Retinal electrophysiological results in patients receiving lamotrigine monotherapy

Autor: Bernard Arnaud, Philippe Derambure, Carl Arndt, Jeremie Husson, Jean Claude Hache, Sabine Defoort-Dhellemmes
Přispěvatelé: Service d'Ophtalmologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Guy de Chauliac, Groupe matière condensée et matériaux (GMCM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Neurosciences Fonctionnelles et Pathologies (LNFP), Université de Lille, Droit et Santé-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)
Jazyk: angličtina
Rok vydání: 2005
Předmět:
Male
genetic structures
medicine.medical_treatment
MESH: Triazines
Visual Acuity
MESH: gamma-Aminobutyric Acid
MESH: Electroretinography
MESH: Visual Acuity
Epilepsy
0302 clinical medicine
MESH: Child
Child
Pigment Epithelium of Eye
gamma-Aminobutyric Acid
MESH: Middle Aged
Triazines
MESH: Retina
Middle Aged
MESH: Electrooculography
3. Good health
Visual field
MESH: Vision Screening
Neurology
MESH: Vision Disorders
Anesthesia
MESH: Perimetry
Anticonvulsants
Female
[SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]
medicine.symptom
medicine.drug
Adult
Phenytoin
Adolescent
MESH: Pigment Epithelium of Eye
Vision Disorders
Lamotrigine
Retina
Central nervous system disease
03 medical and health sciences
Vision Screening
MESH: Anticonvulsants
Blurred vision
Electroretinography
medicine
Humans
MESH: Adolescent
MESH: Humans
business.industry
MESH: Adult
Carbamazepine
medicine.disease
eye diseases
MESH: Male
Electrooculography
MESH: Epilepsies
Partial
Anticonvulsant
030221 ophthalmology & optometry
Visual Field Tests
Epilepsies
Partial
Neurology (clinical)
sense organs
business
MESH: Female
030217 neurology & neurosurgery
Zdroj: Epilepsia
Epilepsia, Wiley, 2005, 46 (7), pp.1055-60. ⟨10.1111/j.1528-1167.2005.43204.x⟩
Epilepsia, 2005, 46 (7), pp.1055-60. ⟨10.1111/j.1528-1167.2005.43204.x⟩
ISSN: 0013-9580
DOI: 10.1111/j.1528-1167.2005.43204.x⟩
Popis: Summary: Purpose: To evaluate the effects on vision in patients receiving lamotrigine (LTG) monotherapy. Methods: Twenty-four consecutive patients taking LTG for partial seizures were referred for a routine ophthalmologic examination including visual acuity testing, tonometry, slit lamp, and fundus examination. Automated kinetic perimetry, electrooculogram (EOG), and electroretinogram were performed after informed consent was obtained. Results: In 18 patients finally included, the clinical ophthalmologic examination showed no abnormality. Four patients complained of blurring; among them, one patient had a visual field constriction in both eyes, which, however, was of unclear clinical significance (poor compliance) and a reduced light/dark ratio of the electrooculogram. One other patient with blurred vision had a reduced EOG, but the visual field was normal. Two patients had a reduced EOG but no visual symptoms. Considering the whole group of patients receiving LTG therapy, the light/dark ratio of the EOG was reduced in a dose-dependent fashion (p < 0.0001). The electroretinogram was normal in all patients. Conclusions: No irreversible visual field impairment in patients treated with LTG was encountered, although a dosedependent retinal toxicity may have been present. The exact cellular mechanism of the electrophysiologic changes in patients taking LTG remain to be explained. Key Words: Lamotrigine—Visual field constriction—Retinal pigment epithelium—Electrooculogram—γ -Aminobutyric acid. Lamotrigine (LTG) is an antiepileptic drug (AED) effective against both partial and generalized seizures, including generalized absence seizures. Among the documented side effects, visual blurring is reported by 23% of the patients treated with LTG (1). Although it is highly improbable that these visual symptoms are all related to a measurable dysfunction, they have never been precisely evaluated by a complete visual, clinical, and electrophysiologic investigation in patients treated with the drug. One published case exists of visual field constriction in a child treated with LTG and valproate (VPA) (2). The only established cellular mechanism of LTG is a sodium-current block (3), a mechanism in common with phenytoin (PHT) and carbamazepine (CBZ) (4). However, different from LTG, PHT and CBZ are ineffective against absence seizures and have never been associated with visual field constriction. Therefore it has been advocated that LTG may have as-yet-uncharacterized cellular actions, which could combine with its sodium channel‐ blocking actions (5). Among other effects, there appears
Databáze: OpenAIRE
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