Recommendations for visual evaluations of patients treated with vigabatrin.
OBJECTIVE
Although vigabatrin has been used for many years in Europe, this antiepileptic medication was approved for use in the USA only 1 year ago because of concerns for irreversible peripheral visual field loss that can result in functional visual disability.


RESULTS
Visual function testing involves both subjective and objective techniques, some of which can be standardized across multiple centers. With these subjective and objectives issues as a reference, the current literature about the pathogenesis of vigabatrin visual toxicity is reviewed in order to develop a practical and reliable testing program for detecting peripheral visual field changes early in their course; thereby, hopefully limiting disabling visual field loss.


CONCLUSIONS
Based upon the existing literature as well as the currently available data about the evaluation of visual function, an algorithm has been developed to serve as a starting point for clinicians to evaluate patients treated with vigabatrin for refractory epilepsy.
Sergott
Robert C
RC
Wills Eye Institute, Neuro-Ophthalmology Service, Thomas Jefferson University Medical College, Philadelphia, Pennsylvania, USA. rcs220@comcast.net
D000612:4-Aminobutyrate Transaminase / Q000037:antagonists & inhibitors*; D000465:Algorithms; D000927:Anticonvulsants / Q000009:adverse effects*; D004791:Enzyme Inhibitors / Q000009:adverse effects*; D006801:Humans; D017410:Practice Guidelines as Topic; D012160:Retina / Q000187:drug effects*; D020888:Vigabatrin / Q000009:adverse effects*; D058609:Visual Field Tests; D014794:Visual Fields / Q000187:drug effects*
D000927:Anticonvulsants; D004791:Enzyme Inhibitors; D000612:4-Aminobutyrate Transaminase; D020888:Vigabatrin