Kjellström Ulrika, Andréasson Sten, Ponjavic Vesna
Department of Ophthalmology, University of Lund, Lund, Sweden.
J Pediatr Ophthalmol Strabismus. 2011 Nov-Dec;48(6):357-65. doi: 10.3928/01913913-20110118-01. Epub 2011 Jan 25.
To evaluate retinal function in children taking vigabatrin and to explore the influence of age and dose parameters on the results of full-field electroretinography (ff-ERG).
The ff-ERGs from 14 children receiving vigabatrin were compared with ff-ERGs from healthy controls. Treated children were further grouped according to age (pre-school = 12-71 months; older = 72-228 months). Parameters of drug dosage were compared.
Treated children showed rod and cone dysfunction reflected by reduced b-wave amplitudes for the isolated rod response, the combined rod-cone response, and the 30-Hz flicker response. The a-wave amplitude and implicit time for the combined rod-cone response, reflecting photoreceptor function, were also altered. Further evaluation of age groups revealed similar findings in the pre-school group but not in the older group. Alterations in ff-ERG were seen in 57% of the treated children. Pre-school children had received significantly higher daily drug doses with start of medication at younger age. No differences were found concerning cumulative doses or duration of medication.
Alterations in ff-ERG are as frequent in children as in adults and the results indicate that exposure to high daily doses of vigabatrin may be associated with increased risk of retinal dysfunction, including photoreceptor damage, not previously shown in children. Thus, recommendations of careful follow-up for children receiving vigabatrin are supported.
评估服用vigabatrin的儿童的视网膜功能，并探讨年龄和剂量参数对全视野视网膜电图（ff-ERG）结果的影响。
将14名接受vigabatrin治疗的儿童的ff-ERG与健康对照者的ff-ERG进行比较。将接受治疗的儿童根据年龄进一步分组（学龄前=12 - 71个月；较大儿童=72 - 228个月）。比较药物剂量参数。
接受治疗的儿童表现出视杆和视锥功能障碍，表现为孤立视杆反应、视杆 - 视锥联合反应和30Hz闪烁反应的b波振幅降低。反映光感受器功能的视杆 - 视锥联合反应的a波振幅和隐含时间也发生了改变。对年龄组的进一步评估显示，学龄前组有类似发现，而较大儿童组则没有。57%接受治疗的儿童出现ff-ERG改变。学龄前儿童开始用药时的每日药物剂量显著更高，且开始用药年龄更小。在累积剂量或用药持续时间方面未发现差异。
ff-ERG改变在儿童中与成人中一样常见，结果表明，每日高剂量服用vigabatrin可能与视网膜功能障碍风险增加有关，包括光感受器损伤，这在儿童中以前未被发现。因此，支持对接受vigabatrin治疗的儿童进行密切随访的建议。
