Kıvrak Ulviye, Güçlü Altun İlknur, Kılınç Ezgi Tanyeri, Tutaş Günaydın Nesrin
Department of Ophthalmology, University of Health Sciences, Kartal Lütfi Kırdar City Hospital, Istanbul, Türkiye.
Department of Neurology, Çanakkale Onsekiz Mart University, Istanbul, Türkiye.
Clin Exp Optom. 2025 Jul;108(5):614-619. doi: 10.1080/08164622.2024.2374871. Epub 2024 Jul 7.
Understanding the causes of visual symptoms in epilepsy patients is important for early diagnosis and taking precautions.
The aim of this study is to evaluate the anterior and posterior segment parameters in patients with generalized tonic-clonic epilepsy (GTCE).
This retrospective study included 50 eyes of 50 patients with GTCE and 55 eyes of 55 healthy controls. For all participants, detailed ophthalmic examinations were obtained from the files of patients. Anterior segment parameters were measured using corneal topography and non-contact specular microscopy, and posterior segment parameters were measured using swept-source optical coherence tomography.
The mean age of the patients with GTCE was 43.3 ± 13.2 years, and in the healthy controls it was 47.6 ± 10.7 years ( = 0.405). In GTCE patients, 34 patients were treated with monotherapy (MT) and 16 patients with polytherapy (PT). Central macular thickness (CMT) was statistically significantly thin in GTCE patients ( = 0.001). The average and four quadrants (superior, inferior, nasal, temporal) retinal nerve fibre layer (RNFL) were thinner in GTCE patients than in the healthy controls, but there was no statistically significant difference ( > 0.05, all). The central corneal thickness was statistically significantly thin in GTCE patients ( = 0.04). Endothelial cell density (ECD), endothelial cell number (ECN), and average cell area (ACA) were statistically significantly lower in GTCE patients than in the healthy controls ( < 0.05, all). Although the CMT, average, and four-quadrants RNFL were thinner in the PT group compared to the MT group, no statistically significant difference was observed ( > 0.05, all). Total high-order aberrations (HOAs) were 0.6 ± 0.4 in the MT group and 0.4 ± 0.1 in the PT group ( = 0.01). ECD, ECN, and ACA measurements were observed to be lower in the PT group compared to the MT group, but no statistically significant difference was detected ( > 0.05, all).
There could be statistically significant differences between GTCE patients and healthy controls in anterior and posterior segment parameters. This situation may be due to the epilepsy itself or to the antiepileptic drugs.
了解癫痫患者视觉症状的原因对于早期诊断和采取预防措施很重要。
本研究的目的是评估全身强直阵挛性癫痫（GTCE）患者的眼前节和眼后节参数。
这项回顾性研究纳入了50例GTCE患者的50只眼和55例健康对照者的55只眼。对于所有参与者，从患者病历中获取详细的眼科检查资料。使用角膜地形图和非接触式镜面显微镜测量眼前节参数，使用扫频光学相干断层扫描测量眼后节参数。
GTCE患者的平均年龄为43.3±13.2岁，健康对照者为47.6±10.7岁（P = 0.405）。在GTCE患者中，34例接受单药治疗（MT），16例接受联合治疗（PT）。GTCE患者的中心黄斑厚度（CMT）在统计学上显著变薄（P = 0.001）。GTCE患者的平均视网膜神经纤维层（RNFL）及其四个象限（上、下、鼻侧、颞侧）均比健康对照者薄，但差异无统计学意义（P>0.05，所有）。GTCE患者的中央角膜厚度在统计学上显著变薄（P = 0.04）。GTCE患者的内皮细胞密度（ECD）、内皮细胞数量（ECN）和平均细胞面积（ACA）在统计学上显著低于健康对照者（P<0.05，所有）。尽管PT组的CMT、平均RNFL及其四个象限的RNFL均比MT组薄，但差异无统计学意义（P>0.05，所有）。MT组的总高阶像差（HOA）为0.6±0.4，PT组为0.4±0.1（P = 0.01）。观察到PT组的ECD、ECN和ACA测量值低于MT组，但差异无统计学意义（P>0.05，所有）。
GTCE患者与健康对照者在眼前节和眼后节参数上可能存在统计学上的显著差异。这种情况可能是由于癫痫本身或抗癫痫药物所致。
