Tuğcu Betül, Bitnel Mesrure Köseoğlu, Kaya Fatma Selin, Güveli Betül Tekin, Ataklı Dilek
Department of Ophthalmology, Bezmialem University Medical Faculty, İstanbul, Turkey.
Department of Neurology, Bakirkoy Research and Training Hospital for Psychiatry, Neurology, Neurosurgery, Bakırköy, 34147, Istanbul, Turkey.
Neurol Sci. 2017 Aug;38(8):1423-1427. doi: 10.1007/s10072-017-2971-0. Epub 2017 May 16.
In order to reveal the underlying retinal pathology leading to dysfunction in vigabatrin-exposed patients, we aimed to evaluate the inner retinal layers encompassing ganglion cell complex (GCC) layer and inner plexiform layer with new generation optic coherence tomography (OCT). Fourteen patients with epilepsy and exposure to vigabatrin and 12 clinically normal individuals, constituting the control group, were included. Retinal images were obtained using spectral-domain OCT (Optovue RTVue Fourier domain). Nasal and superior quadrants of retinal nerve fiber layer (RNFL) were found to be significantly lower in the patient group compared to the controls (p < 0.01). No significant difference was shown in the thickness of GCC layer (p > 0.05). Foveal thickness was significantly higher in the patient group (p: 0.006), but no significant difference was found in perifoveal and parafoveal regions between groups (p > 0.05). The thickness of RNFL was found to be lower in vigabatrin-exposed patients without any reduction in GCC layer in the macular region. However, foveal thickness was found to be significantly higher compared to perifoveal and parafoveal macular regions in vigabatrin-exposed patients. In conclusion, OCT revealed reduced thickness of RNFL without any reduction in ganglion cell layer in our study. The objective quantitative assessment of OCT is a practical noninvasive method and it can have role in future monitoring of these patients.
为了揭示导致接受氨己烯酸治疗的患者出现功能障碍的潜在视网膜病理状况，我们旨在使用新一代光学相干断层扫描（OCT）评估包括神经节细胞复合体（GCC）层和内网状层在内的视网膜内层。研究纳入了14例患有癫痫且接受氨己烯酸治疗的患者以及12名构成对照组的临床正常个体。使用光谱域OCT（Optovue RTVue傅里叶域）获取视网膜图像。发现患者组视网膜神经纤维层（RNFL）的鼻侧和上象限厚度与对照组相比显著降低（p < 0.01）。GCC层厚度未显示出显著差异（p > 0.05）。患者组的黄斑中心凹厚度显著更高（p：0.006），但两组之间的黄斑中心凹周围和旁黄斑区域未发现显著差异（p > 0.05）。在接受氨己烯酸治疗的患者中，发现RNFL厚度降低，而黄斑区域的GCC层厚度没有任何减少。然而，与接受氨己烯酸治疗患者的黄斑中心凹周围和旁黄斑区域相比，黄斑中心凹厚度显著更高。总之，在我们的研究中，OCT显示RNFL厚度降低，而神经节细胞层没有任何减少。OCT的客观定量评估是一种实用的非侵入性方法，它可在未来对这些患者的监测中发挥作用。
