Electroretinography (ERG) Monitoring for Vigabatrin Visual Toxicity (The Pros and The Cons) - ERG versus No ERG with; Clinical Follow-Up (ERG Beneficial & ERG Not Beneficial)

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Identifier 20210223_nanos_controversiespediatricno1_01-abstract
Title Electroretinography (ERG) Monitoring for Vigabatrin Visual Toxicity (The Pros and The Cons) - ERG versus No ERG with; Clinical Follow-Up (ERG Beneficial & ERG Not Beneficial)
Creator Steven F. Stasheff, MD, PhD; Michael J. Wan, MD, FRCSC
Subject Vigabatrin; Toxicity; Vision Loss; Electroretinography (ERG); Epilepsy
Description Pro: Eleven years ago, FDA approval of vigabatrin treatment for complex and refractory childhood epilepsy in the United States added substantially to previous experience in Europe, Canada and elsewhere. This experience has revealed both its utility in a wider variety of complex, refractory seizure disorders and its retina to the optic nerves and central nervous system (CNS) structures. Basic research has pointed towards several underlying pathophysiologic mechanisms of visual loss, which may interact variably with patients' underlying neurodevelopmental diseases. Con: Vigabatrin is a known cause of ocular toxicity and visual field loss. Early reports estimated ocular toxicity at 52% in adults and 34% in children. However, most early data was from small, retrospective studies and, crucially, many patients did not have baseline visual testing and had been on long-term treatment with vigabatrin. Due to the reports of ocular toxicity, the Food and Drug Administration (FDA) started a mandatory drug registry for vigabatrin with robust visual function testing. From 2009 to 2016, 1,509 patients had ophthalmic testing and only 2% had a potential vigabatrin-associated effect on vision. Furthermore, many of the cases of potential toxicity returned to normal on repeat testing. Interestingly, 37% of the cohort did have pre-existing pathology affecting the visual system, which might have been interpreted as toxicity had baseline testing not been done.
Relation is Part of NANOS Annual Meeting 2021: Controversies in Pediatric Neuro-Ophthalmology
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2021-02
Type Text
Format application/pdf
Source 2021 North American Neuro-Ophthalmology Society Annual Meeting
Rights Management Copyright 2021. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Language eng
ARK ark:/87278/s66x55z6
Setname ehsl_novel_nam
Date Created 2021-03-10
Date Modified 2021-06-10
ID 1671098
Reference URL https://collections.lib.utah.edu/ark:/87278/s66x55z6