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Changes in the electroretinogram resulting from discontinuation of vigabatrin in children

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Abstract

Electroretinograms (ERGs) have been recorded longitudinally in children before and during treatment with the antiepileptic drug vigabatrin for the past 3.5 years. Vigabatrin induced changes in ERG responses occur in children; the most dramatic changes occur in the oscillatory potentials. The purpose of this study was to identify changes in ERG responses associated with discontinuation of vigabatrin treatment. If vigabatrin-induced changes reverse after discontinuation of the drug we infer that the original change is not an indicator of toxicity. ERG data were analyzed from 17 children who discontinued vigabatrin therapy. The duration of treatment ranged from 5 to 52 months, the age for the first ERG ranged from 6 to 38 months (median 10 months). ERGs were tested using the standard protocol established by the International Society for Clinical Electrophysiology of Vision, with Burian-Allen bipolar contact-lens electrodes. In addition to standard responses we recorded photopic oscillatory potentials (OPs). During vigabatrin treatment OPs show a greater change than other ERG responses, with the early occurring wavelets from the photopic OPs showing the greatest change. With discontinuation of vigabatrin the amplitude of the early wavelets of the photopic OPs increased dramatically compared with amplitudes while taking the drug (paired t-test, p=0.000075). The scotopic oscillatory potentials also show some recovery. Although changes in oscillatory potentials may occur with vigabatrin toxicity, a large change likely occurs with a non-toxic pharmacological effect of vigabatrin on GABAergic amacrine cells in the inner plexiform layer. Reduction of OPs in children on vigabatrin may not be related to toxicity.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Toronto, Toronto, Ontario, Canada

    Carol A. Westall, Sharon Morong & J. Raymond Buncic

  2. Department of Ophthalmology, The Hospital for Sick Children, Toronto, Ontario, Canada

    Carol A. Westall, Rita Nobile, Sharon Morong, J. Raymond Buncic & Carole M. Panton

  3. Brain and Behaviour Programme, Division of Neurology, Department of Paediatrics, The Hospital for Sick Children (HSC) Research Institute, Toronto, Ontario, Canada

    Carol A. Westall, Sharon Morong, J. Raymond Buncic & William J. Logan

  4. University of Toronto, Toronto, Ontario, Canada

    William J. Logan

  5. The Hospital for Sick Children, Toronto, Ontario, Canada

    William J. Logan

Authors
  1. Carol A. Westall
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  2. Rita Nobile
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  3. Sharon Morong
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  4. J. Raymond Buncic
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  5. William J. Logan
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  6. Carole M. Panton
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Westall, C.A., Nobile, R., Morong, S. et al. Changes in the electroretinogram resulting from discontinuation of vigabatrin in children. Doc Ophthalmol 107, 299–309 (2003). https://doi.org/10.1023/B:DOOP.0000005339.23258.8f

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  • DOI: https://doi.org/10.1023/B:DOOP.0000005339.23258.8f

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