Detecting vigabatrin toxicity by imaging of the retinal nerve fiber layer

Investigative Ophthalmology & Visual Science
John M WildPhilip E M Smith

Abstract

To quantify retinal nerve fiber layer thickness (RNFLT) and macular thickness (MT) in patients exhibiting vigabatrin-attributed visual field loss (VAVFL) and to determine the efficacy of these measures as markers of the retinal damage associated with vigabatrin. This was a prospective cross-sectional observational study involving five groups: Group I, 13 patients exhibiting VAVFL; Group II, 8 patients exposed to vigabatrin but with normal fields; Group III, 14 patients receiving carbamazepine monotherapy; Group IV, 20 normal individuals; and Group V, 7 patients receiving sodium valproate monotherapy. At one of two visits, the right eye of each participant underwent two digital imaging modalities: ocular coherence tomography (OCT; StratusOCT; Carl Zeiss Meditec, Dublin, CA) and scanning laser ophthalmoscopy (SLO; Heidelberg Retinal Tomograph; Heidelberg Engineering GmbH, Heidelberg, Germany). At the other visit, participants underwent three-zone, age-corrected suprathreshold perimetry of the whole field and threshold perimetry of the central field (Humphrey Field Analyzer 750; Carl Zeiss Meditec). The order of the visits was randomized. The group mean RNFLT in Group I was attenuated relative to that of the remaining groups (all ...Continue Reading

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