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A retinotoxic class effect of GABAergic antiepileptic drugs seems unlikely
The paper by Krauss et al (this issue, pp 339–343)1 helps to settle a controversy that has been simmering in the epilepsy world for several years.1 Initial reports that vigabatrin use was associated with irreversible visual field defects evoked scepticism. Various voices held that such visual field defects were not uncommon in patients with epilepsy and might be associated with epilepsy itself rather than from specific drug treatment. Evidence has now accumulated to convince all but the most sceptical that the antiepileptic drug vigabatrin, an irreversible inhibitor of GABA transaminase, has a strong tendency to produce visual field constriction by a …