Visual field defect during therapy with valproic-acid.
Visual field defect because of antiepileptic drug (AED) treatment has been widely reported during the clinical application of vigabatrin. But other gamma-aminobutyric acid (GABA)-ergic and non-GABA-ergic AEDs could also affect the visual field with different mechanisms of action. Here we report a case of a 22-year-old female patient, who suffered from bilateral concentric visual field defect during the long-term therapy with valproic-acid (VPA). A VPA-related metabolic dysfunction was found through blood and urine examination. Reduced B-waves were shown by electroretinography and a bilateral concentric visual field defect was confirmed by both manual and automated perimetry. In conclusion, the concentric visual field defect related to VPA treatment is rare but possible.
Department of Neurology 1, Krankenhaus Barmherzige Brüder Linz, Austria. christian.tilz@bblinz.at
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Tilz
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Wang-Tilz
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Jünemann
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Stefan
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Michelson
D000328:Adult; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D018682:GABA Agents / Q000009:adverse effects*; D006801:Humans; D012160:Retina / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D012162:Retinal Degeneration / Q000139:chemically induced* / Q000378:metabolism / Q000503:physiopathology; D013995:Time; D000637:Transaminases / Q000037:antagonists & inhibitors / Q000378:metabolism; D014508:Urea / Q000378:metabolism; D014635:Valproic Acid / Q000009:adverse effects*; D014786:Vision Disorders / Q000139:chemically induced* / Q000378:metabolism / Q000503:physiopathology; D014794:Visual Fields / Q000187:drug effects / Q000502:physiology; D005680:gamma-Aminobutyric Acid / Q000378:metabolism*
D018682:GABA Agents; D005680:gamma-Aminobutyric Acid; D014635:Valproic Acid; D014508:Urea; D000637:Transaminases