No reversion in vigabatrin-associated visual field defects

Nousiainen, Iiris; Mäntyjärvi, Maija; Kälviäinen, Reetta

doi:10.1212/wnl.57.10.1916

Cited by 56 publications

(53 citation statements)

References 8 publications

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“…The visual field defects caused by vigabatrin seem to be permanent [67]. Retinal damage, assessed by electroretinogram (ERG), can be seen as soon as 2-3 months following vigabatrin initiation [32].…”

Section: Side Effects Of Corticosteroids and Vigabatrinmentioning

confidence: 99%

Recent Advances in the Pharmacotherapy of Infantile Spasms

Riikonen

2014

CNS Drugs

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Adrenocorticotrophic hormone (ACTH), oral corticosteroids and vigabatrin are now first-line treatments for infantile spasms in the US and Europe. There is now increased knowledge regarding the role of ACTH, corticosteroids and vigabatrin (e.g. efficacy, doses, side effects, treatment in specific aetiological subtypes of infantile spasms), and other antiepileptic drugs (i.e. topiramate, valproate, zonisamide, sulthiame, levetiracetam, lamotrigine, pyridoxine, ganaxolone), as well as adjunctive flunarizine and novel drugs not yet in clinical use for infantile spasms (i.e. pulse rapamycin and melanocortin receptor agonists). The existence of a latent period, weeks to months following a precipitating brain insult, raises the possibility of preventive interventions. Recent experimental data emerging from animal models of infantile spasms have provided optimism that new and innovative treatments can be developed, and knowledge that drug treatment can affect long-term cognitive outcome is increasing. The aim of this article is to review recent developments in the pharmacotherapy of infantile spasms and to highlight the practical implications of the latest research.

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Section: Side Effects Of Corticosteroids and Vigabatrinmentioning

confidence: 99%

Recent Advances in the Pharmacotherapy of Infantile Spasms

Riikonen

2014

CNS Drugs

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“…Men appear to be affected more than women (Hardus et al, 2001), while visual function has been reported to remain stable in patients who continue long-term therapy (Paul et al, 2001b). Finally, it remains unclear whether these VFDs are reversible (Vanhatalo et al, 2001) or not (Nousiainen et al, 2001).…”

Section: Completersmentioning

confidence: 99%

Treating cocaine addiction: From preclinical to clinical trial experience with γ‐vinyl GABA

Brodie

Figueroa²,

Dewey

2003

Synapse

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“…1,2 Since 1997 there have been numerous reports of concentric and/or binasal visual field defects associated with the use of Vigabatrin making this the most concerning safety issue with the use of the drug at present. [3][4][5][6] Previous studies have confirmed the high prevalence of visual field defects (up to 30-40%) and the lack of evidence for significant progression or resolution of these defects on cessation of the drug. 3,7,8 To date, there is little information with regard to the natural history of visual field defects in patients who continue on Vigabatrin.…”

Section: Introductionmentioning

confidence: 96%

“…[3][4][5][6] Previous studies have confirmed the high prevalence of visual field defects (up to 30-40%) and the lack of evidence for significant progression or resolution of these defects on cessation of the drug. 3,7,8 To date, there is little information with regard to the natural history of visual field defects in patients who continue on Vigabatrin. 3,9 Our study aimed to look at the natural history of visual field defects in a group of patients with known Vigabatrin-associated field loss who opted to continue on the drug because of good seizure control and consequent improvement in quality of life.…”

Section: Introductionmentioning

confidence: 96%

“…3,7,8 To date, there is little information with regard to the natural history of visual field defects in patients who continue on Vigabatrin. 3,9 Our study aimed to look at the natural history of visual field defects in a group of patients with known Vigabatrin-associated field loss who opted to continue on the drug because of good seizure control and consequent improvement in quality of life.…”

Section: Introductionmentioning

confidence: 99%

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The natural history of Vigabatrin associated visual field defects in patients electing to continue their medication

Best

Acheson

2004

Eye

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Purpose To determine the natural history of visual field defects in a group of patients known to have Vigabatrin-associated changes who elected to continue the medication because of good seizure control. Methods All patients taking Vigabatrin alone or in combination with other antiepileptic drugs for at least 5 years (range 5-12 years) were entered into a visual surveillance programme. Patients were followed up at 6-monthly intervals for not less than 18 months (range 18-43 months). In all, 16 patients with unequivocal defects continued the medication. Following already published methodology (Eye 2002; 16;567-571) monocular mean radial degrees (MRDs) to the I/4e isopter on Goldmann perimetry was calculated for the right eye at the time of discovery of a visual field defect and again after not less than 18 months follow-up. Results Mean right eye MRD at presentation was 36.981 (range 22.25-51.0), compared to 38.401 (range 22.5-49.75) after follow-up; P ¼ 0.338 unpaired t-test. Only one patient demonstrated a deterioration in visual field during the study period and discontinued treatment. Conclusion Established visual field defects presumed to be due to Vigabatrin therapy did not usually progress in spite of continuing use of the medication. These data give support to the hypothesis that the pathogenesis of Vigabatrin-associated visual field defects may be an idiosyncratic adverse drug reaction rather than dose-dependent toxicity.

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No reversion in vigabatrin-associated visual field defects

Cited by 56 publications

References 8 publications

Recent Advances in the Pharmacotherapy of Infantile Spasms

Recent Advances in the Pharmacotherapy of Infantile Spasms

Treating cocaine addiction: From preclinical to clinical trial experience with γ‐vinyl GABA

The natural history of Vigabatrin associated visual field defects in patients electing to continue their medication

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