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BMC Ophthalmology

, 14:166



BackgroundVigabatrin VGB is an anti-epileptic medication which has been linked to peripheral constriction of the visual field. Documenting the natural history associated with continued VGB exposure is important when making decisions about the risk and benefits associated with the treatment. Due to its speed the Swedish Interactive Threshold Algorithm SITA has become the algorithm of choice when carrying out Full Threshold automated static perimetry. SITA uses prior distributions of normal and glaucomatous visual field behaviour to estimate threshold sensitivity. As the abnormal model is based on glaucomatous behaviour this algorithm has not been validated for VGB recipients. We aim to assess the clinical utility of the SITA algorithm for accurately mapping VGB attributed field loss.

MethodsThe sample comprised one randomly selected eye of 16 patients diagnosed with epilepsy, exposed to VGB therapy. A clinical diagnosis of VGB attributed visual field loss was documented in 44% of the group. The mean age was 39.3 years ± 14.5 years and the mean deviation was -4.76 dB ±4.34 dB. Each patient was examined with the Full Threshold, SITA Standard and SITA Fast algorithm.

ResultsSITA Standard was on average approximately twice as fast 7.6 minutes and SITA Fast approximately 3 times as fast 4.7 minutes as examinations completed using the Full Threshold algorithm 15.8 minutes. In the clinical environment, the visual field outcome with both SITA algorithms was equivalent to visual field examination using the Full Threshold algorithm in terms of visual inspection of the grey scale plots , defect area and defect severity.

ConclusionsOur research shows that both SITA algorithms are able to accurately map visual field loss attributed to VGB. As patients diagnosed with epilepsy are often vulnerable to fatigue, the time saving offered by SITA Fast means that this algorithm has a significant advantage for use with VGB recipients.

KeywordsSwedish interactive threshold algorithm Vigabatrin Visual field Electronic supplementary materialThe online version of this article doi:10.1186-1471-2415-14-166 contains supplementary material, which is available to authorized users.

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Autor: Miriam L Conway - Sarah L Hosking - Haogang Zhu - Robert P Cubbidge


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