Clinical Science

Authors: Kinirons, Peter; Cavalleri, Gianpiero L; O'Rourke, Deirdre; Doherty, Colin P.; Reid, Irene; Logan, Patricia; Liggan, Brenda; Delanty, Norman; Hirsch, Lawrence J.; Weintraub, David B.; Buchsbaum, Richard; Spencer, Hilary T.; Straka, Tara; Hager, Melissa; Resor, Stanley R.; Harms, Susan L.; Garrard, Judith; Schwinghammer, Paul; Eberly, Lynn E.; Chang, Yanping; Leppik, Ilo E.; Mac, Tu Luong; Le, Van Tuan; Vu, Anh Nhi; Preux, Pierre-Marie; Ratsimbazafy, Voa; Fregni, Felipe; Thome-Souza, Sigride; Nitsche, Michael; Freedman, Steven; Valente, Kette; Pascual-Leone, Alvaro; Kobayashi, Eliane; Bagshaw, Andrew P.; Bénar, Christian-George; Aghakhani, Yahya; Andermann, Frederick; Dubeau, François; Gotman, Jean; Oishi, Makoto; Kameyama, Shigeki; Masuda, Hiroshi; Tohyama, Jun; Kanazawa, Osamu; Sasagawa, Mutsuo; Otsubo, Hiroshi; Morioka, Takato; Hashiguchi, Kimiaki; Nagata, Shinji; Miyagi, Yasushi; Yoshida, Fumiaki; Mihara, Futoshi; Sakata, Ayumi; Sasaki, Tomio; Cukiert, Arthur; Burattini, Jose Augusto; Mariani, Pedro Paulo; Câmara, Ródio Brandão; Seda, Lauro; Baldauf, Cristine Mella; Argentoni, Meire; Baise-Zung, Carla; Forster, Cássio Roberto; Mello, Valeria Antakli; Khan, Raja B.; Onar, Arzu; Bahi-Buisson, Nadia; Kaminska, Anna; Nabbout, Rima; Barnerias, Christine; Desguerre, Isabelle; De Lonlay, Pascale; Mayer, Michele; Plouin, Perrine; Dulac, Olivier; Chiron, Catherine; Stéphane, Auvin; Florence, Pandit; Julitta, De Bellecize; Nicole, Badinand; Hervé, Isnard; Jacques, Motte; Nathalie, Villeneuve; Marie-Dominique, Lamblin; Louis, Vallée; Kim, Howard L.; Donnelly, Joseph H.; Tournay, Anne E.; Book, Teri M.; Filipek, Pauline; Huat Patrick Chan, Chow; Briellmann, Regula S.; Pell, Gaby S.; Scheffer, Ingrid E.; Abbott, David F.; Jackson, Graeme D.; Gleissner, Ulrike; Clusmann, Hans; Sassen, Robert; Elger, Christian E.

Source: Epilepsia, Volume 47, Number 2, February 2006 , pp. 228-232(5)

Publisher: Wiley-Blackwell

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Abstract:

Vigabatrin Retinopathy in an Irish Cohort: Lack of Correlation with Dose

<namegroup type="author"> <name type="author"> <forenames>Peter</forenames> <surname>Kinirons</surname> </name>, <name type="author"> <forenames>Gianpiero L</forenames> <surname>Cavalleri</surname> </name>, <name type="author"> <forenames>Deirdre</forenames> <surname>O'Rourke</surname> </name>, <name type="author"> <forenames>Colin P.</forenames> <surname>Doherty</surname> </name>, <name type="author"> <forenames>Irene</forenames> <surname>Reid</surname> </name>, <name type="author"> <forenames>Patricia</forenames> <surname>Logan</surname> </name>, <name type="author"> <forenames>Brenda</forenames> <surname>Liggan</surname> </name>, and <name type="author"> <forenames>Norman</forenames> <surname>Delanty</surname> </name> </namegroup> Vigabatrin (VGB) is a effective medication used to treat epilepsy. However, it causes irreversible constriction of vision as a side effect in about 40% of individuals. It is unclear whether the development of this relates to the amount of the drug taken over time. We conducted an analysis of patients taking long-term VGB treatment to examine whether toxicity is related to the daily dose, duration of therapy, or cumulative dose taken. Information from 93 patients receiving long-term, stable VGB therapy was analyzed. We recorded patient demographics, how much VGB they had taken and for how long, and the results of all visual field assessments. We then compared the amount of visual field constriction with the daily dose, duration of therapy, and cumulative dose of VGB. Our results show that in 53% of patients, visual field constriction developed. Male and female subjects were affected equally. We found no correlation between the amount of visual field constriction and either the maximum dose of VGB taken, the duration of exposure, or the cumulative dose. The shortest exposure time to development of constriction was 1.1 years. All patients with normal fields on initial assessment continued to have normal fields on follow-up. Most patients who had evidence of constriction on initial assessment and continued to take VGB showed no progression on follow-up. One patient had substantial recovery of vision after discontinuation of VGB. In conclusion, development of visual constriction in patients taking long-term, standard doses of VGB does not depend on the daily dose, duration of exposure, or cumulative dose. Our data suggest that field defects may develop within the first few years of therapy and possibly remain stable thereafter. Epilepsia 2006;47(2).

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1528-1167.2006.00413_2.x

Publication date: 2006-02-01

Clinical Science

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