Optical Coherence Tomography in Understanding Neurodegeneration in Epilepsy - A Cross-sectional Study.

BACKGROUND: Even with improvements in epilepsy diagnosis and treatment, it is still difficult to comprehend the underlying structural alterations in the brain linked to epilepsy. A noninvasive imaging method that produces high-resolution pictures of tissue microstructure is optical coherence tomography (OCT). OBJECTIVES: The study's objective was to evaluate OCT changes in people with epilepsy (PWE) compared to healthy control patients and examine how these changes relate to the type of epilepsy, duration, abnormal imaging, and anti-seizure medication use. MATERIALS AND METHODS: A cross-sectional study was done. A cohort of adults PWE (from 18 to 40 years) with known epilepsy and healthy controls (n = 40) matched for age and gender were recruited. OCT was used to analyze the thickness of the ganglion cell complex (GCC) and the retinal nerve fiber layer (RNFL). RESULTS: A total of 40 PWE were recruited. Thirty-three people had epilepsy for 10-12 years, while 7 had it for more than 12 years. PWE showed significantly reduced temporal quadrant RNFL thickness compared with control in both right (62.6 ± 10.9 vs. 70.4 ± 6.9 µm; P < 0.001) and left eyes (61.9 ± 11.4 vs. 68.0 ± 6.0 µm; P < 0.004). RNFL thickness was significantly reduced in PWE with abnormal magnetic resonance imaging findings (left eye average: P =0.04; left superior: P =0.03; right eye average: P =0.03). No significant relationship was found between RNFL or GCC thickness and epilepsy type or duration (P > 0.05). CONCLUSION: Our study revealed that there is reduced temporal quadrant RNFL thickness in PWE and average RNFL thickness in those having abnormal imaging. OCT may serve as a noninvasive complementary tool to detect subtle structural changes in epilepsy.