Abstract Details

Title Utilizing Optical Coherence Tomography to Assess the Effect of Phenytoin on Retinal Structures in Epilepsy Patients

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-018

Objective To explore the role of Optical Coherence Tomography (OCT) in assessing the effects of phenytoin on retinal structures in epilepsy patients.

Background Prolonged phenytoin use has been reported to cause brain atrophy in epilepsy patients. OCT is a non-invasive tool utilized to measure retinal structures innervated by the optic nerve. We hypothesize that the long term effects of phenytoin on the brain will be reflected through changes in the retina.

Design/Methods Fifty-six epilepsy patients were included in this retrospective, cross-sectional study and categorized into two groups: 18 with history of phenytoin intake (PHT, mean age 42.4 years, mean disease duration 22.5 years) and 38 with no history of phenytoin intake (NPHT, mean age 35.4 years, mean disease duration 15.2 years). Using OCT, peripapillary retinal nerve fiber layer (pRNFL) thickness and macular retinal layer volumes were measured. A generalized linear model multivariate analysis was applied to test the effects of phenytoin on retinal structures when controlled for age and disease duration.

Results We observed a significant effect of phenytoin on total macular volume (TMV, p=0.008) and the inner nuclear layer (INL, p=0.005). We also observed a significant effect of phenytoin on the retinal pigment epithelium (RPE, p=0.002) and the outer retinal layer (ORL, p=0.01). Furthermore, the mean volumes of TMV and INL were significantly lower in PHT compared to NPHT. In contrast, the mean volumes of RPE and ORL were significantly higher in PHT compared to NPHT.

Conclusions Our preliminary analyses suggest that phenytoin has significant effects on retinal structures that can be quantified utilizing OCT. TMV loss has previously been shown to be correlated with brain atrophy, therefore, linear correlations between brain atrophy and retinal thinning should be tested in longitudinal studies to confirm if OCT can serve as potential surrogate technique to assess the long term effects of antiepileptic medications.

Authors/Disclosures
Melody Gilroy, BS PRESENTER	Ms. Gilroy has nothing to disclose.
Kalyan Yarraguntla, MD (University Health Center)	Dr. Yarraguntla has nothing to disclose.
Samuel Lichtman-Mikol, BA (Wayne State University)	Mr. Lichtman-Mikol has nothing to disclose.
Rohit A. Marawar, MD, FAAN (Wayne State University - Detroit Medical Center)	Dr. Marawar has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jazz Pharmaceuticals. Dr. Marawar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SK Pharma. Dr. Marawar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Xenon. Dr. Marawar has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurelis.
Deepti Zutshi, MD, FAAN (Wayne State University School of Medicine)	Dr. Zutshi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xenon pharmaceuticals. An immediate family member of Dr. Zutshi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Dr. Zutshi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aucta Pharmaceuticals. Dr. Zutshi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aucta.

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