Microstructural Changes in Intraretinal Layers and Macular Structures of People with Epilepsy Measured Using Optical Coherence Tomography.

Introduction: Epilepsy is a network disorder that can cause alterations in retinal morphology due to microstructural changes in the brain. The aim of our study was to use spectral optical coherence tomography (OCT) to assess the possible effects of neuronal degeneration on the intraretinal layers and macular structures of people with epilepsy and epilepsy subgroups.

Methods: We enrolled 52 consecutive people with epilepsy (37 females, 15 males; mean age 29.8±9.9 years; range, 17-48 years) and 40 healthy volunteers (27 females, 13 males; mean age 33.3±10.2 years; range, 19-49 years) in this study. Both eyes of all participants were assessed by using spectral-domain OCT. Optical coherence tomography was used to assess the thickness of the peripapillary retinal nerve fiber layer (RNFL), ganglion cell layer-inner plexiform layer (GCC-IPL), central macula, and central macular volume.

Results: In comparison to healthy controls, people with epilepsy showed a thinner GCC-IPL in the superior and superior-nasal quadrants, as well as reduced macular thickness and macular volume (p<0.05). The thickness of the GCC-IPL layer in the superior and inferior subquadrants was negatively affected by frequent seizures (>5 seizures/year), polytherapy, and long-duration of epilepsy (≥10 years) (p<0.05). However, we did not find any other statistically significant associations between OCT measurements, age, sex, and epilepsy type (focal and generalized onset epilepsy).

Conclusion: Individuals with epilepsy exhibited microstructural alterations in the retinal layers, primarily in the superior and inferior quadrants. Frequent seizures, polytherapy, and long-duration of epilepsy may result in neuronal damage in the afferent visual system.