An investigation of the ocular toxic effects of levetiracetam therapy in children with epilepsy

Durgut, Betül Diler; Türk, Adem; Arslan, Elif Acar; Kamaşak, Tülay; Şahin, Sevim; Dilber, Beril; Soguksulu, Tugce Turkcan; Cansu, Ali

doi:10.1007/s00381-019-04076-5

Cited by 10 publications

(4 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most clinic studies indicated that LEV monotherapy caused no significant function or morphological change in ocular tissues [29,30]. Our results demonstrated that LEV was associated with several ocular neuromuscular disorders, such as blepharospasm.…”

Section: Discussionmentioning

confidence: 50%

Eye Disorders Associated with newer Antiepileptic drugs: A real-world disproportionality analysis of FDA Adverse Reporting System events

Chen

Meana

Humberto

et al. 2021

Proceedings of MOL2NET'21, Conference on Molecular, Biomedical &Amp; Computational Sciences and Engineering, 7th Ed.

View full text Add to dashboard Cite

BackgroundNewer antiepileptic drugs (AEDs), such as Levetiracetam (LEV), Lacosamide(LCM), Topiramate(TPM), Gabapentin(GBP), Oxcarbazepine(OXA), Lamotrigine(LTG) and Zonisamide(ZNS), are prescribed frequently for epilepsy by physicians. Simultaneously, they are known to be associated with a series of eye disorders. But very few studies have systemically compared eye disorders of newer AEDs in a large sample of patients diagnosed with epilepsy. ObjectiveThe aim of this study is to evaluate the association between eye disorders and several newer antiepileptic drugs (AEDs), including LEV, LTG, TPM, GBP, OXA, LCM, ZNS, as well as to look for differences in the frequency of AEs across individual AEDs, by data-mining a self-reporting database, the FDA Adverse Event Report System (FAERS). MethodsThe definition relied on system organ class (SOCs) and preferred terms (PTs) by the Medical Dictionary for Regulatory Activities (MedDRA). Disproportionality analysis was used to detect the risk signals from the data in the US Food and Drug Administration (FDA) adverse event reporting system database (FAERS). The reporting odds ratio (ROR), the proportional reporting ratio (PRR) and χ2 (chi-square) were calculated to assess the association between adverse events (AEs) and AEDs use. ResultsFAERS reports of 158095 cases from January 1, 2015 to September 30, 2020 were included in this study. AEDs were associated with a series of eye related adverse events (AEs) defined by 106 Preferred Terms, which could be classified into ten aspects ： Anterior eye structural change, deposit and degeneration, Glaucoma and ocular hypertension, Ocular haemorrhages and vascular disorders NEC (Not Elsewhere Classified), Ocular infections, irritations and inflammations, Ocular neuromuscular disorders, Ocular sensory symptoms NEC, Ocular structural change, deposit and degeneration NEC, Retina, choroid and vitreous haemorrhages and vascular disorders, Vision disorders, Eye disorders NEC. ConclusionEye disorders occupy a certain proportion compared with other AEs associated with AEDs. There is variation in the types and severity of eye related AEs across individual AEDs. Generally, TPM and LTG are more likely to cause either mild or serious eye-related AEs. Patients with ophthalmic diseases should avoid using TPM and LTG. By contrast, LCM rarely has any severe eye related AEs, only diplopia and metamorphopsia are significant. LEV tend to produce ocular neuromuscular disorders related AEs. The adverse effects to macula induced by GBP should be taken into consideration during the clinic practice. ZNS appears to be heavily associated with choroidal effusion and angle closure glaucoma. OXA is mainly associated with lid lag and several cornea-related AEs.

show abstract

Section: Discussionmentioning

confidence: 50%

Eye Disorders Associated with newer Antiepileptic drugs: A real-world disproportionality analysis of FDA Adverse Reporting System events

Chen

Meana

Humberto

et al. 2021

Proceedings of MOL2NET'21, Conference on Molecular, Biomedical &Amp; Computational Sciences and Engineering, 7th Ed.

View full text Add to dashboard Cite

show abstract

“…This could be due to a difference in patients with epilepsy and healthy controls regardless of the antiseizure drug used. Other studies have found no difference in OCT or OCT angiography parameters in patients treated with levetiracetam compared with healthy controls 14 15…”

Section: Discussionmentioning

confidence: 92%

Toxic optic neuropathy associated with lamotrigine and levetiracetam dual therapy

Chou,

Lai,

Neveu

et al. 2024

BMJ Case Rep

View full text Add to dashboard Cite

We report the case of an early adolescent male on lamotrigine and levetiracetam therapy with a 1-month history of progressive, bilateral, painless visual loss which resolved on cessation of lamotrigine. To our knowledge, we present the first case of lamotrigine and levetiracetam dual therapy associated with toxic optic neuropathy, supported by electrophysiology and optical coherence tomography (OCT) changes. Electrophysiology findings were consistent with retinal ganglion cell dysfunction, with bilateral optic nerve involvement. Macula OCT showed mild retinal ganglion cell loss in all inner quadrants bilaterally. This case highlights the importance of asking patients with epilepsy treated with lamotrigine and levetiracetam about visual problems and considering early dose reduction or cessation of treatment.

show abstract

“…In another study in which pediatric epilepsy patients using LEV for at least 1 year were compared to a control group of healthy children, no difference was found between the groups in terms of RNFL and GCC values. [ 29 ]…”

Section: Discussionmentioning

confidence: 99%

Evaluation of ganglion cell complex and retinal nerve fiber layer thinning in epilepsy patients

Duran¹,

Aykaç

Eliaçık

2023

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose: This study aimed to compare the perimacular ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thickness measurements of epileptic and healthy individuals. Methods: The right eyes of 38 epileptic and 38 healthy individuals who had been using antiepileptic drugs (AEDs) for at least 1 year were included in the study. Central macular thickness, perimacular GCC thickness and volume, and peripapillary retinal nerve fiber layers were measured by optical coherence tomography (OCT) device. Perimacular 1, 3, and 6 mm circle diameters of Early Treatment of Diabetic Retinopathy Study (ETDRS) were selected for GCC measurements. Results: In epilepsy patients, GCC was significantly lower in the 3 mm superior quadrant and 6 mm in all quadrants compared to the control group (P < 0.05). RNFL was significantly thinner in epilepsy patients only in the temporal-inferior quadrant (P < 0.05). There was no significant difference between the patients who received AEDs as monotherapy and polytherapy (P > 0.05). Conclusion: We found that epilepsy patients had significant thinning in the GCC layers and temporal-inferior quadrant of RNFL compared to the control group. Our findings from the study show that early retinal changes in epilepsy patients, especially perimacular GCC layers, can be followed up with OCT.

show abstract

An investigation of the ocular toxic effects of levetiracetam therapy in children with epilepsy

Cited by 10 publications

References 39 publications

Eye Disorders Associated with newer Antiepileptic drugs: A real-world disproportionality analysis of FDA Adverse Reporting System events

Eye Disorders Associated with newer Antiepileptic drugs: A real-world disproportionality analysis of FDA Adverse Reporting System events

Toxic optic neuropathy associated with lamotrigine and levetiracetam dual therapy

Evaluation of ganglion cell complex and retinal nerve fiber layer thinning in epilepsy patients

Contact Info

Product

Resources

About