Retinal electrophysiological results in patients receiving lamotrigine monotherapy.
OBJECTIVE
To evaluate the effects on vision in patients receiving lamotrigine (LTG) monotherapy.


METHODS
Twenty-four consecutive patients taking LTG for partial seizures were referred for a routine ophthalmologic examination including visual acuity testing, tonometry, slit lamp, and fundus examination. Automated kinetic perimetry, electrooculogram (EOG), and electroretinogram were performed after informed consent was obtained.


RESULTS
In 18 patients finally included, the clinical ophthalmologic examination showed no abnormality. Four patients complained of blurring; among them, one patient had a visual field constriction in both eyes, which, however, was of unclear clinical significance (poor compliance) and a reduced light/dark ratio of the electrooculogram. One other patient with blurred vision had a reduced EOG, but the visual field was normal. Two patients had a reduced EOG but no visual symptoms. Considering the whole group of patients receiving LTG therapy, the light/dark ratio of the EOG was reduced in a dose-dependent fashion (p < 0.0001). The electroretinogram was normal in all patients.


CONCLUSIONS
No irreversible visual field impairment in patients treated with LTG was encountered, although a dose-dependent retinal toxicity may have been present. The exact cellular mechanism of the electrophysiologic changes in patients taking LTG remain to be explained.
Arndt
Carl F
CF
Ophtalmologie Hôpital Gui de Chauliac, F-34295 Montpellier cedex 05, France. c-arndt@chu-montpellier.fr
Husson
Jeremie
J
Derambure
Philippe
P
Hache
Jean Claude
JC
Arnaud
Bernard
B
Defoort-Dhellemmes
Sabine
S
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D004585:Electrooculography / Q000187:drug effects*; D004596:Electroretinography / Q000187:drug effects*; D004828:Epilepsies, Partial / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000187:drug effects / Q000502:physiology; D012160:Retina / Q000187:drug effects* / Q000378:metabolism; D014227:Triazines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D014786:Vision Disorders / Q000139:chemically induced / Q000175:diagnosis; D015351:Vision Screening; D014792:Visual Acuity / Q000187:drug effects; D058609:Visual Field Tests / Q000706:statistics & numerical data; D005680:gamma-Aminobutyric Acid / Q000187:drug effects / Q000378:metabolism
D000927:Anticonvulsants; D014227:Triazines; D005680:gamma-Aminobutyric Acid; D000077213:Lamotrigine