Visual function in epilepsy patients treated with initial valproate monotherapy.
OBJECTIVE
To investigate whether initial valproate (VPA) monotherapy for the treatment of epilepsy causes visual field defects and visual dysfunction.


METHODS
In a cross-sectional study, visual fields were examined with the kinetic Goldmann and automated Humphrey perimeters, contrast sensitivity function with the Pelli-Robson letter chart and colour vision with the Standard Pseudoisochromatic Plates Part 2 (SPP 2) and Farnsworth-Munsell 100 Hue test (FM 100) in eighteen epilepsy patients (aged 18--50 years, 30.2.+/-10 years, mean+/-S.D.) treated with initial valproate monotherapy for 2--20 years (8.4+/-5.1 years).


RESULTS
None had vigabatrin-type, concentric visual field defect with the kinetic Goldmann or automated Humphrey perimetries. In the Humphrey perimetry, the mean deviation for the group was within normal limits varying from -2.53 to 0.59 dB (-0.74+/-0.80 dB) in the right eye and from -2.66 to 0.67 dB (-0.78+/-0.82 dB) in the left eye. In the FM 100 test, acquired colour vision deficiency was found in two out of 18 patients (11%, 95% CI: 0--25%). However, the mean total error score was lower in the patient group than in the control group. All patients had normal contrast sensitivity function.


CONCLUSIONS
The use of VPA in the treatment of epilepsy is not associated with visual field defects similar to vigabatrin, but may induce abnormalities in colour vision.
Sorri
Iiris
I
Department of Ophthalmology, Kuopio University Hospital, FIN-70211 Kuopio, Finland. liris.Sorri@uku.fi
Rissanen
Eeva
E
Mäntyjärvi
Maija
M
Kälviäinen
Reetta
R
D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D003118:Color Perception / Q000187:drug effects; D015350:Contrast Sensitivity / Q000187:drug effects; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy; D005260:Female; D007839:Functional Laterality / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D014786:Vision Disorders / Q000139:chemically induced* / Q000503:physiopathology; D014787:Vision Tests; D014794:Visual Fields / Q000187:drug effects
D000927:Anticonvulsants; D014635:Valproic Acid