Skip to main content
AAN.com
Articles
December 1, 1999

Visual dysfunction in patients receiving vigabatrin
Clinical and electrophysiologic findings

December 1, 1999 issue
53 (9) 2082

Abstract

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.

Get full access to this article

View all available purchase options and get full access to this article.

References

1.
Ben-Menschem E. Vigabatrin. Epilepsia 1995;36 (suppl 2):S95–S104.
2.
French JA, Mosier M, Walker S, Sommerville K, Sussman N. A double-blind placebo-controlled study of vigabatrin three g/day in patients with uncontrolled complex partial seizures: Vigabatrin Protocol 024 Investigative Consort. Neurology 1996;46:54–61.
3.
Marson AG, Kadir ZA, Hutton JL, Chadwick DW. The new antiepileptic drugs: a systemic review of their efficacy and tolerability. Epilepsia 1997;38:859–880.
4.
Petroff OA, Rothman DL, Behar KL, Collins TL, Mattson RH. Human brain GABA levels rise rapidly after initiation of vigabatrin therapy. Neurology 1996;47:1567–1571.
5.
Ben-Menachem E, French J. Vigabatrin. In: Engel, J, Pedley TA, eds. Epilepsy: a comprehensive textbook. Philadelphia:Lippincott–Raven, 1998:1609–1618.
6.
Fisher RS, Kerrigan JF. Vigabatrin: toxicity. In: Levy RH, Mattson RH, Meldrum BS, eds. Antiepileptic drugs. 4th ed.New York:Raven Press, 1995:931–939.
7.
Elke T, Talbot JF, Lawden MC. Severe persistent visual field constriction associated with vigabatrin. BMJ 1997;314:180–181.
8.
Wilson EA, Brodie MJ. Severe persistent visual field constriction associated with vigabatrin. BMJ 1997;314:1693.
9.
Wong IC, Mawer GE, Sander JW. Severe persistent visual field constriction associated with vigabatrin. BMJ 1997;314:1693–1694.
10.
Blackwell N, Hayllar J, Kelly G. Severe persistent visual field constriction associated with vigabatrin. BMJ 1997;314:1694.
11.
Harding GF. Severe persistent visual field constriction associated with vigabatrin. BMJ 1997;314:1694.
12.
Kramer G, Scollo-Lavizzari G, Jallon P, et al. Vigabatrin-associated bilateral concentric visual field defects in four patients. Epilepsia 1997;38 (suppl 8):179.
13.
Krauss GL, Johnson MA, Miller NR. Vigabatrin-associated retinal cone system dysfunction: electroretinogram and ophthalmologic findings. Neurology 1998;50:614–618.
14.
Zackon DH, Guberman A, Racette L, et al. Vigabatrin and visual loss. Presented at the North American Neuro-Ophthalmology Society Meeting, Orlando, FL, March 22–26, 1998.
15.
Lawden MC, Eke T, Degg C, et al. Visual field constriction associated with vigabatrin treatment. Neuro-Ophthalmology 1998;20:17.
16.
Kalvianen R, Nousiainen I, Mantyjarvi M, et al. Initial vigabatrin monotherapy is associated with increased risk of visual field constriction: a comparative follow-up study with patients on initial carbamazepine monotherapy and healthy controls. Epilepsia 1998;39 (suppl 6):72.
17.
Ruether K, Pung T, Kellner U, et al. Electrophysiologic evaluation of a patient with peripheral visual field constriction associated with vigabatrin. Arch Ophthalmol 1998;116:817–819.
18.
Diabetic Retinopathy Study. Manual of operations. Baltimore: Diabetic Retinopathy Study Coordinating Center, 1972.
19.
Pourcho RG. Uptake of [H3]glycine and [H3]GABA by amacrine cells in the cat retina. Brain Res 1980;198:33–46.
20.
Euler T, Wässle H. Different contribution of GABA(A) and GABA(C) receptors to rod and cone bipolar cells in the rat retinal slice. Invest Ophthalmol Vis Sci 1997;38:S1141.
21.
Kapousta-Bruneau N. GABAA and GABAC receptor antagonists have opposite effects on the b-wave of ERG in rat retina. Invest Ophthalmol Vis Sci 1998;39:S980.

Information & Authors

Information

Published In

Neurology®
Volume 53Number 9December 1, 1999
Pages: 2082

Publication History

Received: April 23, 1999
Accepted: July 20, 1999
Published online: December 1, 1999
Published in print: December 1, 1999

Permissions

Request permissions for this article.

Authors

Affiliations & Disclosures

N.R. Miller, MD
From the Neuro-Ophthalmology Unit (Drs. MillerGirkin, 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.
M.A. Johnson, PhD
From the Neuro-Ophthalmology Unit (Drs. MillerGirkin, 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.
S.R. Paul
From the Neuro-Ophthalmology Unit (Drs. MillerGirkin, 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.
C.A. Girkin, MD
From the Neuro-Ophthalmology Unit (Drs. MillerGirkin, 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.
J.D. Perry, MD
From the Neuro-Ophthalmology Unit (Drs. MillerGirkin, 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.
M. Endres
From the Neuro-Ophthalmology Unit (Drs. MillerGirkin, 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.
G.L. Krauss, MD
From the Neuro-Ophthalmology Unit (Drs. MillerGirkin, 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.

Notes

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.

Metrics & Citations

Metrics

Citations

Download Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Select your manager software from the list below and click Download.

Cited By
  1. CASE REPORTS: Presumed topiramate-induced retinopathy in a 58-year-old woman, Digital Journal of Ophthalmology, (2023).https://doi.org/10.5693/djo.02.2023.01.004
    Crossref
  2. Field-specific visual-evoked potentials, Neurology, 58, 8, (1261-1265), (2023)./doi/10.1212/WNL.58.8.1261
    Abstract
  3. Using the electroretinogram to detect and monitor the retinal toxicity of anticonvulsants, Neurology, 56, 1, (140-141), (2023)./doi/10.1212/WNL.56.1.140
    Abstract
  4. Visual function loss from vigabatrin, Neurology, 55, 1, (40-45), (2023)./doi/10.1212/WNL.55.1.40
    Abstract
  5. Clinical Utility of Electroretinograms for Evaluating Vigabatrin Toxicity in Children, Journal of Pediatric Ophthalmology & Strabismus, 58, 3, (174-179), (2021).https://doi.org/10.3928/01913913-20210111-03
    Crossref
  6. OCT in Toxic and Nutritional Optic Neuropathies, OCT and Imaging in Central Nervous System Diseases, (375-400), (2020).https://doi.org/10.1007/978-3-030-26269-3_18
    Crossref
  7. The role of optical coherence tomography in therapeutics and conditions, which primarily have systemic manifestations: a narrative review, Therapeutic Advances in Ophthalmology, 11, (251584141983115), (2019).https://doi.org/10.1177/2515841419831155
    Crossref
  8. Objective Derivation of the Morphology and Staging of Visual Field Loss Associated with Long-Term Vigabatrin Therapy, CNS Drugs, 33, 8, (817-829), (2019).https://doi.org/10.1007/s40263-019-00634-2
    Crossref
  9. The Topographical Relationship between Visual Field Loss and Peripapillary Retinal Nerve Fibre Layer Thinning Arising from Long-Term Exposure to Vigabatrin, CNS Drugs, 33, 2, (161-173), (2019).https://doi.org/10.1007/s40263-018-0583-8
    Crossref
  10. Vigabatrin-Induced Visual Dysfunction in Chinese Patients with Refractory Epilepsy, European Journal of Ophthalmology, 18, 4, (624-627), (2018).https://doi.org/10.1177/112067210801800421
    Crossref
  11. See more
Loading...

View Options

Get Access

Login options

Check if you have access through your login credentials or your institution to get full access on this article.

Personal login Institutional Login
Purchase Options

Purchase this article to get full access to it.

Purchase Access, $39 for 24hr of access

View options

Full Text HTML

View Full Text HTML

Media

Figures

Other

Tables

Share

Share

Share article link

Share