J Korean Med Sci.  2006 Aug;21(4):728-732. 10.3346/jkms.2006.21.4.728.

Vigabatrin and Visual Field Defects in Pediatric Epilepsy Patients

• You SJ
• Ahn HS
• Ko TS

• KMID: 2157829
• DOI: http://doi.org/10.3346/jkms.2006.21.4.728

Abstract

We studied the prevalence, type and severity of vigabatrin (VGB)-attributed visual field defects (VFDs), and used these data to assess the associated risk factors in pediatric patients. Medical records were retrospectively reviewed for 67 pediatric patients who received VGB alone or in combination with other antiepileptic drugs, and who had undergone visual field examinations using a Humphrey visual field analyzer. Of the 67 patients, 15 had VGB-attributed VFDs: 13 had nasal arcuate type, 1 had nasal and temporal constricted type and 1 had nasal constricted type. In terms of severity, 7 patients had Grade I VGB-attributed VFDs, 5 had Grade II, 2 had Grade III, and 1 had Grade IV. Although there were no significant differences between the VFD and non-VFD groups with regards to all tested parameters, there were no cases of VGB-attributed VFDs in patients with total treatment durations <2 yr and cumulative doses <10 g/kg. In conclusion, the prevalence of VGB-attributed VFDs in VGB-treated pediatric epilepsy patients was 22%. The high frequency of VGB-attributed VFDs indicates that physicians should inform all patients of this risk prior to VGB treatment and perform periodic visual field examinations.

Keyword

Pediatric; Epilepsy; Vigabatrin; Visual Fields

MeSH Terms

Visual Fields/drug effects
Vision Disorders/*chemically induced
Vigabatrin/adverse effects/*therapeutic use
Time Factors
Risk Factors
Retrospective Studies
Male
Humans
Female
Epilepsy/*drug therapy
Drug Therapy, Combination
Drug Monitoring/statistics & numerical data
Child
Anticonvulsants/adverse effects/*therapeutic use
Adult

Figure

• 

  Fig. 1 Four separate and increasingly severe cases of VBG-attributed field defects, as determined by automated static threshold perimetry using Humphrey Field Analyzer Program 30-2. (A) Grade I (minimal, 25-30°), (B) Grade II (moderate, 20-30°), (C) Grade III (moderate to severe, <20°), (D) Grade IV (severe, ring scotoma).

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