title: Does vigabatrin treatment for infantile spasms cause visual field defects? An international multicentre study.
abstract: OBJECTIVE
  The aim of this study was to examine whether vigabatrin treatment had caused visual field defects (VFDs) in children of school age who had received the drug in infancy.
  
  
  METHODS
  In total, 35 children (14 males, 21 females; median age 11y, SD 3.4y, range 8-23y) were examined by static Humphrey perimetry, Goldmann kinetic perimetry, or Octopus perimetry. The aetiologies of infantile spasms identified were tuberous sclerosis (n=10), other symptomatic causes (n=3), or cryptogenic (n=22).
  
  
  RESULTS
  Typical vigabatrin-attributed VFDs were found in 11 out of 32 (34%) children: in one out of 11 children (9%) who received vigabatrin for <1 year (group 1), in three out of 10 children (30%) who received vigabatrin for 12 to 24 months (group 2), and in seven out of 11 children (63%) who received vigabatrin treatment for longer than 2 years (group 3). VFDs were mild in five and severe in six children. Patients with tuberous sclerosis were at higher risk of VFDs (six out of 10 children). The mean cumulative doses of vigabatrin were 140.5, 758.8, and 2712g in group 1, 2, and 3, respectively.
  
  
  CONCLUSIONS
  VFDs were found in 34% of the cohort of children in this study. The rate of VFD increased from 9% to 63% as duration of treatment increased. The results of this study showed that the risk-benefit ratio should always be considered when using vigabatrin.
authors.affiliation: Children's Hospital, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Raili
authors.initials: R
authors.lastname: Riikonen
authors.forename: Zvonka
authors.initials: Z
authors.lastname: Rener-Primec
authors.forename: Lionel
authors.initials: L
authors.lastname: Carmant
authors.forename: Maria
authors.initials: M
authors.lastname: Dorofeeva
authors.forename: Katalin
authors.initials: K
authors.lastname: Hollody
authors.forename: Ilona
authors.initials: I
authors.lastname: Szabo
authors.forename: Branka S
authors.initials: BS
authors.lastname: Krajnc
authors.forename: Gabriele
authors.initials: G
authors.lastname: Wohlrab
authors.forename: Iiris
authors.initials: I
authors.lastname: Sorri
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013036:Spasms, Infantile / Q000188:drug therapy* / Q000209:etiology; D014402:Tuberous Sclerosis / Q000150:complications; D020888:Vigabatrin / Q000008:administration & dosage / Q000009:adverse effects*; D014786:Vision Disorders / Q000139:chemically induced* / Q000175:diagnosis; D058609:Visual Field Tests; D014794:Visual Fields / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D020888:Vigabatrin