April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Changes in the ERG D-wave with Vigabatrin Treatment in a Pediatric Cohort
Author Affiliations & Notes
  • Rachel Dragas
    Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON, Canada
  • Carol A Westall
    Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON, Canada
    Ophthalmology and Vision Sciences; Institute of Medical Science, The University of Toronto, Toronto, ON, Canada
  • Thomas Wright
    Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON, Canada
  • Footnotes
    Commercial Relationships Rachel Dragas, None; Carol Westall, Lundbeck Pharmaceuticals (F); Thomas Wright, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 1922. doi:
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      Rachel Dragas, Carol A Westall, Thomas Wright; Changes in the ERG D-wave with Vigabatrin Treatment in a Pediatric Cohort. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1922.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: Vigabatrin (VGB), a common treatment for the childhood epilepsy, infantile spasms (IS), is implicated in visual field reduction. Electroretinograms (ERGs) are a substitute to visual field testing in infants and VGB-associated ERG reduction (VAER) is a reduction in age-corrected light adapted 3.0 flicker response amplitude from a pre-treatment measurement. The d-wave ERG response is the result of OFF bipolar cell depolarization to light offset. The purpose of this study is to evaluate if the ERG d-wave response is a marker for VAER toxicity in a pediatric population.

Methods: Eighty-seven children with IS treated with VGB were assessed prospectively and tested for the cone-OFF response elicited to a 250 cd.s.m2 flash with 200 ms duration. Twenty with IS had been tested before VGB and 9 of the 87 developed VAER during the time frame of the study. Thirteen retinally normal controls were also tested. Amplitude and implicit timing of the d-wave response were measured manually.

Results: There was no difference in d-wave amplitude between the IS group tested before VGB treatment (IS-baseline) and controls. Combining data from the IS-baseline and control group, there was no effect on d-wave amplitude whilst there was a reduction in implicit time with increasing age. The d-wave amplitude was reduced in the IS group with VAER compared to those without VAER (p<0.01). Longer duration of treatment was associated with reduced d-wave amplitude (anova p=0.054) in those with and without VAER.

Conclusions: Reduced amplitude of the cone OFF response may be good indicator for VGB-induced adverse retinal changes.

Keywords: 503 drug toxicity/drug effects • 509 electroretinography: clinical • 758 visual fields  
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