Pojda-Wilczek Dorota, Emich-Widera Ewa, Herba Ewa, Pojda Stefan M, Marszał Elzbieta
Z Katedry i Oddziału Klinicznego Okulistyki Slaskiej Akademii Medycznej w Katowicach.
Klin Oczna. 2005;107(10-12):654-7.
The aim of this study is to find the relationship between visual function changes and vigabatrin treatment continuation or discontinuation.
19 patients (11 males, 8 females) from 8 to 20 years old, treated with vigabatrin because of partial epilepsy, were examined. Best corrected visual acuity, contrast sensitivity and static visual field were done. The examinations were repeated after 1-2 months and after 1-2 years. The longest follow-up was about three years (one girl). In some children from this group additional elctrophysiologic tests (ERG, EOG according to ISCEV standards), were done.
Corrected visual acuity was 5/5 in all eyes. Contrast sensitivity was normal and it was not changed in follow-up period. Abnormal visual field was found in more than half of examined patients. The improvement of visual field occurred after vigabatrin discontinuation, but in one patient the improvement occurred although vigabatrin treatment was continued. Most of the patients refused control ERG and EOG, but in first examination decreased or border b-wave amplitude after "flicker 30Hz" was found.
In some patients treated with vigabatrin reversible visual field changes occurred. Multicentre study should be performed, to solve the problem of relationship between visual field changes, vigabatrin and other antiepileptic treatment. All tests in group of epileptic patients are difficult because of poor cooperation.
本研究旨在探寻视觉功能变化与氨己烯酸治疗的持续或中断之间的关系。
对19例（11例男性，8例女性）年龄在8至20岁、因部分性癫痫接受氨己烯酸治疗的患者进行了检查。进行了最佳矫正视力、对比敏感度和静态视野检查。在1至2个月后以及1至2年后重复进行检查。最长随访时间约为三年（一名女孩）。对该组中的一些儿童还进行了额外的电生理检查（根据国际临床视觉电生理学会标准进行的视网膜电图、眼电图检查）。
所有眼睛的矫正视力均为5/5。对比敏感度正常，且在随访期间未发生变化。超过一半的受检患者发现视野异常。视野改善发生在氨己烯酸停药后，但有一名患者尽管继续使用氨己烯酸治疗仍出现了改善。大多数患者拒绝进行视网膜电图和眼电图复查，但在首次检查中发现“30Hz闪烁”后b波振幅降低或处于临界值。
在一些接受氨己烯酸治疗的患者中出现了可逆性视野变化。应开展多中心研究，以解决视野变化、氨己烯酸与其他抗癫痫治疗之间的关系问题。由于癫痫患者群体合作性差，该组的所有检查都存在困难。
