No abstract

Electroretinograms (ERGs) have been recorded longitudinally in children before and during treatment with the antiepileptic drug vigabatrin for the past 3.5 years. Vigabatrin induced changes in ERG responses occur in children; the most dramatic changes occur in the oscillatory potentials. The purpose of this study was to identify changes in ERG responses associated with discontinuation of vigabatrin treatment. If vigabatrin-induced changes reverse after discontinuation of the drug we infer that the original change is not an indicator of toxicity. ERG data were analyzed from 17 children who discontinued vigabatrin therapy. The duration of treatment ranged from 5 to 52 months, the age for the first ERG ranged from 6 to 38 months (median 10 months). ERGs were tested using the standard protocol established by the International Society for Clinical Electrophysiology of Vision, with Burian-Allen bipolar contact-lens electrodes. In addition to standard responses we recorded photopic oscillatory potentials (OPs). During vigabatrin treatment OPs show a greater change than other ERG responses, with the early occurring wavelets from the photopic OPs showing the greatest change. With discontinuation of vigabatrin the amplitude of the early wavelets of the photopic OPs increased dramatically compared with amplitudes while taking the drug (paired t-test, p = 0.000075). The scotopic oscillatory potentials also show some recovery. Although changes in oscillatory potentials may occur with vigabatrin toxicity, a large change likely occurs with a non-toxic pharmacological effect of vigabatrin on GABAergic amacrine cells in the inner plexiform layer. Reduction of OPs in children on vigabatrin may not be related to toxicity.

Early photopic OPs were disrupted more than the late OP, suggesting relative deficit in the ON (depolarizing) retinal pathways.

gestation, AVPD ± SD in the RV was 6.4 ± 2.6 mm, in the septum 4.3 ± 1.3 mm and in the LV 4.1 ± 2.4 mm. In the pilot study with 35 fetuses with a suspicion of IUGR, the mean AVPD z-scores ± SD were significantly lower in the RV wall-0.45 ± 0.87 (p = 0.020) and the septum-0.44 ± 1.05 (p = 0.018). Conclusions: AVPD increased with gestational age in normal pregnancies and it was lower in the RV wall and in the septum in fetuses with a suspicion of IUGR. This study also showed that it is possible to analyse AVPD from cTDI recordings using an automated method. VP18.04 Impact of cardiovascular hemodynamics on surgical and neurodevelopmental outcomes in fetuses with Ebstein's anomaly and tricuspid valve dysplasia