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Visual Field Defect in the Vigabatrin-treated Pediatric Patients
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KMID : 0391520010090010080
Abstract
Vigabatrin(VGB)¿¡ ÀÇÇÑ ¹«Áõ»ó¼º ¾çÃø¼º ½Ã¾ß°á¼Õ¿¡ °üÇÑ ¸¹Àº º¸°í¿Í´Â ´Þ¸® º» ¿¬±¸¿¡¼´Â ½Ã¾ß Ãà¼ÒÀÇ °æ¿ì¸¦ °üÂûÇÒ ¼ö ¾ø¾ú´Ù. ÀÌ´Â Vigabatrin(VGB)ÀÇ Åõ¿©±â°£ÀÌ ´Ù¸¥ ¿¬±¸¿¡ ºñÇØ Æò±Õ 14°³¿ù·Î ª¾Ò´ø Á¡°ú ÀÚµ¿ ½Ã¾ß°è °Ë»ç¸¦ ½ÃÇàÇÑ ¼Ò¾ÆÀÇ ºÎÀûÀýÇÑ
ÇùÁ¶·Î
ÀÎÇÑ °Ë»çÀÇ ºÎÁ¤È®¼ºµµ »ý°¢ÇÒ ¼ö ÀÖ´Ù. À̸¦ º¸¿ÏÇϱâ À§ÇÏ¿© VEP(visual evoked potential) ¹æ¹ý µî ´Ù°¢ÀûÀÎ ¿¬±¸°¡ ÇÊ¿äÇÒ °ÍÀ¸·Î »ý°¢Çϸç, VigabatrinÀ» ó¹æÇÔ¿¡ ÀÖ¾î¼ ÁÖÀÇ¿Í Á¤±âÀûÀÎ ½Ã¾ß ÃøÁ¤ÀÌ ÇÊ¿äÇÒ °ÍÀ¸·Î »ç·áµÈ´Ù.
Purpose: Vigabatrin has proved to be a successful and well tolerated drug used for the treatment of epilepsy of partial onset and for infantile spasms(West's syndrome). It is a selective and irreversible inhibitor of gamma-aminobutyric acid
transaminase
that is associated with visual field defect. We performed this study to investigate visual field defects in children treated with Vigabatrin.
Methods: We performed a complete neuroophthalmologic examination and electrophysiologic studies on 28 patients receiving Vigabatrin. They underwent static perimetry using either full field 81 points or central 30-2 threshold screening program on
the
Humphrey visual field analyser, followed by the ophthalmic examination to rule out ocular causes for visual field defects.
Results: The patients had a mean age of 11.9¡¾3.1 years and the mean treatment duration with Vigabatrin was 14.9 months. 11 of 28 patients were abnormal on static perimetry. Among them, four were false negative, one was false positive and two had
fixation loss, which were suggestive of poor cooperation. Four of them had visual field defects including right homonymous inferior quadrantanopia, left incongruous incomplete hemianopsia, bilateral right homonymous hemianopsia, bilateral left
homonymous hemianopsia.
Conclusion: Visual field examination in children is more difficult than in adults because of a lack of cooperation. Although we could not find any patients with visual field defect from Vigabatrin, vigilance and close follow up are necessary when
the
drug is prescribed.
Å°¿öµå
Vigabatrin; Visual field defect;
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