{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T06:13:28Z","timestamp":1775974408313,"version":"3.50.1"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T00:00:00Z","timestamp":1723593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["2018HXBH023"],"award-info":[{"award-number":["2018HXBH023"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2017M620427"],"award-info":[{"award-number":["2017M620427"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Using Optical coherence tomography (OCT), we evaluated the association between peripapillary retinal nerve fiber, macular thickness, macular ganglion cell\u2010inner plexiform layer, and drug resistance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cross\u2010sectional study, we recruited people diagnosed with epilepsy and healthy controls. People with epilepsy were further stratified as drug\u2010resistant or non\u2010drug\u2010resistant based on their response to anti\u2010seizure medications. OCT measurements were conducted, and findings in right eye were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010one drug\u2010resistant participants, 37 non\u2010drug\u2010resistant, and 45 controls were enrolled. The average peripapillary retinal nerve fiber layer, ganglion cell\u2010inner plexiform layer, and macular thickness were thinner in the epilepsy groups than in controls. The drug\u2010resistant group had significantly lower average ganglion cell\u2010inner plexiform layer thickness (<jats:italic>p<\/jats:italic>\u2009=\u20090.004) and a higher proportion of abnormal\/borderline GC\/IPL thickness (<jats:italic>p<\/jats:italic>\u2009=\u20095.40E\u201004) than the non\u2010drug\u2010resistant group. Nevertheless, no significant differences were seen between the average thickness of peripapillary retinal nerve fiber and macular thickness. The temporal sectors of these three parameters were also significantly thinner in the drug\u2010resistant group than in the non\u2010drug\u2010resistant. In a multivariate regression model, drug resistance was an independent predictor of reduced ganglion cell\u2010inner plexiform thickness (Odds ratios OR\u2009=\u200910.25, 95% CI 2.82 to 37.28). Increased seizure frequency (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.23, <jats:italic>p<\/jats:italic>\u2009=\u20090.039) and a higher number of anti\u2010seizure medications ever used (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.27, <jats:italic>p<\/jats:italic>\u2009=\u20090.013) were negatively associated with ganglion cell\u2010inner plexiform layer thickness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Individuals with drug\u2010resistant epilepsy had a consistent reduction in average ganglion cell\u2010inner plexiform layer thickness and the temporal sector of peripapillary retinal nerve fiber layer and macular thickness. This suggests that ganglion cell\u2010inner plexiform layer thickness could potentially serve as an indicator of the burden of drug resistance, as it correlated with reduced thickness in individuals having more frequent seizures and greater exposure to ASMs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>In our study, we used a special tool called OCT to measure how thick the retina is in people with epilepsy and in healthy control. We found that the retina was consistently thinner in all areas for those with epilepsy compared to healthy control. Particularly, a specific layer called the ganglion cell\u2010inner plexiform layer was a lot thinner in the group that didn't respond to medications, and this thinning was related to how often seizures occurred and how much medications were taken. Also, certain parts of the retina were thinner in the drug\u2010resistant group.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.13004","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T07:00:26Z","timestamp":1723618826000},"page":"1783-1792","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The thickness of the retinal nerve fiber layer, macula, and ganglion cell\u2010inner plexiform layer in people with drug\u2010resistant epilepsy"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1056-0840","authenticated-orcid":false,"given":"Yujie","family":"Chen","sequence":"first","affiliation":[{"name":"London WC1N 3BG &amp; Chalfont Centre for Epilepsy UCL Queen Square Institute of Neurology  Chalfont St Peter Buckinghamshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6835-8664","authenticated-orcid":false,"given":"Weixi","family":"Xiong","sequence":"additional","affiliation":[{"name":"London WC1N 3BG &amp; 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Chalfont Centre for Epilepsy UCL Queen Square Institute of Neurology  Chalfont St Peter Buckinghamshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7024-1051","authenticated-orcid":false,"given":"Jiani","family":"Chen","sequence":"additional","affiliation":[{"name":"London WC1N 3BG &amp; Chalfont Centre for Epilepsy UCL Queen Square Institute of Neurology  Chalfont St Peter Buckinghamshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingfeng","family":"Xiao","sequence":"additional","affiliation":[{"name":"London WC1N 3BG &amp; Chalfont Centre for Epilepsy UCL Queen Square Institute of Neurology  Chalfont St Peter Buckinghamshire UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-9661","authenticated-orcid":false,"given":"Josemir W.","family":"Sander","sequence":"additional","affiliation":[{"name":"London WC1N 3BG &amp; Chalfont Centre for Epilepsy UCL Queen Square Institute of Neurology  Chalfont St Peter Buckinghamshire UK"},{"name":"Department of Neurology West China Hospital of Sichuan University  Chengdu Sichuan China"},{"name":"Stichting Epilepsie Instellingen Nederland (SEIN)  Heemstede The\u00a0Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2067-9965","authenticated-orcid":false,"given":"Bo","family":"Wu","sequence":"additional","affiliation":[{"name":"London WC1N 3BG &amp; 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