. D. Fechtner, A. S. Khouri, E. Figueroa, M. Ramirez, M. Federico, S. L. Dewey, and J. D. Brodie Short-term Treatment of Cocaine and/or Methamphetamine Abuse With Vigabatrin: Ocular Safety Pilot Results. Arch Ophthalmol, September 1, 2006; 124(9): 1257 - 1262. [Abstract] [Full Text] [PDF]

				R. Werth and G. Schadler Visual field loss in young children and mentally handicapped adolescents receiving vigabatrin. Invest. Ophthalmol. Vis. Sci., July 1, 2006; 47(7): 3028 - 3035. [Abstract] [Full Text] [PDF]

				J. M. Wild, C. R. Robson, A. L. Jones, I. A. Cunliffe, and P. E. M. Smith Detecting vigabatrin toxicity by imaging of the retinal nerve fiber layer. Invest. Ophthalmol. Vis. Sci., March 1, 2006; 47(3): 917 - 924. [Abstract] [Full Text] [PDF]

				S Beyenburg, J Bauer, and M Reuber New drugs for the treatment of epilepsy: a practical approach Postgrad. Med. J., October 1, 2004; 80(948): 581 - 587. [Abstract] [Full Text] [PDF]