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.
Tilz
C
C
Department of Neurology 1, Krankenhaus Barmherzige Brüder Linz, Austria. christian.tilz@bblinz.at
Wang-Tilz
Y
Y
Jünemann
A
A
Stefan
H
H
Michelson
G
G
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