Reduced visual function associated with infantile spasms in children on vigabatrin therapy.
OBJECTIVE
To use visual evoked potential (VEP) testing to determine whether visual deficits are present in children with a history of vigabatrin use.


METHODS
Contrast sensitivity and visual acuity were assessed by visual evoked potential testing and compared between 28 children (mean age, 4.90 +/- 4.92 years) with seizure disorders who had taken vigabatrin and 14 typically developing children (mean age, 3.14 +/- 1.70 years). Exclusion criteria were heritable eye disease, suspected cortical visual impairment, nystagmus, and prematurity >2 weeks. The effects of the following factors on contrast sensitivity and visual acuity were examined: type of seizure (infantile spasms versus other), ERG result, duration of vigabatrin therapy, cumulative dosage of vigabatrin, and other seizure medications (other versus no other medication).


RESULTS
Contrast sensitivity and visual acuity were reduced in vigabatrin-treated children with infantile spasms compared with vigabatrin-treated children with other seizure disorders and typically developing control subjects. The other factors examined had no significant effect on contrast sensitivity or visual acuity, with adjustment for seizure type.


CONCLUSIONS
Children with infantile spasms on vigabatrin may have compromised visual function, even in the absence of suspected cortical visual impairment. The children tested in the present study have reduced vision, probably associated with infantile spasms rather than vigabatrin.
Hammoudi
Dena S
DS
Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
Lee
Sophia S F
SS
Madison
Adena
A
Mirabella
Giuseppe
G
Buncic
J Raymond
JR
Logan
William J
WJ
Snead
O Carter
OC
Westall
Carol A
CA
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015350:Contrast Sensitivity; D005074:Evoked Potentials, Visual; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013036:Spasms, Infantile / Q000150:complications* / Q000188:drug therapy*; D020888:Vigabatrin / Q000627:therapeutic use*; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology*; D014792:Visual Acuity
D000927:Anticonvulsants; D020888:Vigabatrin