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© 2003 American Academy of Neurology Peripheral retinal dysfunction in patients taking vigabatrinFrom 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:
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