Ponjavic V, Andréasson S
Department of Ophthalmology, University of Lund, Sweden.
Doc Ophthalmol. 2001 Jan;102(1):63-72. doi: 10.1023/a:1017589301855.
To examine the retinal function with different electrophysiological methods in twelve Swedish patients on long-term treatment (2-10 years) with the anti-epileptic drug vigabatrin.
Ophthalmological examination of twelve consecutive patients included testing of visual acuity, fundus inspection and fundus photography, kinetic perimetry, full-field ERG and multifocal ERG.
All patients had a visual acuity of 0.7 or better. Fundus inspection revealed no pathology except in one patient who had a pallor of the optic disc. All patients had a normal appearance of the macula. The result of kinetic perimetry was normal in five patients while seven patients had a concentric defect of the visual field. The 30 Hz flicker cone b-wave amplitude in the full-field ERG was abnormal in all of the seven patients with a visual field defect. None of the patients with normal visual fields had a reduction of the 30 Hz flicker cone b-wave amplitude. Six of the twelve patients had a reduced multifocal ERG response but without any correlation with visual field defect.
Long-term treatment with vigabatrin seems to selectively reduce retinal cone function. The visual field defects in patients taking vigabatrin correlate with pathology in the full-field ERG (reduction of the cone b-wave amplitude). The results from this study indicate that electroretinography can be used for monitoring patients taking vigabatrin in a more objective manner than with visual field testing.
采用不同的电生理方法检查12例长期（2 - 10年）服用抗癫痫药物氨己烯酸的瑞典患者的视网膜功能。
对12例连续患者进行眼科检查，包括视力测试、眼底检查和眼底摄影、动态视野检查、全视野视网膜电图（ERG）和多焦ERG。
所有患者视力均为0.7或更好。眼底检查除1例视盘苍白的患者外未发现病变。所有患者黄斑外观正常。5例患者动态视野检查结果正常，7例患者有同心性视野缺损。在7例有视野缺损的患者中，全视野ERG中30Hz闪烁视锥细胞b波振幅均异常。视野正常的患者中，无一例30Hz闪烁视锥细胞b波振幅降低。12例患者中有6例多焦ERG反应降低，但与视野缺损无任何相关性。
长期服用氨己烯酸似乎会选择性降低视网膜视锥细胞功能。服用氨己烯酸患者的视野缺损与全视野ERG中的病变相关（视锥细胞b波振幅降低）。本研究结果表明，视网膜电图可用于比视野测试更客观地监测服用氨己烯酸的患者。
