Harding G F, Wild J M, Robertson K A, Lawden M C, Betts T A, Barber C, Barnes P M
Neurosciences Research Institute, Aston University, Birmingham, United Kingdom.
Epilepsia. 2000 Nov;41(11):1420-31. doi: 10.1111/j.1528-1157.2000.tb00117.x.
Symptomatic visual field constriction thought to be associated with vigabatrin has been reported. The current study investigated the visual fields and visual electrophysiology of eight patients with known vigabatrin-attributed visual field loss, three of whom were reported previously. Six of the patients were no longer receiving vigabatrin.
The central and peripheral fields were examined with the Humphrey Visual Field Analyzer. Full visual electrophysiology, including flash electroretinography (ERG), pattern electroretinography, multifocal ERG using the VERIS system, electro-oculography, and flash and pattern visual evoked potentials, was undertaken.
Seven patients showed marked visual field constriction with some sparing of the temporal visual field. The eighth exhibited concentric constriction. Most electrophysiological responses were usually just within normal limits; two patients had subnormal Arden electro-oculography indices; and one patient showed an abnormally delayed photopic b wave. However, five patients showed delayed 30-Hz flicker b waves, and seven patients showed delayed oscillatory potentials. Multifocal ERG showed abnormalities that sometimes correlated with the visual field appearance and confirmed that the deficit occurs at the retinal level.
Marked visual field constriction appears to be associated with vigabatrin therapy. The field defects and some electrophysiological abnormalities persist when vigabatrin therapy is withdrawn.
已有报道称，出现了被认为与氨己烯酸相关的症状性视野缩窄。本研究调查了8例已知因氨己烯酸导致视野缺损的患者的视野及视觉电生理情况，其中3例曾有过报道。6例患者已不再服用氨己烯酸。
使用 Humphrey 视野分析仪检查中央和周边视野。进行了全面的视觉电生理检查，包括闪光视网膜电图（ERG）、图形视网膜电图、使用 VERIS 系统的多焦 ERG、眼电图以及闪光和图形视觉诱发电位。
7例患者表现出明显的视野缩窄，颞侧视野有一定程度的保留。第8例表现为同心性缩窄。大多数电生理反应通常仅在正常范围内；2例患者的 Arden 眼电图指数低于正常；1例患者的明视 b 波延迟异常。然而，5例患者的30Hz 闪烁 b 波延迟，7例患者的振荡电位延迟。多焦 ERG 显示出异常，有时与视野表现相关，并证实缺陷发生在视网膜水平。
明显的视野缩窄似乎与氨己烯酸治疗有关。停用氨己烯酸治疗后，视野缺损和一些电生理异常仍然存在。
