Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, Scotland, UK.
Epilepsy Behav. 2009 Nov;16(3):521-6. doi: 10.1016/j.yebeh.2009.09.003. Epub 2009 Oct 7.
This study investigated the visual defects associated with the antiepileptic drug vigabatrin (VGB). Two hundred four people with epilepsy were grouped on the basis of antiepileptic drug therapy (current, previous, or no exposure to VGB). Groups were matched with respect to age, gender, and seizure frequency. All patients underwent objective assessment of electrophysiological function (wide-field multifocal electroretinography) and conventional visual field testing (static perimetry). Bilateral visual field constriction was observed in 59% of patients currently taking VGB, 43% of patients who previously took VGB, and 24% of patients with no exposure to VGB. Assessment of retinal function revealed abnormal responses in 48% of current VGB users and 22% of prior VGB users, but in none of the patients without previous exposure to VGB. Bilateral visual field abnormalities are common in the treated epilepsy population, irrespective of drug history. Assessment by conventional static perimetry may neither be sufficiently sensitive nor specific to reliably identify retinal toxicity associated with VGB.
本研究调查了抗癫痫药物氨己烯酸（VGB）相关的视觉缺陷。204 名癫痫患者根据抗癫痫药物治疗（目前、以前或无 VGB 暴露）分组。各组在年龄、性别和发作频率方面相匹配。所有患者均接受电生理功能（宽视野多焦视网膜电图）和常规视野测试（静态视野检查）的客观评估。目前服用 VGB 的患者中有 59%、以前服用过 VGB 的患者中有 43%、无 VGB 暴露的患者中有 24%出现双侧视野收缩。视网膜功能评估显示，目前使用 VGB 的患者中有 48%和以前使用过 VGB 的患者中有 22%出现异常反应，但以前没有接触过 VGB 的患者中均无异常反应。无论药物史如何，治疗性癫痫患者中双侧视野异常都很常见。常规静态视野检查既不够敏感，也不够特异，无法可靠识别与 VGB 相关的视网膜毒性。
