IngentaConnect Characterization of vigabatrin-associated optic atrophy

Authors: Frisén, Lars¹; Malmgren, Kristina¹

Source: Acta Ophthalmologica Scandinavica, Volume 81, Number 5, October 2003 , pp. 466-473(8)

Abstract:

. Aims:

To report the discovery of a previously unknown form of optic atrophy associated with use of the anti-epileptic drug vigabatrin. Methods:

We conducted a retrospective analysis of digitally enhanced ocular fundus photographs, kinetic visual field maps and treatment parameters for 25 patients, who were selected to represent a large spectrum of visual field defects. Results:

In all, 21 patients (84%) evidenced subtle, diffuse atrophy of the retinal nerve fibre layer, in a pattern accessible to scoring. Atrophy scores correlated with visual field remains and cumulative vigabatrin doses. A pathophysiological model is proposed that involves the lengths of intraocular (unmyelinated) retinal ganglion cell axons. Conclusion:

Optic atrophy attests to the irreversible nature of vigabatrin's visual toxicity. Ocular fundus imaging should prove useful for objectively monitoring vigabatrin-treated subjects for visual toxicity.

Keywords: vigabatrin; optic atrophy; retinal nerve fibre; layer; visual field

Document Type: Research article

DOI: 10.1034/j.1600-0420.2003.00125.x

Affiliations: 1: Institute of Clinical Neuroscience, Sahlgren's Academy at Gothenburg University, Gothenburg, Sweden

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