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Study of Visual Function in Adult Epileptic Patients on Sodium Valproate or Carbamazepine Monotherapy

Objective Epilepsy is a debilitating disease. Visual function changes have been reported and may be attributed to the epileptic changes or as a result of medication side effect. Sodium valproate and carbamazepine are both first line anti-epileptic medications used in Malaysian health care. Sodium va...

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Autores principales: Matthew, Tong Jong Haw, Tharakan, John, Tai, Evelyn, Hussein, Adil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592832/
https://www.ncbi.nlm.nih.gov/pubmed/31275777
http://dx.doi.org/10.7759/cureus.4553
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author Matthew, Tong Jong Haw
Tharakan, John
Tai, Evelyn
Hussein, Adil
author_facet Matthew, Tong Jong Haw
Tharakan, John
Tai, Evelyn
Hussein, Adil
author_sort Matthew, Tong Jong Haw
collection PubMed
description Objective Epilepsy is a debilitating disease. Visual function changes have been reported and may be attributed to the epileptic changes or as a result of medication side effect. Sodium valproate and carbamazepine are both first line anti-epileptic medications used in Malaysian health care. Sodium valproate inhibits glutamate and γ-aminobutyric acid (GABA) transaminase while carbamazepine acts on the sodium channel - both are an important part of the retina. This study aimed to compare the visual functions of epilepsy patients on carbamazepine or sodium valproate monotherapy. Design A cross-sectional study was conducted at a tertiary hospital between June 2016 and November 2018. Methods Patients with idiopathic epilepsy that fulfill the inclusion and exclusion criteria were recruited from the neurology clinic. They were divided into two groups and underwent complete eye examinations. Visual functions such as color vision testing, contrast sensitivity, visual field and retinal nerve fiber layer measurement were subsequently performed. Statistical analysis was done using Statistical Package for the Social Science, version 24 (SPSS Inc, Chicago, IL, USA). Results A total of 100 patients (sodium valproate: 50 patients; carbamazepine: 50 patients) were recruited for the study. There were no statistically significant changes in anatomical or visual function between the sodium valproate and carbamazepine group. However, patients from both groups displayed color vision defect in the blue and green axes. Changes in color vision could indicate early retina toxicity secondary to the medication. Although there were no visual field changes, patients recorded a slight reduction of mean deviation. Changes of mean deviation could be attributed to the side effect of medication or the disease process. Conclusions Epileptic patients taking sodium valproate or carbamazepine did not demonstrate statistically significant change in visual function.
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spelling pubmed-65928322019-07-02 Study of Visual Function in Adult Epileptic Patients on Sodium Valproate or Carbamazepine Monotherapy Matthew, Tong Jong Haw Tharakan, John Tai, Evelyn Hussein, Adil Cureus Ophthalmology Objective Epilepsy is a debilitating disease. Visual function changes have been reported and may be attributed to the epileptic changes or as a result of medication side effect. Sodium valproate and carbamazepine are both first line anti-epileptic medications used in Malaysian health care. Sodium valproate inhibits glutamate and γ-aminobutyric acid (GABA) transaminase while carbamazepine acts on the sodium channel - both are an important part of the retina. This study aimed to compare the visual functions of epilepsy patients on carbamazepine or sodium valproate monotherapy. Design A cross-sectional study was conducted at a tertiary hospital between June 2016 and November 2018. Methods Patients with idiopathic epilepsy that fulfill the inclusion and exclusion criteria were recruited from the neurology clinic. They were divided into two groups and underwent complete eye examinations. Visual functions such as color vision testing, contrast sensitivity, visual field and retinal nerve fiber layer measurement were subsequently performed. Statistical analysis was done using Statistical Package for the Social Science, version 24 (SPSS Inc, Chicago, IL, USA). Results A total of 100 patients (sodium valproate: 50 patients; carbamazepine: 50 patients) were recruited for the study. There were no statistically significant changes in anatomical or visual function between the sodium valproate and carbamazepine group. However, patients from both groups displayed color vision defect in the blue and green axes. Changes in color vision could indicate early retina toxicity secondary to the medication. Although there were no visual field changes, patients recorded a slight reduction of mean deviation. Changes of mean deviation could be attributed to the side effect of medication or the disease process. Conclusions Epileptic patients taking sodium valproate or carbamazepine did not demonstrate statistically significant change in visual function. Cureus 2019-04-27 /pmc/articles/PMC6592832/ /pubmed/31275777 http://dx.doi.org/10.7759/cureus.4553 Text en Copyright © 2019, Matthew et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Ophthalmology
Matthew, Tong Jong Haw
Tharakan, John
Tai, Evelyn
Hussein, Adil
Study of Visual Function in Adult Epileptic Patients on Sodium Valproate or Carbamazepine Monotherapy
title Study of Visual Function in Adult Epileptic Patients on Sodium Valproate or Carbamazepine Monotherapy
title_full Study of Visual Function in Adult Epileptic Patients on Sodium Valproate or Carbamazepine Monotherapy
title_fullStr Study of Visual Function in Adult Epileptic Patients on Sodium Valproate or Carbamazepine Monotherapy
title_full_unstemmed Study of Visual Function in Adult Epileptic Patients on Sodium Valproate or Carbamazepine Monotherapy
title_short Study of Visual Function in Adult Epileptic Patients on Sodium Valproate or Carbamazepine Monotherapy
title_sort study of visual function in adult epileptic patients on sodium valproate or carbamazepine monotherapy
topic Ophthalmology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6592832/
https://www.ncbi.nlm.nih.gov/pubmed/31275777
http://dx.doi.org/10.7759/cureus.4553
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