Ocular microvascular alterations in epileptic patients

Abstract PURPOSE: The brain and eye are linked by the same nerves and arteries, presenting a hemodynamic continuity. Alterations in ocular perfusion may have an impact on the visual function or the neurodegenerative process. We aimed to assess whether there is a relationship between epilepsy and ocular microvasculature in the adult population by optical coherence tomography angiography (OCTA). METHODS: This observational, cross-sectional study included 22 epilepsy patients (epilepsy group), and 21 healthy controls (control group). OCTA analysis of the vessel density (VD) of the retinal superficial capillary plexus, deep capillary plexus, foveal retinal thickness (FRT), foveal avascular zone (FAZ) areas, and the radial peripapillary capillary, and retinal nerve fiber layer (RNFL) thickness were evaluated. RESULTS: Age, gender, central corneal thicknesses, and mean intraocular pressure levels were similar between the groups ( P >0.05 for all). Superficial and deep retinal capillary VD, FRT, and FAZ areas were not significantly different between the groups. However, significantly lower superior quadrant RNFL thicknesses and lower optic disc whole and peripapillary capillary VD were detected in the epilepsy group when compared to the control group ( P = 0.026, P < 0.001, and P = 0.006, respectively). CONCLUSION: Besides the neurological basis of epilepsy, vascular dysfunction seems to be another risk factor in the pathophysiology of epilepsy. OCTA may be suggested as a potentially useful biomarker for ocular microvascular alterations in epileptic patients.