Optic disc edema during semaglutide therapy: case report and literature review.

This study aimed to investigate normal values and interocular differences in retinal nerve fibre layer (RNFL) thickness, using optical coherence tomography (OCT) and Heidelberg retinal tomography (HRT), in 5-16-year-old children born at full-term with normal birthweights. Fifty-six children with normal visual acuity and refraction were examined with Stratus OCT and HRT. Three examinations were performed in each eye. One eye in each child was randomized for analyses of normal values. Findings in 54 eyes were evaluated. Mean values of RNFL thickness were calculated. Coefficients of variance and intraclass correlations were calculated. The correlation between right and left eyes and the limits of difference were determined for both methods. Mean RNFL thickness was 98.4 μm (standard deviation [SD] 7.88 μm) assessed with OCT and 213.0 μm (SD 54.0 μm) assessed with HRT. No correlations between age or gender and RNFL thickness were found. The coefficients of variance were 2.9% and 5.6% for OCT and HRT, respectively, and intraclass correlations were 0.85 and 0.88, respectively. The limits of difference between the two eyes ranged from -9 μm to 9 μm with OCT and from -109 μm to 87 μm with HRT. Both OCT and HRT can be used in children aged 5-16 years, but OCT provides less variability in determinations of RNFL thickness, both in repeated examinations of the same eye and in comparisons between the two eyes. The present study provides values for normal RNFL thickness in healthy children which can be used to make comparisons with values in children with optic nerve diseases.

To analyse retinal nerve fibre layer (RNFL) thickness in eyes with compression of the optic chiasm by a pituitary adenoma. RNFL thickness was analysed with optical coherence tomography (OCT) and compared to visual field measurements using high-pass resolution perimetry (HRP). Sixteen eyes from eight patients with pituitary adenoma were studied. All had bitemporal visual field depression caused by compression of the optic chiasm. Patients were submitted to an ophthalmic examination more than 14 months after surgery (seven patients had undergone trans-sphenoidal and one trans-cranial adenomectomy). The examination included HRP, fundus photography and measurement of the peripapillar RNFL thickness using OCT. In spite of temporal visual field depression, not all eyes showed reduced RNFL thickness by OCT. This was also true for some eyes in which RNFL was judged to be reduced on fundus photographs. Contrary to our expectations, RNFL thickness in the nasal quadrant was normal in nine of the 16 eyes. Corresponding figures for the superior, inferior and temporal quadrants were eight, six and five, respectively. The overall RNFL thickness, as measured by OCT, did not correlate well with neural capacity, which is an index of remaining retino-cortical neural channels in HRP. RNFL thickness as measured with OCT was reduced in most, but not all, eyes with temporal field depression caused by chiasmal compression. The pattern of RNFL loss did not correlate well with the visual field defect. Sensitivity of RNFL thickness measurement in OCT was low. The method has limited value in the diagnosis of pituitary tumour compression.

The purpose of this study was to model the influence of cataract on Spectral Domain Optical Coherence Tomography (SDOCT) image quality and Retinal Nerve Fibre Layer (RNFL) thickness measurements. SDOCT images, made with two different devices (3DOCT-1000, Topcon and Cirrus HD-OCT), before and after cataract surgery were compared and judged against measurements from normal subjects using artificial filters simulating the effects of cataract. Optical density of the images was calculated based on a mathematical model described previously. In total, forty-eight eyes were included for pre- and postoperative cataract extraction measurements. OCT image quality significantly (p < 0.001) improved postoperative and postoperative RNFL thickness was significantly (p < 0.001) thicker in both groups of patients. The measurements using artificial filters showed a rather precise linear relation between change in filter induced optical density and change in RNFL thickness (R = 0.941, p < 0.001 for 3DOCT-1000 and R = 0.785, p < 0.001 for Cirrus HD-OCT). For the patient groups, the relation was less marked, 3DOCT-1000 Rs = 0.697, p < 0.03 and Cirrus HD-OCT Rs = 0.444, p < 0.03. The predictive potential based on the found linear relationship between OCT-effective optical density of cataract and the cataract-induced underestimation was however limited, and mean difference ± SD between predicted and measured RNFL thickness were 1.68 ± 7.55 (3DOCT-1000) and 3.71 ± 2.97 (Cirrus HD-OCT) micron. A linear relationship exists between OCT-effective optical density of cataract and underestimation of RNFL thickness measured with OCT. This finding holds promise to correct for cataract-induced changes in RNFL measurements, but will differ for each type of OCT device.

Macular Thickness

To investigate the change of optic retinal nerve fiber layer (RNFL) thickness in nonproliferative diabetic retinopathy (NPDR) and to evaluate the correlation between the optic RNFL structural change and visual function. A cross-sectional study. All cases came from ophthalmology department of Zhejiang Province Traditional Chinese Medical Hospital, and the First People's Hospital of Ningbo, and Zhongshan Ophthalmic Center, Sun Yat-Sen University from December 2009 to October 2012. All the disease and control cases were coming from the same hospitals at the same period. Subjects were divided into 3 different groups: patients with NPDR (n = 89, 89 eyes), patients with diabetic mellitus but without diabetic retinopathy (NRD) (n = 96, 96 eyes) and disease-free controls (n = 115, 115 eyes). One eye of each subject was randomly selected for study. Participants aged from 40 to 70 years at baseline and all diabetic patients had a diabetic history of at least 5 years. Optic RNFL thickness of each subject was measured by spectral domain optical coherence tomography(SD-OCT). Visual function examinations including contrast sensitivity test in spatial frequencies of 1.5, 3.0,6.0, 12.0, 18.0 cycles per degree (c/d), pattern electroretinograms (PERG) and best corrected visual acuity (BCVA) assay. The analysis of RNFL thickness in each group was performed at four preset locations of the optic disc (i.e., temporally, superiorly, nasally, and inferiorly). To assess the structure-function relationship, the BCVA,contrast sensitivity, PERG-P50 amplitude and latency to optic RNFL thickness at each quadrant were analyzed in both NPDR and NRD groups. The RNFL thickness at four preset locations of the optic disc (meanly, nasally, temporally, superiorly, and inferiorly) were (97.7 ± 13.0), (71.7 ± 10.3), (70.9 ± 13.3), (118.3 ± 19.7), and (123.1 ± 20.8) µm in the NPDR group; (98.6 ± 15.3), (74.8 ± 13.1), (71.8 ± 14.6), (119.5 ± 17.2), and (125.6 ± 19.9) µm in the NRD group;and (99.1 ± 11.8), (77.4 ± 12.6), (72.6 ± 13.2), (119.1 ± 18.1), and (127.1 ± 19.3) µm in the normal group. The nasally optic RNFL thickness was significantly different among the three groups (F = 8.56, P = 0.000). The thickness in the NPDR and in the NRD group were significantly thinner than that in the normal group (SNK-q test:q = 3.16, 3.11, respectively; both P < 0.05). In the NPDR group, the nasally optic RNFL thickness was significantly thinner than that in the NRD group (SNK-q test:q = 3.07, P < 0.05). The inferiorly optic RNFL thickness was also significantly different among the three groups (F = 3.841, P = 0.035). The thickness in the NPDR group was significantly thinner than that in the normal group (SNK-q test:q = 3.090, P < 0.05). Yet, the difference of inferiorly optic RNFL thickness between the NRD group and the normal or the NPDR group did not reach the level of statistical significance (SNK-q test:q = 2.101, 1.955, P > 0.05). The temporally or superiorly optic RNFL thickness,or the average thickness of optic RNFL did not differ significantly among the three groups (F = 0.985, P = 0.375; F = 0.333, P = 0.71; F = 0.975, P = 0.379, respectively). Contrast sensitivities (1.5, 3.0,6.0, 12.0, 18.0 c/d), PERG-P50 amplitude and latency were all significantly correlated with the RNFL thickness of the nasal quadrant (nasal = 0.28, 0.26, 0.3, 0.25, 0.45, 0.65, 0.48, respectively; P < 0.05) and the inferior quadrant (inferior = 0.25, 0.28, 0.27, 0.26, 0.28, 0.37, 0.71; P < 0.05) in the NPDR group. Contrast sensitivities in high spatial frequencies (6.0, 12.0, 18.0 c/d), PERG-P50 amplitude were also significantly correlated with the RNFL thickness of the nasal quadrant (nasal = 0.59, 0.45, 0.66, 0.33, respectively; P < 0.05) and the inferior quadrant (inferior = 0.46, 0.71, 0.52, 0.41, respectively; P < 0.05) in the NRD group. The optic RNFL thickness of the nasal and inferior quadrant have been already reduced in patients with NPRD and are significantly correlated with the change of vision function.

To investigate whether persistent visual field defects among patients exposed once to the antiepileptic drug vigabatrin (VGB) were associated with peripapillary retinal nerve fibre layer thickness (RNFLT) attenuation. Nine individuals with partial epilepsy and VGB-attributed visual field loss (group 1; 18 eyes) and seven age- and gender-matched individuals with epilepsy and no previous VGB exposure (group 2; 14 eyes) were included in the study. Full-field 120 point screening perimetry out to 60 degrees from central fixation using the Humphrey Field Analyzer was performed. RNFLT was quantified by optical coherence tomography (OCT) using Fast RNFLT protocol, Stratus OCT (3.0) after pupillary dilation. The results from the right eye are presented in this article. Among the patients with VGB-attributed visual field loss, five patients had only peripheral field defect (group 1a) and the remaining four had advanced field defects both in the periphery and within 30° from central fixation (group 1b). None of the patients in the control group had manifest visual field loss. The mean RNFLT among the patients with VGB-attributed visual field loss was significantly attenuated compared to the controls [mean total RNFLT: group 1: 75.6 ± 12.7 μm, group 2: 103.5 ± 9.7 μm, mean difference 27.9 μm, (CI 15.9-39.9; p < 0.001)]. RNFLT values classified as borderline according to normative database (Stratus OCT) occurred more frequently among individuals with VGB-attributed visual field loss than in controls (frequency in group 1: 6/9; group 2: 0/7, p = 0.011). The nasal, superior and inferior quadrants of RNFLT in individuals with VGB-attributed visual field loss were significantly attenuated, while no difference was detected in temporal quadrants compared to controls. Both individuals with peripheral and those with advanced visual field losses in the VGB group had attenuated mean total RNFLT compared to controls (p = 0.006, p = 0.002, respectively). Occurrence of borderline classification of total RNFLT ≤5th percentile was more frequent among individuals with advanced visual field loss than among controls (p = 0.048). Persistent visual field loss attributed to VGB is associated with reduced peripapillary RNFLT and was detected both among patients with advanced and among patients with only peripheral visual field defects. Measurements of RNFLT with OCT might be considered as a diagnostic supplement in the follow-up of patients exposed to vigabatrin.

To investigate the factors affecting visual field recovery in patients with pituitary adenoma following surgical removal, both eyes of 35 patients with pituitary adenoma who had been followed up for > six months post-surgery were retrospectively analyzed. Pre- and post-operative visual acuity, visual field test, retinal nerve fiber layer (RNFL), and ganglion cell inner plexiform layer (GCIPL) thickness were investigated. The average age of the 35 patients was 58.3 ± 11.5 years. Preoperatively, 30 eyes (mean average RNFL thickness, 99.73 ± 5.89 μm) and 40 eyes (mean average RNFL thickness, 77.55 ± 8.35 μm) were included in the thick (≥ 90 μm) and thin RNFL group (< 90 μm), respectively. In the thick RNFL group, pre- and post-operative mean deviation (MD) and pattern standard deviation (PSD) were favorable (all p < 0.001), and the proportion of eyes of postoperative MD change which were stable or improved was greater than in the thin RNFL group (p = 0.042). Preoperative MD, RNFL (except nasal quadrant) and GCIPL thickness were positively correlated to postoperative MD values (all, p < 0.05). Preoperative MD and temporal RNFL thickness were significantly correlated with postoperative MD change rate (p = 0.03 and 0.04, respectively). Preoperative GC IPL thickness and postoperative MD change rate were not significantly correlated (p = 0.61). Using univariate regression analysis, preoperative best corrected visual acuity (Odds ratio [OR], 0.050; p < 0.001), tumor volume (OR, 1.110, p = 0.002), higher preoperative MD values (OR, 0.858; p < 0.001), lower preoperative PSD values (OR, 1.169, p = 0.002), thick RNFL (OR, 0.215; p = 0.003) and thick GCIPL (OR, 0.305, p = 0.018) were significantly associated with a good visual field outcome following surgery. According to multivariate analysis, any other parameters were not significant. In patients with thick RNFL, postoperative MD values were better than in the thin RNFL group. Eyes with preoperative higher MD and thick temporal RNFL showed more improvement in their visual fields postoperative. Preoperative thick RNFL could be a potential predictor of visual field recovery following TSA-TR, while macular GCIPL thickness does not appear to be a reliable predictor.

Objective: To assess correlation between functional changes of the optic nerve evaluated with automated perimetry (AP) and morphological changes of retinal nerve fiber layer (RNFL) evaluated with optical coherence tomography (OCT) in post treatment follow-up of papilledema due to idiopathic intracranial hypertension (IIH). Methods: We prospectively reviewed 40 eyes (20 patients) having recently diagnosed first attack of IIH with papilledema. Frisen grade of papilledema, Perimetric mean deviation (PMD) and spectral domain optical coherence tomography (SD-OCT) measurement of peripapillary retinal nerve fiber layer (RNFL) thickness were recorded at presentation and at 1st ,3rd and 6th months after starting treatment. We excluded patients with papilledema due to causes other than IIH or glaucoma, and patients who were unwilling to give consent. Results: Our study included 20 patients (40 eyes). Age of patients ranged from 13 to 39 years (mean 27.55±8.4 years). Significant improvement of Frisen grade of papilledema was found throughout the study (p < 0.0001). No patients in the study showed worsening of papilledema grade through the follow up period. There was a significant improvement (p < 0.001) of the retinal nerve fiber layer (RNFL) thickness through the follow up in all patients. At presentation, the median papilledema grade was 2 (range 2-3), which dropped gradually through the study to reach a median of 1 (range 0-1) at the last visit. The mean PMD at presentation was -2.05 ±7.25 dB, improved gradually to reach a mean of -0.59 ±4.02 dB at the last visit. RNFL thickness was (176.7±89µ) at presentation, declined significantly (p < 0.001) to 131.16±25.50 then 121.57±14.20µ then 120.3±14.7µ at 1st, 3rd and 6th month respectively. There was a significant correlation between PMD and RNFL thickness at the last visit (p=0.04). There was also a significant correlation (p < 0.013) between Frisen grade of papilledema and RNFL thickness at all visits. We found that the correlation between papilledema grade and RNFL thickness (r=0.590) was stronger than the correlation between papilledema grade and PMD (r=-0.205) as shown by the correlation coefficient (r). We found no correlation between any of patient’s age, laterality of the eye, oral contraceptive pills (OCP) intake or body mass index (BMI) and any of the study findings including best corrected visual acuity (BCVA), Frisen grade of papilledema, PMD or RNFL thickness. Conclusion: Our study showed a significant correlation between RNFL thickness and PMD at the end-of-study visit. Post treatment improvement of RNFL thickness was paralleled by recovery in PMD. As shown by the correlation coefficient (r), we found that the correlation between papilledema grade and RNFL thickness (r=0.590) was stronger than the correlation between papilledema grade and PMD (r=-0.205).

We define uveitic optic disc edema as disc edema that is partly or solely associated with uveitis. Our study describes the clinical and imaging characteristics of patients with UDE evaluated at the University of Minnesota. We retrospectively reviewed medical records of patients with UDE seen by a single uveitis provider for a 3-year period. Inclusion criteria were (1) the presence of uveitis and optic disc edema in one or both eyes and (2) optical coherence tomography (OCT) optic disc raster and retinal nerve fiber layer (RNFL) thickness measurements obtained within 2 weeks of one other. Disc raster OCT scans were analyzed to determine retinal height at the disc, focus of thickening, and retinal reflectance. Automated visual field (VF) testing and fluorescein angiography (FA) images were reviewed when available. FA pixel intensity was used to quantify disc fluorescence. Brain MRI scans were reviewed when available. Fifty-five eyes from 31 patients were analyzed. Patients' ages ranged from 11 to 78 years. Uveitis was present in all anatomic compartments, including retinal vasculitis and choroiditis. A total of 24 patients (77.4%) presented with unilateral disc edema and 7 patients (22.6%) had bilateral disc edema. VF testing was organized into 7 descriptive categories based on severity: normal, scattered/nonspecific defects, blind spot enlargement, central/paracentral defects, nasal/arcuate defects, mixed defects, and generalized depression. Each eye was assigned a primary VF defect type with an associated severity score. Overall, 12.7% of eyes had no/minor VF defects, 40.0% had focal VF defects, and 47.3% had severe VF defects. The average RNFL thickness for all eyes was 149 μm. A statistically significant positive correlation was found between the severity of VF defects and RNFL thickness when the entire group was analyzed (P = 0.042). Structural optic disc raster OCT scans showed no focal thickening (7.3%), isolated nerve fiber layer thickening (5.5%), focal inner-middle thickening (32.7%), and diffuse retinal thickening (54.5%). Disc fluorescence on FA showed a statistically significant positive correlation with maximum disc height (P = 0.0177), but did not correlate with mean reflectance on OCT. We did not detect a relationship between OCT reflectance and maximum disc height. Twenty-nine of 31 patients underwent brain MRI and 5 of these patients with bilateral disc edema showed radiographic features, suggestive of elevated intracranial pressure (ICP). Only 4 of 31 patients had elevated opening pressure of greater than 25 cm H2O by lumbar puncture. UDE as a distinct clinical entity has not been well categorized in the literature. A multimodal imaging approach including OCT RNFL, OCT disc raster scan, VF testing, and FA can aid in diagnosis of UDE. OCT disc raster height may be used as a surrogate for FA intensity and may be a useful adjunctive modality for monitoring UDE severity along with serial OCT scans. Increased intracranial pressure was rare in our patient cohort so neuroimaging should not be obtained solely based on optic disc appearance and imaging abnormalities.

Objective To investigate the early alterations of the retinal nerve fiber layer (RNFL)thickness caused by panretinal photocoagulation (PRP) treatment in patients with type 2 diabetes.Methods The RNFL thickness of all the participants was measured by optical coherence tomography (OCT).The selected patients accepted the PRP treatment for 4 times,once a week.The RNFL thickness was measured for continuous 4 weeks after the beginning of the PRP treatment.Results Compared with the control subjects,the RNFL thickness in patients with diabetic retinopathy (DR) decreased significantly (P ＜0.05 or P ＜0.01),but no statistical difference was observed between severe non-proliferative diabetic retinopathy (NPDR) and early proliferative diabetic retinopathy (PDR).The PRP treatment for DR could cause the early increase of the peripapillary RNFL thickness,especially in the superior and inferior quadrants (P ＜0.05 or P ＜0.01).The RNFL thickness increased along with the times of the PRP operation,and peaked for 3 times at 3 week3.Conclusions DR,either severe NPDR or early PDR,resulted in the decrease of the RNFL thickness in patients with type 2 diabetes.However,PRP treatment for DR can increase the RNFL thickness,due to the PRP caused lesion.The early alteration of the RNFL thickness may provide a valuable guide for the selection of the PRP parameters. Key words: Retinal nerve fiber layer; Panretinal photocoagulation; Diabetic retinopathy

To determine the prognostic value of optical coherence tomography (OCT) measurement of the peripapillary retinal nerve fiber layer (RNFL) thickness in visual recovery after orbital decompression of patients with dysthyroid optic neuropathy (DON). A total of 52 eyes of 37 patients who underwent orbital decompression for DON between 2013 and 2019 were retrospectively reviewed. We examined peripapillary RNFL thickness, best-corrected visual acuity (BCVA), visual field (VF) for mean deviation (MD) and pattern standard deviation (PSD), and pattern-reversed visual evoked potential (PVEP) for P100 latency and amplitude before and after surgery. Black and white checkerboard square sizes of PVEP were 15 and 60 arcmin (arcminute and minute of angle). Changes in RNFL overall thickness and by quadrant and interocular differences were evaluated and studied regarding changes in BCVA, VF and PVEP. There was a significant improvement in BCVA, VF, and PVEP, whereas a dramatic reduction in RNFL thickness of all DON patients in global average, temporal, superior, and inferior quadrants (P = 0.005, P = 0.024, P = 0.016, and P = 0.001, respectively) after decompression surgery, except for nasal quadrant (P = 0.057). The preoperative RNFL thickness in each quadrant was negatively correlated with postoperative changes of BCVA and PSD and positively correlated with changes of MD and P100 amplitude at 60 arcmin (all P < 0.05). Except for temporal quadrant (P = 0.125), the preoperative RNFL thickness in other quadrants was positively correlated with postoperative changes of P100 amplitude at 15 arcmin (all P < 0.05). The nasal RNFL thickness was an excellent predictor for improvement in BCVA by 20/25 or better and in MD by 10dB or more after surgery, whose cutoff value was 73.50μm, while the inferior and superior RNFL thickness could act as a predictor for improvement in P100 amplitude by 5μV or more at 60 arcmin and at 15 arcmin, respectively, whose cutoff value was, respectively, 143.00μm and 130.50μm (all P < 0.05). RNFL thickness measured by OCT was correlated with visual function recovery after decompression surgery in patients with DON, which could also act as a predictor for better visual prognosis.

Objective To investigate the relationship between retinal nerve fiber layer thickness and peripheral neuropathy in elderly patients with type 2 diabetes. Methods Clinical data of elderly patients with T2DM in Endocrinology Department in Beijing Hospital were retrospectively collected.Global and sectorial retinal nerve fiber layer(RNFL)thicknesses were measured by using optical coherence tomography(OCT), and never conduction velocity measurements were performed in all patients.Diabetic peripheral neuropathy was diagnosed by the criteria in diabetic neuropathies update(2010, American Diabetes Association). RNFL thickness was compared between diabetic non-peripheral neuropathy group(control group, n=30)and diabetic peripheral neuropathy group(DPN group, n=17)and between different sub-groups. Results The RNFL thicknesses of temporal, nasal, superior and inferior visual fields and the mean RNFL thickness were less in DPN group than in control group, among which there were significant differences in the RNFL thicknesses of superior, inferior visual fields and the mean RNFL thickness 〔(107.7±27.4)μm vs.(128.1±17.3)μm, (112.9±20.8)μm vs.(130.8±21.8)μm, (88.2±15.5)μm vs.(100.5±11.3)μm, F=7.446, 7.468, 7.988, respectively, P=0.009, 0.009 and 0.007〕. RNFL thickness was decreased along with the aggravation of DPN from the control group, the subclinical DPN group to the DPN group successively(all P<0.05). Conclusions Retinal nerve fiber layer thickness is associated with diabetic peripheral neuropathy in elderly patients with type 2 diabetes, and the relationship is more significant in patients with serious DPN. Key words: Diabetic retinopathy; Retinal neurons; Tomography, optical coherence

To evaluate the impairment of optic nerve of different types of multiple sclerosis (MS) by optic coherence tomography (OCT). Cross-sectional study. 52 eyes of 30 patients who diagnosed as MS up to the 2010 Mcdonald criteria were included. 13 eyes of 13 healthy people matched with sex and age were set as the control group. Patients with MS were divided into 3 subgroups based on the history of optic neuritis (ON): 22 eyes of MS patients with the history of ON were in MS-ON group, 16 eyes of MS patients without ON were in MS-NON group and 14 contralateral eyes of MS-ON patients were in MS-ON Contra group. Fourier domain OCT was used to examine. The protocol included macula scanning, retinal nerve fiber layer (RNFL) analysis and ganglion cell complex (GCC) and optic nerve head (ONH) scanning. Visual acuity (VA) and visual field (VF) were also compared. The major measurements were RNFL and GCC thickness. ANOVA was used to compare the overall difference of RNFL and GCC thickness among all the groups. LSD method was used to compare the difference between every two groups. The thickness of average GCC, superior GCC and inferior GCC of MS-ON group is (80.65 ± 16.03) µm, (81.50 ± 14.56) µm, (79.83 ± 17.65) µm. Compared with the MS-NON group which is (99.65 ± 9.35) µm, (99.26 ± 9.73) µm, (100.06 ± 9.31) µm correspondingly, MS-ON contra group (99.36 ± 8.25) µm, (100.39 ± 8.97) µm, (98.34 ± 7.88) µm correspondingly and the control group (104.87 ± 8.71) µm, (105.36 ± 8.21) µm, (103.96 ± 10.33) µm correspondingly, they decreased significantly (P < 0.05). While the GCC thickness has no significantly difference among the MS-NON, MS-ON Contra and the control group. The average RNFL thickness and nasal inferior quadrant RNFL thickness in MS-ON group was (83.68 ± 29.91) µm, (92.26 ± 35.97) µm. And they were significantly thinner than that in the MS-NON group which was (108.83 ± 15.33) µm, (120.85 ± 35.96) µm correspondingly and that in the control group which was (111.60 ± 14.90) µm, (139.95 ± 7.77) µm correspondingly (P < 0.05). The RNFL thickness in temporal inferior quadrant in MS-ON group was (109.63 ± 44.54) µm and it was (60.47 ± 26.94) µm in the temporal quadrant. And they decreased significantly compared with that in the MS-NON which was (149.92 ± 18.51) µm, (90.64 ± 16.15) µm correspondingly, and in the MS-ON Contra group which was (135.70 ± 28.66) µm, (77.30 ± 23.40) µm correspondingly and in the control group which was (172.72 ± 15.29) µm,( 90.90 ± 6.15) µm correspondingly (P < 0.05). The RNFL thickness in nasal inferior, temporal inferior and temporal quadrant in the MS-ON Contra group was (106.60 ± 44.07) µm, (135.70 ± 28.66) µm, (77.30 ± 23.40) µm respectively which was significantly thinner than that in the control group which was (139.95 ± 7.77) µm, (172.72 ± 15.29) µm, (90.90 ± 6.15) µm correspondingly (P < 0.05). GCC and RNFL thickness of OCT test can be used to evaluate the impairment of optic nerve of MS patients, and the RNFL scanning can reflect the early and latent lesion of optic nerve in MS.

Objective To evaluate the significance of the retinal nerve fiber layer (RNFL) thickness and optic nerve head parameters measured by optical coherent tomography (OCT) in the early diagnosis of glaucoma, combined with visual field change. Methods Thirty-six eyes of glaucoma patients, 34 eyes of suspected glaucoma and 10 healthy eyes were included in this study. All patients performed ONH and RNFL thickness examination with OCT during the same visit. Comparisons were made with regard to each quadrant and average RNFL thickness. Comparison of Cup/Disc horizontal and vertical ratio and area ratio were made between each group. Analyze the correlation between the average RNFL thickness and visual field. Results There was significant difference of RNFL thickness and optic disc parameters in various quadrants and means among the three groups (P< 0.05). Normal and SACG group: RNFL thickness in superior, inferior and the average was significant difference. Normal and CACG group: Every quadrant and average RNFL thickness was significant differences. CACG and SACG Group: the superior, inferior, nasal and the average of RNFL thickness was significant difference. The average RNFL thickness and visual field mean defect (MD) showed a strong and positive linear relationship. Conclusions OCT can early reflect the changes of glaucoma in RNFL thickness and optic disc parameters, also can find the RNFL thickness damage before the of visual field changes, and have a better correlation with the vision. It can serve as a method of early diagnosis of glaucoma. Key words: Optical coherence tomography; Retinal nerve fiber layer; Cup/Disc ratio; Glaucoma; Diagnosis

Objective To measure RNFL thickness by Frequency-domain optical coherence tomography (OCT) in patients with different stages of primary glaucoma (CACG and POAG),to evaluate the correlation between RNFL thickness and visual field mean defect (MD),to detect RNFL thickness change of early stage primary glaucoma,and to discuss the clinical significance in the early diagnosis of primary glaucoma objectively. Methods Ninety-two subjects of 40 normal and 52 with different stages of primary glaucoma were enrolled in this study.RNFL thickness was measured by Zeiss Cirru HD-OCT,and visual field was tested by Zeiss Humphrey-750.The association between visual field MD and RNFL thickness was evaluated with Pearson correlation coefficients. Results In the normal group,mean RNFL thickness was 112.91±9.36μm; the early period glaucoma group 94.43±7.67μm; the middle period glaucoma group 80.82±10.36μm; the later period glaucoma group 67.86±8.01μm.Visual field MD in each group was-0.88±1.53dB,-4.26±1.83dB,-7.43±2.64dB and -17.06±5.85dB.The differences in mean RNFL thickness and visual field MD between normal and each stage glaucoma group were significant (P ＜0.05) by independent sample t-test.In each stages of glaucoma group,mean RNFL thickness and visual field MD (early period:r =-0.537,middle period:r =-0.615,later period:r=-0.804) correlated significantly (P ＜0.05).In the early period glaucoma group,superior RNFL thickness was 116.32±11.65μm,inferior RNFL thickness 105.58±9.73μm,nasal RNFL thickness 75.40±10.91μm,and temporal RNFL thickness 70.28±13.08μm.In group B,superior RNFL thickness was 140.15±8.79μm,inferior RNFL thickness 137.29±10.07μm,nasal RNFL thickness 90.20±14.19μm,and temporal RNFL thickness 88.43±10.85μm.The difference of superior and inferior RNFL thickness between group A1 and group B had statistical significance tested by independent sample t-test,P ＜0.05; nasal and temporal RNFL thickness between group A1 and group B was tested by independent sample t-test,P ＞0.05,there was no statistical significance difference. Conclusions Frequency-domain OCT detected that the average of RNFL thickness become thinning with the progression of disease in the primary glaucoma patients,have negative correlation with vision MD,it is able to objectively reflect the degree of glaucomatous optic nerve damage.Frequency-domain OCT can show significantly decreased superior and inferior RNFL thickness of the early period primary glaucoma,which shows good ability in distinguishing normal from early period primary glaucomatous eyes. Key words: Optical coherence tomography (OCT); Retinal nerve fiber layer (RNFL); Mean defect (MD); Early diagnosis primary glaucoma