Optic coherence tomography in analyzes of optic nerve and macula in neuro‐ophthalmological patients

Abstract

PurposeHistorically, is made the distinction between optic neuropathies and macular diseases. Although, in our practical experience we believe that optic nerve (ON) damage, such as nerve edema or atrophy, at certain point will affect the macula. We have analyzed the scientific/structural impact of this clinical impression. The authors studied the correlation between Retinal Nerve Fiber Layer (RNFL) thickness and total macular/ganglionic cell layer (GCL) thicknesses using Optic Coherence Tomography (Heidelberg Spectralis®).MethodsThis retrospective study, evaluate 114 patients with the initial diagnose of optic neuropathy. First, was measured the average thickness of RNFL in 4 quadrants and the central macula and GCL thicknesses in 1º, 2º and 3º mm in fovea. We studied it in 3 groups: ON pathology (1º – n: 68), chiasmal compressive lesions (2º – n: 8) and retro‐chiasmal pathology (3º – n: 38). The layer's thickness was correlated in 3 groups.ResultsThe 1º and 3º group had a significant impairment in all measures (RNFL, total central macula and GCL). There is a moderate correlation between RNFL and total central macular thicknesses (r: 0,354 and r: 0,314) and the correlation is strong comparing RNFL and GCL in 2º mm (r: 0,653 and r: 0.775) and 3º mm (r: 0,674 and r: 0, 839) thicknesses. Although, we didn't find any correlation between the RNFL and GCL thicknesses in 1º mm of fovea. In 2º group the results wasn't statistically significant, possible because the sample is short (n: 8).ConclusionsIn both groups, there is a correlation between the RNFL and total macula thicknesses. The impairment of total macula thickness is strongly correlated with the decreased thickness in GCL of foveae's 2º and 3º mm. This study shows in that pré‐chiasmal and retrochiasmal lesions, the impairment RNFL co‐exists with affection of macula thickness.