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Gabapentin and Memantine for Treatment of Acquired Pendular Nystagmus: Effects on Visual Outcomes.
J Neuroophthalmol. 2020 06; 40(2):198-206.JN

Abstract

BACKGROUND

The most common causes of acquired pendular nystagmus (APN) are multiple sclerosis (MS) and oculopalatal tremor (OPT), both of which result in poor visual quality of life. The objective of our study was to evaluate the effects of memantine and gabapentin treatments on visual function. We also sought to correlate visual outcomes with ocular motor measures and to describe the side effects of our treatments.

METHODS

This study was single-center cross-over trial. A total of 16 patients with chronic pendular nystagmus, 10 with MS and 6 with OPT were enrolled. Visual acuity (in logarithm of the minimum angle of resolution [LogMAR]), oscillopsia amplitude and direction, eye movement recordings, and visual function questionnaires (25-Item National Eye Institute Visual Functioning Questionnaire [NEI-VFQ-25]) were performed before and during the treatments (gabapentin: 300 mg 4 times a day and memantine: 10 mg 4 times a day).

RESULTS

A total of 29 eyes with nystagmus were evaluated. Median near monocular visual acuity improved in both treatment arms, by 0.18 LogMAR on memantine and 0.12 LogMAR on gabapentin. Distance oscillopsia improved on memantine and on gabapentin. Median near oscillopsia did not significantly change on memantine or gabapentin. Significant improvement in ocular motor parameters was observed on both treatments. Because of side effects, 18.8% of patients discontinued memantine treatment-one of them for a serious adverse event. Only 6.7% of patients discontinued gabapentin. Baseline near oscillopsia was greater among those with higher nystagmus amplitude and velocity.

CONCLUSIONS

This study demonstrated that both memantine and gabapentin reduce APN, improving functional visual outcomes. Gabapentin showed a better tolerability, suggesting that this agent should be used as a first-line agent for APN. Data from our investigation emphasize the importance of visual functional outcome evaluations in clinical trials for APN.

Authors+Show Affiliations

Hospices Civils de Lyon (EN, LA, FP-V, A-LV, AV, CT), Neuro-Ophthalmology and Neuro-Cognition Unit, Hôpital Neurologique Pierre Wertheimer, Bron, France; Lyon I University (EN, SV, JB, AV, CT), Lyon, France; Service de Neurologie, Sclérose en Plaques, Pathologies de la Myéline et Neuro-Inflammation, Hôpital Neurologique Pierre Wertheimer, Bron, France; INSERM U1028 CNRS UMR5292 Lyon Neuroscience Center, Team ImpAct (AV, CT) and Observatoire Français de la Sclérose en Plaques (SV), Bron, France; Hospices Civils de Lyon (JB), Pôle Information Médicale Evaluation Recherche Unit, Equipe d'Accueil 4129, Bron, France; and Hospices Civils de Lyon (BC), Pharmacie Department, Hôpital Neurologique Pierre Wertheimer, Bron, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31169568

Citation

Nerrant, Elodie, et al. "Gabapentin and Memantine for Treatment of Acquired Pendular Nystagmus: Effects On Visual Outcomes." Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society, vol. 40, no. 2, 2020, pp. 198-206.
Nerrant E, Abouaf L, Pollet-Villard F, et al. Gabapentin and Memantine for Treatment of Acquired Pendular Nystagmus: Effects on Visual Outcomes. J Neuroophthalmol. 2020;40(2):198-206.
Nerrant, E., Abouaf, L., Pollet-Villard, F., Vie, A. L., Vukusic, S., Berthiller, J., Colombet, B., Vighetto, A., & Tilikete, C. (2020). Gabapentin and Memantine for Treatment of Acquired Pendular Nystagmus: Effects on Visual Outcomes. Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society, 40(2), 198-206. https://doi.org/10.1097/WNO.0000000000000807
Nerrant E, et al. Gabapentin and Memantine for Treatment of Acquired Pendular Nystagmus: Effects On Visual Outcomes. J Neuroophthalmol. 2020;40(2):198-206. PubMed PMID: 31169568.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gabapentin and Memantine for Treatment of Acquired Pendular Nystagmus: Effects on Visual Outcomes. AU - Nerrant,Elodie, AU - Abouaf,Lucie, AU - Pollet-Villard,Frédéric, AU - Vie,Anne-Laure, AU - Vukusic,Sandra, AU - Berthiller,Julien, AU - Colombet,Bettina, AU - Vighetto,Alain, AU - Tilikete,Caroline, PY - 2019/6/7/pubmed PY - 2021/7/1/medline PY - 2019/6/7/entrez SP - 198 EP - 206 JF - Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society JO - J Neuroophthalmol VL - 40 IS - 2 N2 - BACKGROUND: The most common causes of acquired pendular nystagmus (APN) are multiple sclerosis (MS) and oculopalatal tremor (OPT), both of which result in poor visual quality of life. The objective of our study was to evaluate the effects of memantine and gabapentin treatments on visual function. We also sought to correlate visual outcomes with ocular motor measures and to describe the side effects of our treatments. METHODS: This study was single-center cross-over trial. A total of 16 patients with chronic pendular nystagmus, 10 with MS and 6 with OPT were enrolled. Visual acuity (in logarithm of the minimum angle of resolution [LogMAR]), oscillopsia amplitude and direction, eye movement recordings, and visual function questionnaires (25-Item National Eye Institute Visual Functioning Questionnaire [NEI-VFQ-25]) were performed before and during the treatments (gabapentin: 300 mg 4 times a day and memantine: 10 mg 4 times a day). RESULTS: A total of 29 eyes with nystagmus were evaluated. Median near monocular visual acuity improved in both treatment arms, by 0.18 LogMAR on memantine and 0.12 LogMAR on gabapentin. Distance oscillopsia improved on memantine and on gabapentin. Median near oscillopsia did not significantly change on memantine or gabapentin. Significant improvement in ocular motor parameters was observed on both treatments. Because of side effects, 18.8% of patients discontinued memantine treatment-one of them for a serious adverse event. Only 6.7% of patients discontinued gabapentin. Baseline near oscillopsia was greater among those with higher nystagmus amplitude and velocity. CONCLUSIONS: This study demonstrated that both memantine and gabapentin reduce APN, improving functional visual outcomes. Gabapentin showed a better tolerability, suggesting that this agent should be used as a first-line agent for APN. Data from our investigation emphasize the importance of visual functional outcome evaluations in clinical trials for APN. SN - 1536-5166 UR - https://www.unboundmedicine.com/medline/citation/31169568/Gabapentin_and_Memantine_for_Treatment_of_Acquired_Pendular_Nystagmus:_Effects_on_Visual_Outcomes_ L2 - https://doi.org/10.1097/WNO.0000000000000807 DB - PRIME DP - Unbound Medicine ER -