AMELIA ISLAND, Fla. -- Corneal confocal microscopy can help identify corneal nerve fiber irregularities in women with epilepsy, according to a speaker at the Women in Ophthalmology Summer Symposium.

Emma Orekovi, MD, said research has indicated that increased seizure frequency is associated with hormonal abnormalities.

"What we don't quite understand and what the goal of this project was to figure out how these hormonal abnormalities increase seizure frequency and nerve degeneration at the cellular level," Orekovi said.

Orekovi and colleagues examined corneal confocal microscopy scans of 12 women with epilepsy and hormonal degeneration and abnormalities and compared them with 15 age-matched controls who had epilepsy and normal hormone profiles. They also reviewed patients' menstrual cycle histories and seizure logs.

Orekovi said there was a focus on two nerve fiber parameters: automated nerve fiber length, which shows much nerve is in a specific area, and fractal dimension, which shows "how convoluted the structure is."

Patients with epilepsy and hormonal irregularities had reduced nerve fiber length and reduced fractal dimension with increased nerve disorganization compared with controls.

The corneal confocal microscope is in the early stages of clinical implementation, but Oreskovic said their findings show potential.

"The confocal microscope could potentially be used as an early monitoring device to give us real-time disease diagnostics as well as improve the care to women with epilepsy and other neuro-endocrinologic conditions that might otherwise unfortunately go overlooked because of 'whininess,'" Orekovi said. "Although the road ahead of this microscope may be nerve-racking ... the confocal microscope takes a big step forward toward women-centered and individualized epilepsy care and perhaps in the near future a vast spectrum of neurodegenerative diseases."