Bakhshandeh Bali M K, Otaghsara S M Taheri, Soltansanjari Mostafa, Sadighi Nadia, Nasehi Mohammad Mahdi, Ashrafi Mahmoud Reza, Karimzadeh Parvaneh, Taghdiri Mohammad Mahdi, Ghofrani Mohammad
Pediatric Neurology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Brain and Spinal Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
J Child Neurol. 2014 Jun;29(6):765-8. doi: 10.1177/0883073813490073. Epub 2013 Jun 6.
Vigabatrin is an antiepileptic drug that results in higher gamma-aminobutyrate levels in the brain and retina. Vigabatrin-induced visual field defects are usually asymptomatic and only detectable by perimetry. Further, perimetry requires good cooperation, and children aged under 10 years cannot do it. Electroretinogram response amplitude to full-field 30-Hz flicker shine has been offered to be more specific in predicting visual field defects. This study is scheduled to investigate the vigabatrin-associated visual complications in 67 epileptic children taking vigabatrin using full-field electroretinogram. Electroretinographic surveys showed normal range parameters despite 3 months of vigabatrin treatment, and just 3 (4.47%) children had been visually impaired at the end of 6-month treatment. Among these 3 cases, 1 patient had persistent electroretinogram abnormality despite vigabatrin discontinuation. Our study suggests that vigabatrin is secure for short-term pediatric antiepileptic treatment, with few cases of visual impairments and that are often reversible.
氨己烯酸是一种抗癫痫药物，可使大脑和视网膜中的γ-氨基丁酸水平升高。氨己烯酸引起的视野缺损通常无症状，仅通过视野检查才能检测到。此外，视野检查需要良好的配合，10岁以下儿童无法进行。全视野30赫兹闪烁光刺激的视网膜电图反应幅度在预测视野缺损方面更具特异性。本研究计划使用全视野视网膜电图调查67例服用氨己烯酸的癫痫儿童中与氨己烯酸相关的视觉并发症。尽管进行了3个月的氨己烯酸治疗，但视网膜电图检查显示参数在正常范围内，在6个月治疗结束时仅有3例（4.47%）儿童出现视力损害。在这3例病例中，1例患者在停用氨己烯酸后视网膜电图仍持续异常。我们的研究表明，氨己烯酸用于儿科短期抗癫痫治疗是安全的，视力损害病例很少，且通常是可逆的。
