. Purpose: To investigate whether persistent visual field defects among patients exposed once to the antiepileptic drug vigabatrin (VGB) were associated with peripapillary retinal nerve fibre layer thickness (RNFLT) attenuation. Methods: Nine individuals with partial epilepsy and VGB‐attributed visual field loss (group 1; 18 eyes) and seven age‐ and gender‐matched individuals with epilepsy and no previous VGB exposure (group 2; 14 eyes) were included in the study. Full‐field 120 point screening perimetry out to 60 degrees from central fixation using the Humphrey Field Analyzer was performed. RNFLT was quantified by optical coherence tomography (OCT) using Fast RNFLT protocol, Stratus OCT (3.0) after pupillary dilation. The results from the right eye are presented in this article. Results: Among the patients with VGB‐attributed visual field loss, five patients had only peripheral field defect (group 1a) and the remaining four had advanced field defects both in the periphery and within 30° from central fixation (group 1b). None of the patients in the control group had manifest visual field loss. The mean RNFLT among the patients with VGB‐attributed visual field loss was significantly attenuated compared to the controls [mean total RNFLT: group 1: 75.6 ± 12.7 μm, group 2: 103.5 ± 9.7 μm, mean difference 27.9 μm, (CI 15.9–39.9; p < 0.001)]. RNFLT values classified as borderline according to normative database (Stratus OCT) occurred more frequently among individuals with VGB‐attributed visual field loss than in controls (frequency in group 1: 6/9; group 2: 0/7, p = 0.011). The nasal, superior and inferior quadrants of RNFLT in individuals with VGB‐attributed visual field loss were significantly attenuated, while no difference was detected in temporal quadrants compared to controls. Both individuals with peripheral and those with advanced visual field losses in the VGB group had attenuated mean total RNFLT compared to controls (p = 0.006, p = 0.002, respectively). Occurrence of borderline classification of total RNFLT ≤5th percentile was more frequent among individuals with advanced visual field loss than among controls (p = 0.048). Conclusion: Persistent visual field loss attributed to VGB is associated with reduced peripapillary RNFLT and was detected both among patients with advanced and among patients with only peripheral visual field defects. Measurements of RNFLT with OCT might be considered as a diagnostic supplement in the follow‐up of patients exposed to vigabatrin.
Purpose To investigate whether peripheral and central visual field defects detected among epilepsy patients treated with vigabatrin are associated with reduced peripapillary retinal nerve fiber layer thickness as measured with optic coherence tomography (OCT). Methods Nine epilepsy patients with vigabatrin‐attributed visual field loss (group 1) and seven patients(age and sex matched) with epilepsy treated with other drugs(control group 2) were regularly examined with automated perimetry up to 60 degrees from fixation point (Humphrey Field Analyser). Peripapillary retinal nerve fiber layer thickness (RNFLT) was quantified by optic coherence tomography (OCT) using Fast RNFLT protocol, Stratus OCT (3.0). Five of the patients in group 1 had peripheral visual field defects, (group 1a), four had a central field defect(group 1b). All patients in control group 2 had normal visual field. Results Patients with vigabatrin‐attributed visual field loss had attenuated total RNFLT compared to controls (right eye : mean total RNFLT: group 1: 75.6 µm (SD 12.7); group 2: 103.5 µm (SD 9.7), mean difference 27.9 µm (CI 15.9‐39.9;P < 0.001). The nasal and inferior sectors RNFLT were more attenuated in patients with vigabatrin‐attributed visual field loss compared to controls, while no difference was detected in the temporal RNFLT. Both individuals with peripheral and central visual field losses had attenuated mean total RNFLT compared to controls (P = 0.006 and P= 0.002, respectively). Conclusion Vigabatrin‐attributed visual field defects are associated with reduced RNFLT. Combination of perimetry and OCT can efficiently detect vigabatrin induced retinal nerve fiber damage.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.