The wide field multifocal ERG reveals a retinal defect caused by vigabatrin toxicity?

McDonagh, Jan

doi:10.1136/bjo.85.1.110k

Cited by 7 publications

(10 citation statements)

References 5 publications

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Section: Discussionmentioning

confidence: 99%

“…Attenuation of nerve fibre layer detected by OCT might be a result of primary or secondary ganglion cell or nerve fibre atrophy. Based on ERG results, damage primarily involving cones and rods has been also suspected (McDonagh et al 2001;Eklund et al 2006;Kjellstrom et al 2008 It is well known that there are regional variations in retina regarding the susceptibility to damage (Tanito et al 2008). Interestingly, the effect of VGB is different from that encountered in individuals with ethambutol-induced optic neuropathy, where the greatest decrease of RNFLT was in the temporal quadrants (Chai & Foroozan 2007).…”

Section: Discussionmentioning

confidence: 99%

“…The visual field loss attributed to VGB is apparently neuronal in origin. A range of electrophysiological abnormalities (Krauss et al 1998;Lawden et al 1999;Harding et al 2000a,b;McDonagh et al 2001;Eklund et al 2006) and extensive loss of retinal ganglion cells and their axons at a post-mortem examination have been reported (Ravindran et al 2001). However, in most patients exposed to VGB, standard clinical examination of the retina and optic disc does not reveal any abnormalities.…”

Section: Introductionmentioning

confidence: 99%

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Retinal nerve fibre layer attenuation: clinical indicator for vigabatrin toxicity

Moseng¹,

Sæter²,

Mørch-Johnsen³

et al. 2011

Acta Ophthalmologica

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. 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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Retinal nerve fibre layer attenuation: clinical indicator for vigabatrin toxicity

Moseng¹,

Sæter²,

Mørch-Johnsen³

et al. 2011

Acta Ophthalmologica

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“…As mentioned in previous sections, studies have demonstrated that WF-mfERG is useful in the assessment of retinal function in patients with CRVO, 50 retinitis pigmentosa, 49 and in the evaluation of vigabatrin-associated retinal toxicity. 193,194 However, the system is not readily available at present and future commercially available models should broaden the utilization of this technique.…”

Section: Wide-field Mfergmentioning

confidence: 99%

“…The WF-mfERG was developed as a technique to objectively measure more peripheral retinal function and has been applied in the evaluation of visual field constrictions in vigabatrin patients. 193,194 McDonagh et al conducted a study to evaluate the use of WF-mfERG in patients taking vigabatrin. 194 Among all the WF-mfERG parameters, the most consistent overall predictor of bilateral visual field defects was the difference between the central and peripheral implicit times.…”

Section: Vigabatrinmentioning

confidence: 99%

The Clinical Applications of Multifocal Electroretinography: A Systematic Review

Lai

Chan

Lai

et al. 2007

Survey of Ophthalmology

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Abstract. Multifocal electroretinography (mfERG) is an investigation that can simultaneously measure multiple electroretinographic responses at different retinal locations by cross-correlation techniques. mfERG therefore allows topographic mapping of retinal function in the central 40--50 of the retina. The strength of mfERG lies in its ability to provide objective assessment of the central retinal function at different retinal areas within a short duration of time. Since the introduction of mfERG in 1992, mfERG has been applied in a large variety of clinical settings. This article reviews the clinical applications of mfERG based on the currently available evidence. mfERG has been found to be useful in the assessment of localized retinal dysfunction caused by various acquired or hereditary retinal disorders. The use of mfERG also enabled clinicians to objectively monitor the treatment outcomes as the changes in visual functions might not be reflected by subjective methods of assessment. By changing the stimulus, recording, and analysis parameters, investigation of specific retinal electrophysiological components can be performed topographically. Further developments and consolidations of these parameters will likely broaden the use of mfERG in the clinical setting.

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Binasal visual field defects are not specific to vigabatrin

González

Sills

Parks

et al. 2009

Epilepsy & Behavior

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The wide field multifocal ERG reveals a retinal defect caused by vigabatrin toxicity?

Cited by 7 publications

References 5 publications

Retinal nerve fibre layer attenuation: clinical indicator for vigabatrin toxicity

Retinal nerve fibre layer attenuation: clinical indicator for vigabatrin toxicity

The Clinical Applications of Multifocal Electroretinography: A Systematic Review

Binasal visual field defects are not specific to vigabatrin

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