Hardus P, Verduin W M, Engelsman M, Edelbroek P M, Segers J P, Berendschot T T, Stilma J S
Departments of Ophthalmology, Academic Hospital Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Epilepsia. 2001 Feb;42(2):262-7. doi: 10.1046/j.1528-1157.2001.15000.x.
To describe the correlation between visual field loss and the duration, dosage, and total amount of vigabatrin (VGB) medication in a group of patients with epilepsy. Co-medication of antiepileptic drugs (AEDs) and compliance were also studied.
Ninety-two patients (53 male and 39 female) taking VGB medication in the past or the present, attending the Outpatient Epilepsy Clinic in Utrecht, were examined with the Goldmann perimeter. The amount of visual field loss was calculated by the Esterman grid method and by a new method, with which the percentage surface loss of the visual field is measured. A complete drug history was compiled, specifying the amount and duration of VGB medication. Concomitant AED medication was noted. Serum levels of AEDs were determined.
Linear regression showed the total amount of VGB as the most significant parameter to predict visual field loss (p < 0.001). Further, men were more affected than women (p = 0.026). Compliance was good, and other AEDs did not influence the results.
Because prolonged use of VGB medication is correlated with the amount of visual field loss, VGB should be prescribed only when there are no alternatives. In such cases, we recommend an examination of the peripheral visual field before starting therapy and a repeated examination every 6 months.
描述一组癫痫患者的视野缺损与氨己烯酸（VGB）用药时间、剂量和总量之间的相关性。同时研究抗癫痫药物（AEDs）的联合用药情况及依从性。
对92例曾服用或正在服用VGB的患者（53例男性，39例女性）进行检查，这些患者均前往乌得勒支癫痫门诊就诊，使用戈德曼视野计进行检查。采用埃斯特曼方格法和一种新方法计算视野缺损量，新方法用于测量视野表面损失的百分比。收集完整的用药史，明确VGB的用药量和用药时间。记录伴随使用的AEDs药物。测定AEDs的血清水平。
线性回归分析显示，VGB总量是预测视野缺损的最显著参数（p < 0.001）。此外，男性比女性受影响更大（p = 0.026）。依从性良好，其他AEDs不影响结果。
由于长期使用VGB与视野缺损量相关，仅在没有其他替代药物时才应开具VGB处方。在这种情况下，我们建议在开始治疗前检查周边视野，并每6个月重复检查一次。
