V Ponjavic1, S Andréasson. 1. Department of Ophthalmology, University of Lund, Sweden. vesna.ponjavic@telia.com
Abstract
PURPOSE: To examine the retinal function with different electrophysiological methods in twelve Swedish patients on long-term treatment (2-10 years) with the anti-epileptic drug vigabatrin. METHODS: Ophthalmological examination of twelve consecutive patients included testing of visual acuity, fundus inspection and fundus photography, kinetic perimetry, full-field ERG and multifocal ERG. RESULTS: All patients had a visual acuity of 0.7 or better. Fundus inspection revealed no pathology except in one patient who had a pallor of the optic disc. All patients had a normal appearance of the macula. The result of kinetic perimetry was normal in five patients while seven patients had a concentric defect of the visual field. The 30 Hz flicker cone b-wave amplitude in the full-field ERG was abnormal in all of the seven patients with a visual field defect. None of the patients with normal visual fields had a reduction of the 30 Hz flicker cone b-wave amplitude. Six of the twelve patients had a reduced multifocal ERG response but without any correlation with visual field defect. CONCLUSION: Long-term treatment with vigabatrin seems to selectively reduce retinal cone function. The visual field defects in patients taking vigabatrin correlate with pathology in the full-field ERG (reduction of the cone b-wave amplitude). The results from this study indicate that electroretinography can be used for monitoring patients taking vigabatrin in a more objective manner than with visual field testing.
PURPOSE: To examine the retinal function with different electrophysiological methods in twelve Swedish patients on long-term treatment (2-10 years) with the anti-epileptic drug vigabatrin. METHODS: Ophthalmological examination of twelve consecutive patients included testing of visual acuity, fundus inspection and fundus photography, kinetic perimetry, full-field ERG and multifocal ERG. RESULTS: All patients had a visual acuity of 0.7 or better. Fundus inspection revealed no pathology except in one patient who had a pallor of the optic disc. All patients had a normal appearance of the macula. The result of kinetic perimetry was normal in five patients while seven patients had a concentric defect of the visual field. The 30 Hz flicker cone b-wave amplitude in the full-field ERG was abnormal in all of the seven patients with a visual field defect. None of the patients with normal visual fields had a reduction of the 30 Hz flicker cone b-wave amplitude. Six of the twelve patients had a reduced multifocal ERG response but without any correlation with visual field defect. CONCLUSION: Long-term treatment with vigabatrin seems to selectively reduce retinal cone function. The visual field defects in patients taking vigabatrin correlate with pathology in the full-field ERG (reduction of the cone b-wave amplitude). The results from this study indicate that electroretinography can be used for monitoring patients taking vigabatrin in a more objective manner than with visual field testing.
Authors: S Andréasson; V Ponjavic; M Abrahamson; B Ehinger; W Wu; R Fujita; M Buraczynska; A Swaroop Journal: Am J Ophthalmol Date: 1997-07 Impact factor: 5.258
Authors: Yue Pan; Madina R Gerasimov; Trine Kvist; Petrine Wellendorph; Karsten K Madsen; Elena Pera; Hyunbeom Lee; Arne Schousboe; Mary Chebib; Hans Bräuner-Osborne; Cheryl M Craft; Jonathan D Brodie; Wynne K Schiffer; Stephen L Dewey; Steven R Miller; Richard B Silverman Journal: J Med Chem Date: 2011-12-30 Impact factor: 7.446