Visual Field Changes in Pediatric and Adolescent Patients Treated with Vigabatrin

PURPOSE: To investigate perimetric changes in pediatric and adolescent patients treated with vigabatrin and to assess the relationship between the visual field defect and the cumulative dose, the duration of treatment, or the age when vigabatrin was first taken. METHODS: Pediatric and adolescent patients treated with vigabatrin for seizure for at least 6 months were examined with Goldmann perimetry. The cumulative dose, the duration of treatment, the age when vigabatrin was first taken, and whether a combination of anticonvulsants and vigabatrin was taken were recorded. Mean radial degree (MRD) determination from the right eye was used to compare the amount of constriction. RESULTS: Visual field constriction developed in 19 (27.1%) out of 70 patients and MRD decreased by 22.7% a mean duration of 86.7+/-27.4 months of treatment. The visual field significantly decreased in the superior, nasal, and inferior field with temporal and central sparing (p<0.001). There was a statistically significant correlation between the average MRD and the cumulative dose (r2=0.1772, p<0.001), and the duration of treatment (r2=0.1713, p<0.001), but no correlation between the average MRD and either the age when vigabatrin was first taken, or the combination of anticonvulsants with vigabatrin. CONCLUSIONS: Visual field constriction developed in one quarter of pediatric and adolescent patients treated with vigabatrin, which significantly correlated with the cumulative dose and the duration of treatment. Therefore, a regular examination of the visual field is warranted for pediatric and adolescent patients treated with vigabatrin.

Visual Field Changes in Children with Vigabatrin Treatment

PURPOSE: Recently, several reports have documented persistent visual field changes associated with long-term use of Vigabatrin, an antiepileptic drug. Epilepsy is a common disease in children, therefore we investigated perimetric changes in children who were on Vigabatrin treatment. METHODS: Total 36 eyes of 18 patients who had been treated with Vigabatrin were tested with Humphrey Field Analyzer. The visual fields were assessed using central 30-2 threshold test and peripheral 60-4 threshold test. RESULTS: In central 30-2 threshold tests, 13 eyes(40.6%) showed mild visual field constrictions and 4 eyes(12.5%) showed severe visual field constrictions. In peripheral 60-4 threshold tests, 23 eyes(71.8%) showed visual field changes. CONCLUSIONS: Asymptomatic visual field loss may develop in Vigabatrin-treated children. Regular examinations of the visual field is warranted for Vigabatrin-teated children.