NEW YORK (Reuters Health) – The risk of visual field loss with the antiepileptic drug vigabatrin is lower when it is given during infancy rather than later in life, findings reported in the February issue of Epilepsia suggest.

Vigabatrin has proven to be an effective agent for infantile spasms, but findings from studies in older children and adults have raised concerns about visual field loss, the researchers note. Until now, however, no studies had examined how vigabatrin treatment during infancy affects visual fields later in childhood.

Dr. Eija Gaily, from Helsinki University Central Hospital, Finland, and colleagues addressed this issue by conducting visual field testing in 16 subjects, 6 to 12 years of age, who had received vigabatrin for infantile spasms.

On average, the subjects began vigabatrin therapy at 7.6 months of age, were treated for 21.0 months, and received a cumulative dose of 655 g. Eight children had been treated with vigabatrin only, five with vigabatrin and adrenocorticotropic hormone, and three with vigabatrin and other anti-epileptic drugs.

Fifteen of the 16 children had normal visual fields. One child, who had mild field loss, had received vigabatrin for 19 months with a cumulative dose of 572 g.

The authors note that the rate of visual field loss in this study is much lower than rates of 20% to 40% previously reported in subjects who had received vigabatrin at older ages.

“Our results may encourage doctors to use vigabatrin to treat infantile spasms as the risk for visual field damage may be relatively low in many children compared to the risks caused by continuous seizures,” Dr. Gaily said in a statement.

Reference:
Epilepsia 2009;50:206-216.