Purpose: To describe the correlation between visual field loss and the dura
tion, dosage. and total amount of vigabatrin (VGB) medication in a group of
patients with epilepsy. Co-medication of antiepileptic drugs (AEDs) and co
mpliance were also studied.
Methods: Ninety-two patients (53 male and 39 female) taking VGB medication
in the past or the present, attending the Outpatient Epilepsy Clinic in Utr
echt, were examined with the Goldmann perimeter. The amount of visual field
loss was calculated by the Esterman grid method and by a new method, with
which the percentage surface loss of the visual field is measured. A comple
te drug history was compiled, specifying the amount and duration of VGB med
ication. Concomitant AED medication was noted. Serum levels of AEDs were de
termined.
Results: Linear regression showed the total amount of VGB as the most signi
ficant parameter to predict visual field loss (p < 0.001). Further, men wer
e more affected than women (p = 0.026). Compliance was good, and other AEDs
did not influence the results.
Conclusions: Because prolonged use of VGB medication is correlated with the
amount of visual field loss, VGB should be prescribed only when there are
no alternatives. In such cases, we recommend an examination of the peripher
al visual field before starting therapy and a repeated examination every 6
months.