Inferior Retinal Nerve Fiber Layer Thickness Research Articles

The correlation between visual acuity outcomes and optical coherence tomography parameters following surgery for diabetic epiretinal membrane and taut posterior hyaloid.

PurposeTo evaluate the relationship between visual outcomes and the determinants detected by spectral domain optical coherence tomography (OCT) in eyes with epiretinal membrane (ERM) and/or taut posterior hyaloid (TPH) that underwent pars plana vitrectomy (PPV).Materials and methodsA total of 30 participants with diabetic ERM and TPH were included in the study. All study participants underwent PPV. Preoperative and postoperative best corrected visual acuity (BCVA), peripapillary retinal nerve fiber layer (RNFL), macular RNFL, ganglion cell layer, inner plexiform layer, and ganglion cell complex thicknesses were measured in each participant. Linear regression analyses were performed to determine the association between the OCT parameters and the visual acuity measured at the time of the OCT measurement.ResultsThe postoperative BCVA logarithm of the minimum angle of resolution (logMAR) values were statistically higher than the preoperative values in the ERM group and TPH group (P=0.001 and P<0.001, respectively). The postoperative BCVA logMAR value was negatively correlated with average RNFL, inferior RNFL thicknesses, and image quality (P=0.002, P=0.004, and P=0.006, respectively). The preoperative and postoperative BCVA logMAR value difference was not correlated with age and all of the OCT parameters measured (P>0.05).ConclusionThis study shows that achievement of better peripapillary RNFL thickness results in better visual outcome after PPV and ERM/TPH removal.

Ganglion cell-inner plexiform layer thickness in patients with Parkinson disease and association with disease severity and duration.

To evaluate the average, minimum, and 6-sectoral macular ganglion cell-inner plexiform layer (GC-IPL) thickness measured by spectral domain optical coherence tomography (SD-OCT) in patients with Parkinson disease (PD), as well as average and 4-sectoral retinal nerve fiber layer (RNFL) thickness and to determine whether thickness parameters are correlated to disease severity and duration. Patients with PD (n = 54) and age-matched healthy controls (n = 54) were prospectively examined with SD-OCT. Randomly selected eyes of all subjects were included. The average, minimum, and 6-sectoral (superior, superotemporal, superonasal, inferonasal, inferior, and inferotemporal) GC-IPL thickness values were analyzed. Average and 4-sectoral (inferior, superior, temporal, and nasal) peripapillary RNFL thicknesses were also evaluated. Each parameter was compared between patients with PD and age-matched healthy controls. PD severity was quantified with the Hoehn and Yahr (HY) scale. A correlation analysis was performed to evaluate the association between SD-OCT measurements and the duration and severity of PD. The mean age of patients with PD and age-matched healthy controls was 66.62 ± 8.71 years and 66.68 ± 7.85 years, respectively. Disease duration ranged from 1 to 15 years with a mean of 5.12 years. The mean PD severity, according to the HY scale, was 2.26 (range, 1-5). SD-OCT measurements revealed significant differences in inferior and temporal peripapillary RNFL values between groups (P = 0.018 and P = 0.031, respectively). All GC-IPL thickness parameters were statistically lower in the patients with PD when compared with the healthy controls (P < 0.001). PD duration was not correlated to any of the RNFL thicknesses, but PD severity was correlated inversely only with inferior peripapillary RNFL thickness (P = 0.006). Average, inferior (P = 0.011), inferotemporal (P = 0.007), and superotemporal (P = 0.007) GC-IPL thicknesses were correlated inversely with both PD severity and duration. Retinal dopaminergic neurodegeneration in patients with PD can be detected with macular GC-IPL thickness measurements. Macular GC-IPL thickness was correlated with PD severity and duration. It may be used to follow disease progression and efficacy of the neuroprotective treatment in patients with PD.

Retinal nerve fiber layer and ganglion cell complex thicknesses measured with spectral-domain optical coherence tomography in eyes with no light perception due to nonglaucomatous optic neuropathy.

To measure retinal nerve fiber layer thickness (RNFLT) and ganglion cell complex thickness (GCCT) in eyes with no light perception due to nonglaucomatous optic neuropathy using spectral-domain optical coherence tomography. Fourteen eyes of 14 patients (9 women, 5 men; mean age 56.0 ± 16.6 (standard deviation) years] with no light perception due to optic neuropathy were recruited to this retrospective study. Only clinically stable eyes were included. Eyes were imaged at least 6 months after the onset of the disease. Five patients lost light perception due to traumatic optic neuropathy, four patients had ischemic optic neuropathy, two patients had optic neuritis, two patients had compressive optic neuropathy, and one patient had optic nerve atrophy. Global and quadrant RNFLTs were measured with the Cirrus HD-optical coherence tomography (OCT) system; global and hemisphere GCCTs were measured by spectral-domain OCT (RTVue OCT system). Only reliable OCT images were used for further analysis. Reliable RNFL images were obtained in 12 eyes, and reliable GCC images were obtained in 11 eyes. Global, superior, temporal, inferior, and nasal RNFLT were 57.5 ± 6.7, 60.6 ± 7.6, 54.1 ± 11.2, 59.7 ± 9.5, and 55.6 ± 7.4 µm, respectively. Global, superior, and inferior GCC thicknesses were 68.8 ± 9.6, 70.7 ± 12.2, and 67.8 ± 8.8 µm, respectively. A considerable proportion of RNFL and GCC remained in eyes with no light perception vision. Clinicians should take this into account when evaluating the severity of optic neuropathy from OCT-measured RNFLT and GCCT.

Retinal vessel diameters and their correlation with retinal nerve fiber layer thickness in patients with pseudoexfoliation syndrome.

To compare retinal artery-vein diameters (RAVDs) of patients with pseudoexfoliation (PSX) syndrome with healthy controls and investigate the correlations between retinal nerve fiber layer (RNFL) thickness parameters and RAVDs. Seventeen eyes with PSX and 17 eyes of age-matched controls were included in the study. All participants underwent routine ophthalmological examination, Humphrey visual field and RNFL examination by using Stratus OCT. Retinal images were obtained by using a retinal camera (Topcon 501X). RAVDs were measured from inferior nasal, inferior temporal, superior nasal and superior temporal arcuates by using IMAGEnet software. Superior, inferior, nasal, temporal and average RNFL thicknesses were recorded. RAVDs and RNFL parameters in groups and correlations were analyzed by Mann-Whitney U and Spearmann correlation tests. Only inferior quadrant and average RNFL thickness were detected thinner in the PSX group compared with control group (P=0.009, P=0.038, respectively). No statistically significant difference regarding RAVDs was found between two groups. RAVDs seems to be comparable in the PSX and control group. RNFL is thinner in the inferior quadrant in the PSX group. RNFL thickness and RAVDs show significant correlations in both groups. This correlation doesn't seem to be specific to PSX.

Retinal nerve fiber layer and macular thinning in systemic lupus erythematosus: an optical coherence tomography study comparing SLE and neuropsychiatric SLE.

Due to the lack of reliable biomarkers in diagnosing and monitoring neuropsychiatric systemic lupus erythematosus (NPSLE), the aim of this study was to examine the utility of measurements obtained through spectral domain optical coherence tomography (SD-OCT) as a biomarker for NP involvement in SLE. Retinal nerve fiber layer (RNFL) and macula scans were performed using SD-OCT on 15 NPSLE patients, 16 SLE patients without NP symptoms (non-NP SLE), and 16 healthy controls. Macular volume and thickness of the central macula and peripapillary RNFL were compared between the groups and to scores on two validated cognitive tests. NPSLE patients did not differ significantly from non-NP SLE patients in retinal thickness or macular volume. However, SLE patients as a whole showed significant RNFL and macular thinning compared to controls. Scores on the Trail Making Test B, a test of complex attention, showed significant correlation to temporal superior and temporal inferior RNFL thickness. Our results demonstrate RNFL thinning in SLE, and confirm the previous finding of high incidence of abnormal brain scans in SLE. These findings suggest that OCT measurements may be indicative of neurodegeneration in SLE and may be a useful biomarker for early cognitive impairment in SLE.

Interocular retinal nerve fiber layer thickness difference in normal adults.

PurposeTo determine the interocular retinal nerve fiber layer (RNFL) thickness difference of normal subjects.MethodsBoth eyes of 230 normal adults received peripapillary RNFL thickness measurements using OCT. The effect of ocular cyclotorsion on the RNFL thickness profile was mathematically corrected. The fractional and absolute interocular RNFL thickness differences at 256 points of peripapillary area were calculated. We divided the subjects into 3 groups according to the locations of superior and inferior peak thickness, respectively, and compared the interocular RNFL thickness differences between the subgroups.ResultsThe fractional interocular RNFL thickness difference exhibited smaller regional variations than the absolute interocular difference. The means of fractional interocular differences were 0.100 ± 0.077 in the temporal half area and 0.146 ± 0.105 in the nasal half area, and the tolerance limits for the 95th and 99th distributions were about 0.246 and 0.344 in the temporal half area and 0.293 and 0.408 in the nasal half area, respectively. The fractional interocular differences of subgroups classified by the locations of superior and inferior peak RNFL thickness showed difference at smaller areas than the absolute interocular differences (19 and 8 points versus 49 and 23 points, respectively).ConclusionGlaucoma can be strongly suspected, if interocular fractional RNFL thickness difference is over 25% at 5 consecutive points or over 35% at 3 consecutive points in the temporal half area. The fractional interocular comparison is a better diagnostic approach because the fractional interocular RNFL thickness difference is less influenced by the locations of peak RNFL thickness.

The impact of hypertension on retinal nerve fiber layer thickness and its association with carotid intima media thickness

Objective. Our aim was to investigate retinal nerve fiber layer (RNFL) thickness in hypertensive patients using spectral-domain optical coherence tomography (SD-OCT) and to evaluate the relationship between RNFL thickness and carotid intima media thickness (CIMT). Methods. This study included 59 patients with hypertension (HT) (53.6 ± 10.7 years) and 54 age-matched healthy controls (51.0 ± 8.1 years). We evaluated anthropometric and metabolic parameters as well as RNFL and CIMT measurements in patients with hypertension and controls. Results. The average RNFL thickness was 86.60 ± 10.86 μm in hypertensive patients and 93.63 ± 7.30 μm in healthy controls (p < 0.001). Selective thinning of the RNFL was found in the superior and inferior quadrants. Mean CIMT values were higher in patients with HT (0.80 ± 0.15 mm) than the healthy subjects (0.71 ± 0.1 mm) (p < 0.001). The average, inferior and nasal RNFL thickness were negatively associated with diastolic blood pressure respectively (r = − 0.112, r = − 0.210, r = − 0.225). There was an inverse correlation between RNFL thickness in the average and superior retinal quadrant and CIMT (r = − 0.201, r = − 0.185). There were no correlations between RNFL thickness and age, body mass index, fasting plasma glucose, lipid parameters, high-sensitive C-reactive protein and microalbuminuria. Conclusion. RNFL thickness is reduced in hypertensive patients and may be associated with atherosclerosis.

The effect of cigarette smoking on retinal nerve fiber layer thickness in patients with migraine

Context: Migraine is a frequent and disabling chronic neurological condition with complex pathophysiology. Both cigarette smoking and migraine may cause damage to the optic nerve. Objective: The primary objective of this study was to investigate the effect of cigarette smoking on retinal nerve fiber layer (RNFL) thickness in patients with migraine.Materials and methods: Eighty-four consecutive patients diagnosed with migraine (34 smokers and 50 nonsmokers) and 66 age- and gender-matched healthy non-smoker controls were enrolled for this observational cross-sectional study. RNFL thickness was measured using spectral-domain optical coherence tomography (OCT) and then RNFL thickness in patients with migraine who smoke was compared to nonsmoking patients with migraine and healthy subjects.Results: The average, superior, nasal and inferior RNFL thicknesses were significantly thinner in patients with migraine compared to the control group (p < 0.001, p = 0.02, p < 0.001 and p = 0.04, respectively). The average and inferior RNFL thicknesses were significantly reduced in smoker patients with migraine compared to the nonsmokers (p = 0.011, p = 0.045, respectively). Nonsmoker patients with migraine had significantly thinner average and nasal RNFL thicknesses than the control group (p = 0.001, p = 0.001, respectively).Conclusion: Cigarette smoking may cause significant RNFL thinning in patients with migraine. OCT may be a feasible technique for determination of smoking-induced ocular damage in patients with migraine.

Diagnostic Ability of Spectral Domain OCT: Comparision between Preperimetric Glaucoma and Large Physiologic Cupping

Purpose: To assess the distinction ability for differentiating glaucoma patients based on optic disc, retinal nerve fiber layer (RNFL) and ganglion cell‐inner plexiform layer (GCIPL) measured using spectral domain optical coherence tomography (SD‐ OCT). Additionally, the diagnostic ability of these parameters was evaluated by comparing preperimetic glaucoma patients who frequently visited the clinic and normal patients with and without a large physiologic cup/disc (C/D) ratio. Methods: Using SD-OCT, the optic disc, RNFL and GCIPL of preperimetic glaucoma patients were compared with normal people with and without a large C/D ratio from March, 2011 to December, 2014 at Department of Ophthalmology, Inha University Hospital. Preperimetic glaucoma was defined using the normal standard automated perimetry for glaucomatous optic nerve changes such as asymmetry of vertical C/D ratio, rim thinning, notching, excavation and RNFL defect. Results: When comparing preperimetic glaucoma patients to normal people without large disc cupping, the most reliable parameter for optic disc parameters, vertical C/D ratio (0.89), showed more reliable diagnostic ability than the most reliable parameter for retinal nerve fiber, inferior RNFL thickness (0.79) and superonasal and inferonasal GCIPL thickness were the most reliable GCIPL parameters (p = 0.005 and 0.002, respectively). When comparing preperimetic glaucoma patients to normal people having a large physiologic disc cupping, average C/D ratio among optic nerve parameters, inferior RNFL thickness among RNFL thickness parameters and inferior GCIPL thickness among GCIPL parameters showed highly reliable diagnostic abilities. These 3 parameters were not statistically different (all p > 0.05) and had lower distinction ability than reported in previous studies. Conclusions: Diagnostic abilities of SD-OCT for distinguishing preperimetric glaucoma from normal people having large physiologic disc cupping were similar for optic disc, RNFL and GCIPL and showed low diagnostic ability than compared to normal people without large disc cupping. J Korean Ophthalmol Soc 2015;56(9):1400-1407

Detecting the progression of normal tension glaucoma: a comparison of perimetry, optic coherence tomography, and Heidelberg retinal tomography.

PurposeWe compared the abilities of Stratus optical coherence tomography (OCT), Heidelberg retinal tomography (HRT) and standard automated perimetry (SAP) to detect the progression of normal tension glaucoma (NTG) in patients whose eyes displayed localized retinal nerve fiber layer (RNFL) defect enlargements.MethodsOne hundred four NTG patients were selected who met the selection criteria: a localized RNFL defect visible on red-free fundus photography, a minimum of five years of follow-up, and a minimum of five reliable SAP, Stratus OCT and HRT tests. Tests which detected progression at any visit during the 5-year follow-up were identified, and patients were further classified according to the state of the glaucoma using the mean deviation (MD) of SAP. For each test, the overall rates of change were calculated for parameters that differed significantly between patients with and without NTG progression.ResultsForty-seven (45%) out of 104 eyes displayed progression that could be detected by red-free fundus photography. Progression was detected in 27 (57%) eyes using SAP, 19 (40%) eyes using OCT, and 17 (36%) eyes using HRT. In early NTG, SAP detected progression in 44% of eyes, and this increased to 70% in advanced NTG. In contrast, OCT and HRT detected progression in 50 and 7% of eyes during early NTG, but only 30 and 0% of eyes in advanced NTG, respectively. Among several parameters, the rates of change that differed significantly between patients with and without progression were the MD of SAP (p = 0.013), and the inferior RNFL thickness (p = 0.041) and average RNFL thickness (p = 0.032) determined by OCT.ConclusionsSAP had a higher detection rate of NTG progression than other tests, especially in patients with advanced glaucoma, when we defined progression as the enlargement of a localized RNFL defect. The rates of change of the MD of SAP, inferior RNFL thickness, and average RNFL thickness differed between NTG patients with and without progression.

Differences between Non-arteritic Anterior Ischemic Optic Neuropathy and Open Angle Glaucoma with Altitudinal Visual Field Defect.

PurposeTo investigate the differences in retinal nerve fiber layer (RNFL) change and optic nerve head parameters between non-arteritic anterior ischemic optic neuropathy (NAION) and open angle glaucoma (OAG) with altitudinal visual field defect.MethodsSeventeen NAION patients and 26 OAG patients were enrolled prospectively. The standard visual field indices (mean deviation, pattern standard deviation) were obtained from the Humphrey visual field test and differences between the two groups were analyzed. Cirrus HD-OCT parameters were used, including optic disc head analysis, average RNFL thickness, and RNFL thickness of each quadrant.ResultsThe mean deviation and pattern standard deviation were not significantly different between the groups. In the affected eye, although the disc area was similar between the two groups (2.00 ± 0.32 and 1.99 ± 0.33 mm2, p = 0.586), the rim area of the OAG group was smaller than that of the NAION group (1.26 ± 0.56 and 0.61 ± 0.15 mm2, respectively, p < 0.001). RNFL asymmetry was not different between the two groups (p = 0.265), but the inferior RNFL thickness of both the affected and unaffected eyes were less in the OAG group than in the NAION group. In the analysis of optic disc morphology, both affected and unaffected eyes showed significant differences between two groups.ConclusionsTo differentiate NAION from OAG in eyes with altitudinal visual field defects, optic disc head analysis of not only the affected eye, but also the unaffected eye, by using spectral domain optical coherence tomography may be helpful.

Relationship between Peripapillary Retinal Nerve Fiber Layer Thickness Measured by Optical Coherence Tomography and Visual Field Severity Indices.

PurposeThough there are many reports regarding the structure-function relationship in glaucoma, they are too complicated to apply to the routine clinical setting. The aim of this study was to investigate the direct relationship between peripapillary retinal nerve fiber layer (RNFL) thickness measured by optical coherence tomography (OCT) and visual field (VF) severity indices computed by standard automated perimetry.MethodsThis cross-sectional comparative study included 104 glaucomatous patients and 59 healthy subjects. Peripapillary RNFL thickness was measured by spectral domain (SD) and time domain (TD) OCTs. Four glaucoma VF severity indices, including mean deviation (MD), pattern standard deviation (PSD), Collaborative Initial Glaucoma Treatment Study (CIGTS) VF score, and Advanced Glaucoma Intervention Study (AGIS) VF score, were calculated using standard automated perimetry. The Pearson's correlation coefficients (r) between the average and quadrants of peripapillary RNFL thicknesses and the four VF severity indices were calculated.ResultsIn glaucomatous eyes, the r value between the average RNFL thickness measured by SD OCT and each VF severity index were 0.562, -0.514, -0.577, and -0.567 for the MD, PSD, CIGTS VF score, and AGIS VF score, respectively (all p < 0.001). Among each quadrant, the inferior RNFL thickness showed the largest r value; 0.587, -0.552, -0.613, and -0.598 for the MD, PSD, CIGTS VF score, and AGIS VF score, respectively (all p < 0.001). Measurements by TD OCT showed similar strengths of association with SD OCT.ConclusionsModerate correlation was identified between peripapillary RNFL thicknesses measured by SD/TD OCT and glaucoma VF severity indices. Among each quadrant, the inferior RNFL thickness showed the greatest association with glaucoma VF severity indices. There was no significant difference according to the type of VF severity index or the type of OCTs.

Relationships among serum lipoprotein lipase mass, visceral fat, and retinal nerve fiber layer thickness.

The purpose of the study was to determine whether there were significant correlations among the serum lipoprotein lipase mass, visceral fat, and the retinal nerve fiber layer (RNFL) thickness. We studied 118 consecutive subjects. Optical coherence tomography (OCT) was used to measure the RNFL thickness. The Pearson correlation coefficient was used to determine the relationships among lipoprotein lipase (LPL) mass, visceral fat area by computed tomography, OCT, and other parameters. We performed a multiple regression analysis to identify independent factors for the RNFL sectors that were the most strongly correlated with the LPL mass and visceral fat area. The LPL mass was significantly correlated with the nasal RNFL thickness in both eyes (right eye: r = 0.24, p = 0.008, left eye: 0.32, 0.0008) and inferior RNFL thickness in the left eye ( r = 0.23, p = 0.01). The visceral fat area was significantly correlated with the nasal RNFL thickness in both eyes (right eye: r = -0.19, p = 0.04, left eye: -0.30, 0.0008) and the inferior RNFL thickness in the left eye ( r = -0.23, p = 0.01). The subcutaneous fat area was not significantly correlated with any OCT parameters. The multiple regression analysis revealed that age, LPL mass, and visceral fat area were independent contributors to the nasal RNFL thickness in the left eye (age, standard regression coefficient = -0.34 , p = 0.0004; LPL mass, 0.26, 2.49, 0.01; visceral fat area, -0.21, 0.03). A reduction of lipoprotein lipase and accumulation of visceral fat might produce retinal neurodegenerative disorders that decrease the RNFL thickness, especially on the nasal side.

Spectral domain optical coherence tomography cross-sectional image of optic nerve head during intraocular pressure elevation.

To analyze changes of the optic nerve head (ONH) and peripapillary region during intraocular pressure (IOP) elevation in patients using spectral domain optical coherence tomography (SD-OCT). Both an optic disc 200×200 cube scan and a high-definition 5-line raster scan were obtained from open angle glaucoma patients presented with monocular elevation of IOP (≥30 mm Hg) using SD-OCT. Additional baseline characteristics included age, gender, diagnosis, best-corrected visual acuity, refractive error, findings of slit lamp biomicroscopy, findings of dilated stereoscopic examination of the ONH and fundus, IOP, pachymetry findings, and the results of visual field. The 24 patients were selected and divided into two groups: group 1 patients had no history of IOP elevation or glaucoma (n=14), and group 2 patients did have history of IOP elevation or glaucoma (n=10). In each patient, the study eye with elevated IOP was classified into group H (high), and the fellow eye was classified into group L (low). The mean deviation (MD) differed significantly between groups H and L when all eyes were considered (P=0.047) and in group 2 (P=0.042), not in group 1 (P=0.893). Retinal nerve fiber layer (RNFL) average thickness (P=0.050), rim area (P=0.015), vertical cup/disc ratio (P=0.011), cup volume (P=0.028), inferior quadrant RNFL thickness (P=0.017), and clock-hour (1, 5, and 6) RNFL thicknesses (P=0.050, 0.012, and 0.018, respectively), cup depth (P=0.008), central prelaminar layer thickness (P=0.023), mid-inferior prelaminar layer thickness (P=0.023), and nasal retinal slope (P=0.034) were significantly different between the eyes with groups H and L. RNFL average thickness, rim area, vertical cup/disc ratio, cup volume, inferior quadrant RNFL thickness, and clock-hour (1, 5, and 6) RNFL thicknesses significantly changed during acute IOP elevation.

Diagnostic Capability of Peripapillary Retinal Thickness in Glaucoma Using 3D Volume Scans

To determine the diagnostic capability of spectral-domain optical coherence tomography (SD OCT) peripapillary retinal thickness (RT) measurements from 3-dimensional (3D) volume scans for primary open-angle glaucoma (POAG). Cross-sectional study. setting: Institutional. study population: 156 patients (89 POAG and 67 normal subjects). observation procedures: One eye of each subject was included. SD OCT peripapillary RT values from 3D volume scans were calculated for 4 quadrants of 3 different sized annuli. Peripapillary retinal nerve fiber layer (RNFL) thickness values were also determined. main outcome measures: Area under the receiver operating characteristic curve (AUROC) values, sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios. The top 5 RT AUROCs for all glaucoma patients and for a subset of early glaucoma patients were for the inferior quadrant of outer circumpapillary annulus of circular grid (OCA) 1 (0.959, 0.939), inferior quadrant of OCA2 (0.945, 0.921), superior quadrant of OCA1 (0.890, 0.811), inferior quadrant of OCA3 (0.887, 0.854), and superior quadrant of OCA2 (0.879, 0.807). Smaller RT annuli OCA1 and OCA2 consistently showed better diagnostic performance than the larger RT annulus OCA3. For both RNFL and RT measurements, best AUROC values were found for inferior RT OCA1 and OCA2, followed by inferior and overall RNFL thickness. Peripapillary RT measurements from 3D volume scans showed excellent diagnostic performance for detecting both glaucoma and early glaucoma patients. Peripapillary RT values have the same or better diagnostic capability compared to peripapillary RNFL thickness measurements, while also having fewer algorithm errors.

Peripapillary retinal nerve fibre layer thickness in women with iron deficiency anaemia

To evaluate peripapillary retinal nerve fibre layer (RNFL) thickness in adult women with iron deficiency anaemia and healthy control subjects. Women with iron deficiency anaemia and age- and sex-matched healthy control subjects were sequentially recruited and underwent detailed ophthalmic examination, including spectral-domain optical coherence tomography (OCT). Serum haemoglobin (Hb), iron and ferritin concentrations, total iron-binding capacity (TIBC) and mean corpuscular volume were determined. Peripapillary RNFL thicknesses in the nasal and inferior quadrants were significantly smaller in patients (n = 40) than in controls (n = 40). In the patient group, there were significant correlations between inferior quadrant RNFL thickness and Hb, and between nasal quadrant RNFL thickness and serum iron and ferritin concentrations, and TIBC. Iron deficiency anaemia reduces RNFL thickness in adult women.

Peripapillary Retinal Nerve Fiber Layer Assessment of Spectral Domain Optical Coherence Tomography and Scanning Laser Polarimetry to Diagnose Preperimetric Glaucoma

PurposeTo compare the abilities of peripapillary retinal nerve fiber layer (RNFL) parameters of spectral domain optical coherence tomograph (SDOCT) and scanning laser polarimeter (GDx enhanced corneal compensation; ECC) in detecting preperimetric glaucoma.MethodsIn a cross-sectional study, 35 preperimetric glaucoma eyes (32 subjects) and 94 control eyes (74 subjects) underwent digital optic disc photography and RNFL imaging with SDOCT and GDx ECC. Ability of RNFL parameters of SDOCT and GDx ECC to discriminate preperimetric glaucoma eyes from control eyes was compared using area under receiver operating characteristic curves (AUC), sensitivities at fixed specificities and likelihood ratios (LR).ResultsAUC of the global average RNFL thickness of SDOCT (0.786) was significantly greater (p<0.001) than that of GDx ECC (0.627). Sensitivities at 95% specificity of the corresponding parameters were 20% and 8.6% respectively. AUCs of the inferior, superior and temporal quadrant RNFL thickness parameters of SDOCT were also significantly (p<0.05) greater than the respective RNFL parameters of GDx ECC. LRs of outside normal limits category of SDOCT parameters ranged between 3.3 and 4.0 while the same of GDx ECC parameters ranged between 1.2 and 2.1. LRs of within normal limits category of SDOCT parameters ranged between 0.4 and 0.7 while the same of GDx ECC parameters ranged between 0.7 and 1.0.ConclusionsAbilities of the RNFL parameters of SDOCT and GDx ECC to diagnose preperimetric glaucoma were only moderate. Diagnostic abilities of the RNFL parameters of SDOCT were significantly better than that of GDx ECC in preperimetric glaucoma.

The relationship between retinal nerve fiber layer thickness and carotid intima media thickness in patients with type 2 diabetes mellitus

AimsThe aim of the present study was to investigate retinal nerve fiber layer (RNFL) thickness in patients with type 2 diabetes mellitus (T2D) using spectral-domain optical coherence tomography and to evaluate the relationship between RNFL thickness and carotid intima media thickness (CIMT). MethodsThis study included 171 patients with T2D (53.2±8.8 years) and age matched 61 healthy controls (51.9±8.1 years). We evaluated anthropometric and metabolic parameters as well as RNFL and CIMT measurements in patients with T2D and controls. The Mann–Whitney U test was used to compare the continuous variables and the Chi-square test was used to compare categorical variables. Spearmanʼs rank correlation test was used for calculation of associations between variables. ResultsThe average RNFL thickness was 84.82±11.22μm in patients with T2D and 92.35±8.45μm in healthy controls (p<0.001). Mean CIMT values were higher in patients with T2D (0.80±0.1mm) than the healthy subjects (0.72±0.1mm) (p<0.001). A significant negative correlation was found between age and all quadrants of RNFL. There was a negative correlation between average RNFL thickness and HbA1c (r=−0.176), uric acid (r=−0.145), CIMT (r=−0.190) and presence of carotid plaque (r=−0.193). The superior RNFL thickness was negatively associated with HbA1c (r=−0.175), CIMT (r=−0.207) and carotid plaque (r=−0.176). There was also an inverse correlation between the inferior RNFL thickness and HbA1c (r=−0.187) and carotid plaque (r=−0.157). ConclusionThinning of RNFL might be associated with atherosclerosis in patients with T2D.

Analysis of peripapilary retinal nerve fiber layer thickness of healthy Chinese from northwestern Shanghai using Cirrus HD-OCT.

To investigate peripapillary retinal nerve fiber layer (RNFL) thickness of healthy Chinese individuals from northwestern Shanghai using Cirrus HD-OCT (Carl Zeiss Meditec, Inc. Dublin, CA, USA). The peripapillary RNFL thickness of 720 eyes from 360 healthy Chinese participants were measured using the Optic Disc Cube 200×200 protocol. Each eye was scanned 3 times. Global and each quadrant's RNFL thickness around the optic nerve were compared between genders, and interocular differences were analyzed. The correlation between global RNFL thickness and age were also assessed in this study. The mean global, superior, nasal, inferior and temporal RNFL thickness of all the eyes were 96.04±7.40 µm, 118.36±13.52 µm, 67.63±8.60 µm, 125.17±13.48 µm, 72.49±10.70 µm, respectively. When analyzing between genders, the mean nasal RNFL thickness of male and female were 68.29±8.44 µm and 66.97±8.70 µm, with statistically significant difference (P=0.038), while the data of global, superior, inferior and temporal quadrant showed no significant difference (all P>0.05). When analyzing interocular differences, the mean RNFL thickness of all the right eyes and all the left eyes were 116.46±13.17 µm and 120.27±13.61 µm in superior quadrant (P<0.001); 68.74±8.80 µm and 66.52±8.25 µm in nasal quadrant (P<0.001); 73.16±10.95 and 71.83±10.41 in temporal quadrant (P<0.001), all having statistically significant differences. There were no statistically significant interocular differences of global and inferior RNFL thickness (both P>0.05). There was a significantly negative correlation (r=-0.618, P<0.001) between the mean global RNFL thickness and the age. In healthy Chinese from northwestern Shanghai, there were no significant differences detected interocular difference and between genders in the mean global RNFL thickness. Nevertheless, significant difference existed in the nasal quadrant between genders, and interocular differences existed in the superior, nasal and temporal quadrants. The RNFL thickness appeared to gradually decrease with age.

Evaluation of Octopus Polar Trend Analysis for Detection of Glaucomatous Progression

To investigate the clinical usefulness of Polar Trend Analysis (PTA) of the Octopus Field Analysis software for detection of glaucoma progression in medically treated glaucoma. One eye each of 52 participants underwent Octopus Normal G2 perimetry and imaging with the RTVue-100 optical coherence tomograph at 6-month intervals (median follow-up 5 years). The eyes were classified as progressors or nonprogressors with PTA, which graphically presents pointwise linear regression analysis of focal defect at the corresponding nerve fiber angle at the disc margin. Polar Trend Analysis progression was defined as more than 1 significantly progressing test point location per sector. Progression of the retinal nerve fiber layer thickness (RNFLT) and ganglion cell complex (GCC) thickness parameters were evaluated with linear regression analysis. Seventeen eyes were classified as PTA progressors (all in the inferotemporal or superotemporal areas or in both), and 35 eyes as nonprogressors. Frequencies of statistically significant RNFLT and GCC progressions did not differ significantly between the groups for any peripapillary area (p&gt;0.05 for all comparisons). Significant inferior average RNFLT progression occurred in 50% of the PTA progressor eyes. Long-term measurement variability during the follow-up period was significantly higher in the PTA progressor group for inferior and superior GCC thickness and inferior average RNFLT (p&lt;0.001 for all comparisons). In glaucoma, PTA may indicate glaucomatous progression earlier than linear regression analysis of the RNFLT and GCC parameters. It may already draw attention to glaucomatous progression when the alteration of the corresponding structural parameters is represented only by increased long-term variability.