Attenuation of retinal nerve fibre layer in people with epilepsy receiving valproate
Attenuation of retinal nerve fibre layer in people with epilepsy receiving valproate
复制标题
接受丙戊酸治疗的癫痫患者视网膜神经纤维层的衰减
DOI：
10.1016/j.eplepsyres.2019.05.015
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发表时间：
2019-08-01
影响因子：
2.2
通讯作者：
Zhou, Dong
中科院分区：
文献类型：
--
作者：
Xiong, Weixi;Lu, Lu;Zhou, Dong
目的：丙戊酸盐（VPA）是全球最常用的抗癫痫药物之一。其降低视网膜神经纤维层（RNFL）厚度的作用仍存在争议。我们的目的是评估与其他AED相比，VPA使用对RNFL的影响，并没有AED的使用在人与epilepsy（PWE.Methods）：在这项观察性病例对照研究中，PWE入组，并分为三组：PWE 1）接受VPA单药治疗在整个临床过程中; 2）接受AED以外的VPA作为单药治疗;和3）谁从来没有采取任何AED。用光学相干断层扫描（OCT）测量右眼RNFL厚度。在每一个人，疾病相关的信息recorded.Results：共86个人（51名男性，中位年龄，25岁），平均癫痫持续时间为6.88年。除性别外，未观察到组间人口统计学差异。接受VPA治疗的26名患者（第I组）的平均RNFL厚度为93.73 ± 9.24 μ m，显著低于接受其他单一AED治疗的31名患者的相应值（组II; 99.71 +/- 8.50 μ m; p = 0.031）或29名从未使用过任何AED的个体（第III组; 102.79 +/- 8.05 μ m; p = 5.67 x 10（-4）），尤其是在上级和下象限。组II和组III的RNFL衰减与癫痫持续时间显著相关（r = 0.351，p = 0.006）。然而，癫痫持续时间，VPA的累积剂量，VPA治疗时间和RNFL厚度之间没有相关性被发现在组I。结论：这些初步研究结果表明，VPA的使用和PWE的视网膜厚度减少之间的关联，特别是在上级和下层象限。癫痫本身也可能是RNFL衰减的另一个危险因素。进一步的研究需要证实这一发现并阐明其潜在机制。
Objectives: Valproate (VPA) is one of the most frequently used anti-epileptic drugs (AEDs) worldwide. Its effects in decreasing the retinal nerve fibre layer (RNFL) thickness remain debatable. We aimed to evaluate the effect of VPA usage on the RNFL in comparison with other AEDs and no AED usage in people with epilepsy (PWE).Methods: In this observational case-control study, PWE were enrolled and divided into three groups: PWE 1) receiving VPA monotherapy throughout their clinical course; 2) receiving an AED other than VPA as monotherapy; and 3) who never took any AED. RNFL thickness of the right eye was measured by optical coherence tomography (OCT). In each individual, disease-related information was recorded.Results: A total of 86 individuals (51 males; median age, 25 years) with an average epilepsy duration of 6.88 years were enrolled. No difference in the demographics except for sex was noted between the groups. The average RNFL thickness in 26 individuals who had received VPA (group I) was 93.73 +/- 9.24 mu m, which was significantly lower than the corresponding values for the 31 individuals who received other single AED regimens (group II; 99.71 +/- 8.50 mu m; p = 0.031) or the 29 individuals who never used any AED (group III; 102.79 +/- 8.05 mu m; p = 5.67 x 10(-4)), especially in the superior and inferior quadrants. The RNFL attenuation was significantly correlated with the epilepsy duration in groups II and III (r = 0.351, p = 0.006). However, no correlation between epilepsy duration, cumulative dosage of VPA, duration of treatment with VPA and RNFL thickness was found in group I.Conclusion: These preliminary findings suggest an association between VPA usage and reduction of retinal thickness in PWE, especially in the superior and inferior quadrants. Epilepsy itself might also be another risk factor for RNFL attenuation. Further studies need to confirm this finding and to unravel the underlying mechanism.