Retinal nerve fibre layer thinning is associated with drug resistance in epilepsy.
Détails
ID Serval
serval:BIB_9C667DED258B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Retinal nerve fibre layer thinning is associated with drug resistance in epilepsy.
Périodique
Journal of neurology, neurosurgery, and psychiatry
ISSN
1468-330X (Electronic)
ISSN-L
0022-3050
Statut éditorial
Publié
Date de publication
04/2016
Peer-reviewed
Oui
Volume
87
Numéro
4
Pages
396-401
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
Retinal nerve fibre layer (RNFL) thickness is related to the axonal anterior visual pathway and is considered a marker of overall white matter 'integrity'. We hypothesised that RNFL changes would occur in people with epilepsy, independently of vigabatrin exposure, and be related to clinical characteristics of epilepsy.
Three hundred people with epilepsy attending specialist clinics and 90 healthy controls were included in this cross-sectional cohort study. RNFL imaging was performed using spectral-domain optical coherence tomography (OCT). Drug resistance was defined as failure of adequate trials of two antiepileptic drugs to achieve sustained seizure freedom.
The average RNFL thickness and the thickness of each of the 90° quadrants were significantly thinner in people with epilepsy than healthy controls (p<0.001, t test). In a multivariate logistic regression model, drug resistance was the only significant predictor of abnormal RNFL thinning (OR=2.09, 95% CI 1.09 to 4.01, p=0.03). Duration of epilepsy (coefficient -0.16, p=0.004) and presence of intellectual disability (coefficient -4.0, p=0.044) also showed a significant relationship with RNFL thinning in a multivariate linear regression model.
Our results suggest that people with epilepsy with no previous exposure to vigabatrin have a significantly thinner RNFL than healthy participants. Drug resistance emerged as a significant independent predictor of RNFL borderline attenuation or abnormal thinning in a logistic regression model. As this is easily assessed by OCT, RNFL thickness might be used to better understand the mechanisms underlying drug resistance, and possibly severity. Longitudinal studies are needed to confirm our findings.
Three hundred people with epilepsy attending specialist clinics and 90 healthy controls were included in this cross-sectional cohort study. RNFL imaging was performed using spectral-domain optical coherence tomography (OCT). Drug resistance was defined as failure of adequate trials of two antiepileptic drugs to achieve sustained seizure freedom.
The average RNFL thickness and the thickness of each of the 90° quadrants were significantly thinner in people with epilepsy than healthy controls (p<0.001, t test). In a multivariate logistic regression model, drug resistance was the only significant predictor of abnormal RNFL thinning (OR=2.09, 95% CI 1.09 to 4.01, p=0.03). Duration of epilepsy (coefficient -0.16, p=0.004) and presence of intellectual disability (coefficient -4.0, p=0.044) also showed a significant relationship with RNFL thinning in a multivariate linear regression model.
Our results suggest that people with epilepsy with no previous exposure to vigabatrin have a significantly thinner RNFL than healthy participants. Drug resistance emerged as a significant independent predictor of RNFL borderline attenuation or abnormal thinning in a logistic regression model. As this is easily assessed by OCT, RNFL thickness might be used to better understand the mechanisms underlying drug resistance, and possibly severity. Longitudinal studies are needed to confirm our findings.
Mots-clé
Adult, Anticonvulsants/adverse effects, Anticonvulsants/therapeutic use, Cohort Studies, Cross-Sectional Studies, Drug Resistant Epilepsy/pathology, Female, Humans, Intellectual Disability/complications, Magnetic Resonance Imaging, Male, Middle Aged, Nerve Fibers/pathology, Retinal Neurons/pathology, Tomography, Optical Coherence, Vigabatrin/adverse effects, Vigabatrin/therapeutic use, Visual Fields
Pubmed
Web of science
Open Access
Oui
Création de la notice
05/06/2015 9:50
Dernière modification de la notice
30/04/2024 7:06