Article
Vigabatrin associated retinal dysfunction in children with
epilepsy
R Koula, A Chackoa, A Ganeshb, S Bulusuc, K Al Riyamid
a Department of Child
Health (Division of Paediatric Neurology), Sultan Qaboos University
Hospital, Al Khod, PO Box 38, Zip Code 123, Sultanate of Oman, b Department of Paediatric
Ophthalmology, Sultan Qaboos University Hospital, c Department of Clinical Neurophysiology, Sultan
Qaboos University Hospital, d Department
of Pharmacy and Therapeutics, Sultan Qaboos University Hospital
Correspondence to: Dr Koul rkoul{at}omantel.net.om
Accepted 20 August
2001
BACKGROUND
Recent reports have
established that eye changes occur in patients treated with vigabatrin.
AIMTo identify the eye changes
associated with vigabatrin, based on a prospective study of children
treated for seizures.
METHODSTwenty nine children on
vigabatrin (mainly as add on therapy) were followed up for 6.5 years.
Ophthalmic examination was performed before starting treatment and then
six monthly in the outpatient clinic.
RESULTSTwenty one children
fulfilled the inclusion criteria. Most had epileptic syndromes with
infantile spasmsnamely West syndrome, Lennox-Gastaut syndrome, and
partial seizures. Vigabatrin dose was 25-114 mg/kg/day (mean 55.8);
duration of therapy was 6-85 months (mean 35.7). Four children (19%)
developed eye changes (retinal pigmentation, hypopigmented retinal
spots, vascular sheathing, and optic atrophy). Visual evoked potentials
were abnormal in 16 children. Electroretinography and
electro-oculography, which could have picked up eye changes in early
stages, were not performed, as this facility was not available.
CONCLUSIONSVigabatrin causes eye
damage. Most children with epileptic syndromes on vigabatrin cannot
complain of their eye problems, hence 3-6 monthly ophthalmic follow up
is strongly advised, along with regular electroretinography,
electro-oculography, and visual evoked potentials if possible.
Keywords: vigabatrin; epilepsy; retinal dysfunction
© 2001 by Archives of Disease in Childhood
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Arch. Dis. Child. 2001 85: 0.[Extract] [Full Text] [PDF]
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Drugs: CNS (not psychiatric)
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Child health
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Epilepsy and seizures
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