Longitudinal evaluation of retinal neuroaxonal loss in epilepsy using optical coherence tomography.

IF 6.6 1区 医学 Q1 CLINICAL NEUROLOGY Epilepsia Pub Date : 2024-10-09 DOI:10.1111/epi.18139
Livia Stauner, Han Bao, Luisa Delazer, Isabel Kirsch, Tara Christmann, Soheyl Noachtar, Joachim Havla, Michael Lauseker, Elisabeth Kaufmann
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Abstract

Objective: People with epilepsy (PwE) suffer from progressive brain atrophy, which is reflected as neuroaxonal loss on the retinal level. This study aims to provide initial insight into the longitudinal dynamics of the retinal neuroaxonal loss and possible driving factors.

Methods: PwE and healthy controls (HC; 18-55 years of age) underwent spectral domain optical coherence tomography at baseline and 7.0 ± 1.5 and 6.7 ± 1.0 months later, respectively. The change in retinal thickness/volume and annualized percentage change (APC) were calculated for the peripapillary retinal nerve fiber layer (pRNFL), the macular RNFL (mRNFL), the ganglion cell inner plexiform layer (GCIP), the inner nuclear layer, and the total macular volume (TMV). Group comparisons and multiple linear models with stepwise backward selection were performed to evaluate associations with demographic and clinical parameters.

Results: PwE (n = 44, 21 females, mean age = 35.6 ± 10.9 years) revealed a significant decrease in the pRNFL, mRNFL, GCIP, and TMV thickness or volume in the study interval. When compared to HC (n = 56, 37 females, mean age = 32.7 ± 8.3 years), the APC of the pRNFL (-.98 ± 3.13%/year) and the GCIP (-1.24 ± 2.56%/year) were significantly more pronounced in PwE (p = .01 and p = .046, respectively). Of note, atrophy of the mRNFL was significantly influenced by the number of antiseizure medications (ASMs; p = .047) and increasing age of PwE (p = .03). Contradictory results, however, were revealed for the impact of seizures.

Significance: In epilepsy, progression of retinal neuroaxonal loss was already detectable at short-term follow-up. PwE who receive a high number of ASMs seem to be at risk for accelerated neuroaxonal loss, stressing the importance of well-considered and effective antiseizure therapy.

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利用光学相干断层扫描对癫痫患者视网膜神经轴突缺失情况进行纵向评估。
目的:癫痫患者(PwE)患有进行性脑萎缩,这种萎缩反映为视网膜神经轴突的缺失。本研究旨在初步了解视网膜神经轴突丢失的纵向动态变化以及可能的驱动因素:方法:患者和健康对照组(HC;18-55 岁)分别在基线和 7.0 ± 1.5 个月后及 6.7 ± 1.0 个月后接受光谱域光学相干断层扫描。计算了毛细血管周围视网膜神经纤维层 (pRNFL)、黄斑 RNFL (mRNFL)、神经节细胞丛状内层 (GCIP)、核内层和黄斑总体积 (TMV) 的视网膜厚度/体积变化和年化百分比变化 (APC)。通过分组比较和逐步后向选择的多重线性模型来评估与人口统计学和临床参数之间的关联:PwE(n = 44,21 名女性,平均年龄 = 35.6 ± 10.9 岁)的 pRNFL、mRNFL、GCIP 和 TMV 厚度或体积在研究期间显著下降。与 HC(n = 56,37 名女性,平均年龄 = 32.7 ± 8.3 岁)相比,PwE 的 pRNFL(-.98 ± 3.13%/年)和 GCIP(-1.24 ± 2.56%/年)的 APC 明显更明显(分别为 p = .01 和 p = .046)。值得注意的是,mRNFL 的萎缩受到抗癫痫药物(ASMs)的数量(p = .047)和 PwE 年龄增加(p = .03)的显著影响。然而,在癫痫发作的影响方面却出现了相互矛盾的结果:重要意义:在癫痫患者中,视网膜神经轴突丢失的进展在短期随访中已经可以检测到。接受大量 ASM 的癫痫患者似乎面临着神经轴突加速丧失的风险,这强调了经过深思熟虑的有效抗癫痫治疗的重要性。
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来源期刊
Epilepsia
Epilepsia 医学-临床神经学
CiteScore
10.90
自引率
10.70%
发文量
319
审稿时长
2-4 weeks
期刊介绍: Epilepsia is the leading, authoritative source for innovative clinical and basic science research for all aspects of epilepsy and seizures. In addition, Epilepsia publishes critical reviews, opinion pieces, and guidelines that foster understanding and aim to improve the diagnosis and treatment of people with seizures and epilepsy.
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