Macular Retinal Nerve Fiber Layer Research Articles

The effects of nasal septum deviation on eye posterior segment finding

Aim: Deviation of the nasal septum, which can cause upper respiratory tract obstruction and systemic hypoxia, may also affect the eye. The aim of this study was to detect changes in posterior segment parameters of the eye in patients with nasal septal deviation. Material and Methods: The study included 50 patients with nasal septal deviation, and a control group of 30 healthy subjects with no nasal septal deviation. Choroidal thickness, central macular thickness and retinal nerve fiber layer thickness were measured with Optical Coherence Tomography.Results: Choroidal thickness was significantly lower in patients with severe nasal septal deviation compared to the control group. (p=0.001) There is no statistically significant change in other measurements.Conclusion: The study results suggest that marked nasal septal deviation may lead to significant hypoxia and sympathetic activation, resulting in deterioration of the choroidal blood flow and consequent choroidal thickening.

Evaluation of Papillomacular Nerve Fiber Bundle Thickness in Glaucoma Patients with Visual Acuity Disturbance

ABSTRACT Purpose Assessing the papillomacular nerve fiber bundle (PMB) can identify glaucoma patients with decreased visual acuity. In this study, we explore efficient methods for evaluating PMB thickness in glaucoma patients, based on swept source-optical coherence tomography (SS-OCT). Methods This study included 347 eyes of 205 open-angle glaucoma (OAG) patients. Patients were excluded if they had best-corrected decimal visual acuity < 0.3, axial length >28 mm, non-glaucoma ocular disease, or systemic disease affecting the visual field. We obtained vertical 12.0 × 9.0 mm 3D volume scans covering both the macular and optic disc regions with SS-OCT (DRI OCT Triton, Topcon), and measured the thickness of the PMB, as well as average macular retinal nerve fiber layer thickness (mRNFLT) and macular ganglion cell complex thickness (mGCCT) in the macular map and temporal-quadrant circumpapillary RNFL thickness (tcpRNFLT). We also measured central-strip RNFLT (csRNFLT) and GCC (csGCCT) in a 1.5 × 6.6 mm area of the scan centered between the fovea and optic nerve head. CsRNFLT and csGCCT were divided lengthwise into three 1.5 × 2.2 mm sections. We then calculated Spearman’s rank correlation coefficient between these OCT measurements and visual acuity. Logistic regression analysis was used to find the cutoff value for the OCT measurements to predict logMAR < 0. Results The correlation coefficients with logMAR were 0.38 for mRNFLT, 0.44 for mGCCT, 0.37 for middle csRNFLT, 0.50 for middle csGCCT, and 0.33 for tcpRNFLT (all P < .0001). For middle csGCCT, the area under the curve indicating decreased visual acuity was 0.80, with a cutoff value of 88.6 μm (P < .001). Conclusions We found strong associations between OCT parameters in the PMB, especially middle csGCCT, and visual acuity in patients with OAG. The thickness of the PMB may therefore be valuable information for glaucoma care and may help prevent visual acuity disturbance.

Measurement of Retinal Changes in Primary Acute Angle Closure Glaucoma under Different Durations of Symptoms.

Purpose To investigate the changes of retinal nerve fiber layer (RNFL) in patients after an attack of primary acute angle closure glaucoma (PAACG) and to assess the impact of attack time on prognosis of retinal changes. Design cross-sectional study. Methods Twenty-six patients with unilateral PAACG attack and cataracts from 2017 to 2019 were enrolled. Eyes with PAACG attack time less than 1 day constituted the group A (n = 13), while eyes with PAACG attack time more than 1 day constituted the group B (n = 13). All patients received phacoemulsification and viscogoniosynechialysis after intraocular pressure (IOP) lowering. All patients underwent ophthalmic examinations including IOP, best-corrected visual acuity (BCVA), and visual field (VF). Optical coherence tomography angiography (OCTA) was used to obtain circumpapillary RNFL vessel density (cpVD). Spectral domain optical coherence tomography (SD-OCT) was used to examine the peripapillary RNFL and macular ganglion cell complex (GCC). All patients accepted 2 assessments before and 1 month after the procedure. Results The IOP of all patients recovered to normal (12.77 ± 2.65 mm Hgvs. 12.77 ± 3.85 mmHg, p=0.834) after the procedure. Patients in the group A had better BCVA improvement than those in the group B (1.32 ± 0.84 vs. 0.50 ± 0.21, p=0.004), as well as better mean defect (MD) values from VF (−3.65 ± 2.54 vs −16.05 ± 5.99, p < 0.001). Compared with group B, patients in the group A had thicker macula (Fovea area: 255.00 ± 27.94 μm vs. 203.92 ± 59.73 μm, p=0.010), thicker GCC (82.62 ± 8.76 μm vs. 65.23 ± 18.56 μm, p=0.005), and thicker RNFL (105.08 ± 9.38 μm vs. 77.69 ± 20.23 μm, p < 0.001). Higher blood flow density in all-plexus peripapillary retina was observed in the group A eyes compared with group B (full sector: 0.56 ± 0.02 vs. 0.41 ± 0.07, p < 0.001). In both groups, the association between average RNFL thickness and cpVD as well as MD values and pattern standard deviation (PSD) values from VF was stronger (R2 = 0.58, 0.60, −0.54, respectively, all p < 0.001) than the association between GCC thickness and cpVD, as well as MD values and PSD values (R2 = 0.37, p=0.001; R2 = 0.37, p=0.001; R2 = −0.27, p=0.007). Conclusion Patients with attack time less than 1 day had better retinal thickness and all-plexus peripapillary retina blood flow density. Controlling the attack time could decrease retinal damage by PAACG.

Normative Data and Minimally Detectable Change for Inner Retinal Layer Thicknesses Using a Semi-automated OCT Image Segmentation Pipeline.

Neurodegenerative and neuroinflammatory diseases regularly cause optic nerve and retinal damage. Evaluating retinal changes using optical coherence tomography (OCT) in diseases like multiple sclerosis has thus become increasingly relevant. However, intraretinal segmentation, a necessary step for interpreting retinal changes in the context of these diseases, is not standardized and often requires manual correction. Here we present a semi-automatic intraretinal layer segmentation pipeline and establish normative values for retinal layer thicknesses at the macula, including dependencies on age, sex, and refractive error. Spectral domain OCT macular 3D volume scans were obtained from healthy participants using a Heidelberg Engineering Spectralis OCT. A semi-automated segmentation tool (SAMIRIX) based on an interchangeable third-party segmentation algorithm was developed and employed for segmentation, correction, and thickness computation of intraretinal layers. Normative data is reported from a 6 mm Early Treatment Diabetic Retinopathy Study (ETDRS) circle around the fovea. An interactive toolbox for the normative database allows surveying for additional normative data. We cross-sectionally evaluated data from 218 healthy volunteers (144 females/74 males, age 36.5 ± 12.3 years, range 18–69 years). Average macular thickness (MT) was 313.70 ± 12.02 μm, macular retinal nerve fiber layer thickness (mRNFL) 39.53 ± 3.57 μm, ganglion cell and inner plexiform layer thickness (GCIPL) 70.81 ± 4.87 μm, and inner nuclear layer thickness (INL) 35.93 ± 2.34 μm. All retinal layer thicknesses decreased with age. MT and GCIPL were associated with sex, with males showing higher thicknesses. Layer thicknesses were also positively associated with each other. Repeated-measurement reliability for the manual correction of automatic intraretinal segmentation results was excellent, with an intra-class correlation coefficient >0.99 for all layers. The SAMIRIX toolbox can simplify intraretinal segmentation in research applications, and the normative data application may serve as an expandable reference for studies, in which normative data cannot be otherwise obtained.

Decreased retinal thickness in patients with Alzheimer's disease is correlated with disease severity.

Background and purposeThe loss of retinal ganglion cells observed in Alzheimer’s disease (AD) may be attributable to a neurodegeneration of the neuro-retinal structure. Amnestic mild cognitive impairment (aMCI) has been considered a prodromal stage of AD. We evaluated retinal thicknesses in patients with aMCI and AD compared to healthy controls using spectral-domain optical coherence tomography (OCT) to investigate whether changes in retinal thickness are correlated with the clinical severity of dementia.MethodsPatients with aMCI (n = 14), mild to moderate AD (n = 7), severe AD (n = 9), and age-matched controls (n = 17) underwent neuro-ophthalmologic examinations. Global deterioration scale (GDS), clinical dementia rating (CDR), and mini-mental status examination (MMSE) were used to evaluate the clinical overall severity of dementia. The thicknesses of the peripapillary retinal nerve fiber layer (RNFL), total macula, and macular ganglion cell-inner plexiform layer (GC-IPL) were measured using Cirrus HD-OCT.ResultsThe severe AD group had overall significantly thinner GC-IPL, total macula, and peripapillary RNFL compared to the controls (p<0.05). In the mild to moderate AD group, the total macula, average RNFL, and superior RNFL thickness were each significantly reduced compared to controls (p<0.05). The aMCI group had reduced total macula, average RNFL, and inferior RNFL thickness, but there were no significant differences compared to the controls. The GDS and CDR scores had a negative correlation with the thickness of the GC-IPL and the total macula. The MMSE scores had a positive correlation with both the total macular and average RNFL thickness, when adjusted for age (p<0.05).ConclusionsThis study confirmed that retinal thickness is decreased in AD patients. There is a correlation between reduced retinal thickness and the clinical severity of dementia.

The correlation between the thickness of the inner macular layers and the mean deviation of the visual field in children with primary congenital glaucoma

Abstract Purpose To analyse the association between the thickness of the circumpapillary retinal nerve fibre layer (cpRNFL) and the thickness of the inner macular layers with the mean deviation of the visual field (MD) in children with primary congenital glaucoma (PCG). Materials and Methods A total of 41 children with PGC were included in the study. They all had a complete ophthalmological examination, including visual acuity, intraocular pressure, funduscopy, Octopus™ visual field, as well as circumpapillar and macular spectral domain optical coherence tomography (SD-OCT). SD-OCT with automated segmentation was used to measure the thicknesses and volumes of the macular retinal nerve fibre layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer. Results The mean age was 11.2 ± 3.86 years, and the mean MD was 8.85 ± 6.76 dB. The visual field was classified as normal in 46% of the patients, and 20% of the patients had a concentrical restriction of the visual field. A positive correlation was found between between the cup-to-disc ratio and the MD, r = 0.51 (P = 0.004). The correlation between the MD and the cpRNFL was r = −0.63 (P Conclusions Inner macular layers thickness and cpRNFL thickness show a good correlation with the mean deviation of the visual field in children with primary congenital glaucoma.

Optical Coherence Tomography Findings After Childhood Lensectomy.

PurposeTo explore the impact of childhood lensectomy on posterior segment development.MethodsCross-sectional observational study at children's eye clinics at a tertiary referral center in London, UK. We included 45 children age 4 to 16 years with healthy eyes and 38 who had undergone lensectomy. We acquired posterior segment optical coherence tomography scans of both eyes. We used parametric and nonparametric tests in SPSS24 for the comparison of parameters between groups and within individuals; a P value less than 0.05 was considered significant. The main outcome measures were foveal pit depth and subfoveal choroidal thickness (CT). Secondary outcomes were inner and outer ring CT and photoreceptor layer parameters, macular and peripapillary retinal nerve fiber layer thickness.ResultsFoveal pit depth and subfoveal CT are significantly reduced in eyes that have undergone lensectomy compared with nonoperated eyes. Inner ring CT and outer ring CT are reduced. Foveal inner retinal layer thickness is increased. Mean inner retinal and outer nuclear layer thickness are not affected.ConclusionsChildhood lensectomy is associated with a reduction in developmental foveal pit deepening and lack of developmental thickening of the posterior choroid. Mechanical and optical disruption of foveal and subfoveal choroidal development may affect structural foveal development after childhood lensectomy.

Thinning rates of retinal nerve layer and ganglion cell-inner plexiform layer in various stages of normal tension glaucoma

AimsTo compare the changes in the macular retinal nerve fibre layer (mRNFL), macular ganglion cell layer and inner plexiform layer (mGCIPL), and circumpapillary retinal nerve fibre layer (cpRNFL) in various...

Focal Thickness Reduction of the Ganglion Cell-Inner Plexiform Layer Best Discriminates Prior Optic Neuritis in Patients With Multiple Sclerosis.

PurposeThe goal was to visualize topographic thickness maps of the intraretinal layers and evaluate their discrimination abilities and relationships with clinical manifestations in patients with multiple sclerosis (MS) and a history of optic neuritis (ON).MethodsThirty patients with relapsing-remitting MS (34 eyes with a history of ON [MSON] and 26 non-ON fellow eyes [MSFE]) were recruited together with 63 age- and sex-matched controls (HC). Ultrahigh resolution optical coherence tomography was used to image the macula and the volumetric data set was segmented to yield six intraretinal layers. Topographic thickness maps were aligned and averaged for the visualization. The thickness maps were partitioned using the Early Treatment Diabetic Retinopathy Study (ETDRS) and related to Sloan low-contrast letter acuity (LCLA), Expanded Disability Status Scale (EDSS), and disease duration.ResultsFocal thickness reduction occurred in the macular retinal nerve fiber layer (mRNFL) and ganglion cell-inner plexiform layer (GCIPL), with the most profound reduction occurring in MSON eyes (P < 0.05). A horseshoe-like thickness reduction pattern (U Zone) in the GCIPL appeared in MSON. The thickness of the U Zone had better discrimination power than the ETDRS partitions (area under the curve = 0.97) and differentiated 96% of MSON from HC. The thickness of the U Zone was positively correlated to 2.5% LCLA (r = 0.38, P < 0.05) and 1.25% LCLA (r = 0.57, P < 0.05).ConclusionsThe horseshoe-like thickness reduction of the GCIPL appeared to be an ON-specific focal thickness alteration with the highest discrimination power of prior ON.

Optical coherence tomography analysis of inner and outer retinal layers in eyes with chiasmal compression caused by suprasellar tumours.

To compare postoperative macular thickness measurements of inner and outer retinal layers in eyes of patients with chiasmal compression with or without visual field (VF) recovery and healthy controls using optical coherence tomography (OCT). Macular spectral-domain OCT has been used for the auto-segmentation of images obtained from 100 eyes affected with chiasmal compression compared with 100 healthy controls enrolled in this study. We have divided eyes with chiasmal compression into two groups: group 1 characterized by VF recovery after tumour excision and group 2 showing partial or no recovery of VF. The thickness of the macular retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), photoreceptor layer (PRL), inner retinal layer (IRL) and outer retinal layer (ORL) was segmented. The correlation between macular RNFL (mRNFL) and functional parameters has been analysed. Both groups 1 and 2 showed significant thinning of RNFL, GCL, IPL and IRL in all quadrants. However, no significant changes have been detected in PRL and ORL of patients in either group compared with healthy controls. A significant thickening was detected in INL and ONL of group 2 compared with healthy controls and group 1. Postoperative mRNFL thickness is significantly correlated with VF defects and visual acuity except temporal quadrant. Eyes with chiasmal compression showed thinning of the inner retinal layers with thickening of the INL and ONL in patients with partial to no recovery of VF. The changes in retinal microstructures are well-correlated with functional recovery. Further studies are needed to reveal the clinical implications of these findings in patients with chiasmal compression.

Optical Coherence Tomography Evaluation of Retinal Nerve Fiber Layer and Ganglion Cell Layer Thickness before and after Argon Laser in Treatment of Diabetic Retinopathy

Background: Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes with the potential to cause severe vision loss and blindness and a devastating effect on quality of life. Objective: Discuss the macular ganglion cell and retinal nerve fiber layer (RNFL) changes after laser treatment as a management of diabetic retinopathy. Patients and Methods: This study was carried out on 55 eyes of 35 patients designed as a prospective, interventional case series at Sohag Ophthalmic Diagnostic Laser Unit between January 2016 and March 2017. A complete ophthalmologic examination was performed, including best-corrected visual acuity (BCVA) using the ETDRS charts, intraocular pressure (IOP) measurement, slit-lamp biomicroscopic examination, fundus examination, fluorescein angiography, and 3D optical coherence tomography (OCT) 2000. Results: The value of RNFL (superior and total) in the GRID group is more than in the pan-retinal photocoagulation (PRP) group which increased at 1 month post laser (not significant) then significantly decreased at 6 month follow up. The value of RNFL (inferior) in the GRID group is more than in the PRP group which significantly increased at 1 month post laser then decreased at 6 month follow up table 4. Conclusion: Significant ganglion cell (GC) and RNLF decrease at the sixth month of follow-up can be attributed to axonal loss secondary to direct or indirect effects of PRP treatment. SD OCT is a very valuable tool to document the RNFL thickness changes following the argon laser photocoagulation.

Optical Coherence Tomography Evaluation of Retinal Nerve Fiber Layer and Ganglion Cell Layer Thickness before and after Argon Laser in Treatment of Diabetic Retinopathy

Background: Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes with the potential to cause severe vision loss and blindness and a devastating effect on quality of life. Objective: Discuss the macular ganglion cell and retinal nerve fiber layer (RNFL) changes after laser treatment as a management of diabetic retinopathy. Patients and Methods: This study was carried out on 55 eyes of 35 patients designed as a prospective, interventional case series at Sohag Ophthalmic Diagnostic Laser Unit between January 2016 and March 2017. A complete ophthalmologic examination was performed, including best-corrected visual acuity (BCVA) using the ETDRS charts, intraocular pressure (IOP) measurement, slit-lamp biomicroscopic examination, fundus examination, fluorescein angiography, and 3D optical coherence tomography (OCT) 2000. Results: The value of RNFL (superior and total) in the GRID group is more than in the pan-retinal photocoagulation (PRP) group which increased at 1 month post laser (not significant) then significantly decreased at 6 month follow up. The value of RNFL (inferior) in the GRID group is more than in the PRP group which significantly increased at 1 month post laser then decreased at 6 month follow up table 4. Conclusion: Significant ganglion cell (GC) and RNLF decrease at the sixth month of follow-up can be attributed to axonal loss secondary to direct or indirect effects of PRP treatment. SD OCT is a very valuable tool to document the RNFL thickness changes following the argon laser photocoagulation.

Effect of Diabetic Retinopathy on Retinal Nerve Fiber Layer Thickness

Background: Diabetic retinopathy is one of the most common causes of vision loss in developed countries. Objective: The objective of this study was to assess the effect of diabetic retinopathy (DR) on the retinal nerve fiber layer (RNFL) thickness. Patients and methods: This study was carried out on 55 eyes of 35 patients designed as a prospective, interventional case series at Sohag Hospital from January, 2016 to December, 2016. A complete ophthalmologic examination was performed including best-corrected visual acuity (BCVA) using the ETDRS charts, intraocular pressure (IOP) measurement, slit-lamp biomicroscopic examination, fundus examination and fluorescein angiography. Results: The RNFL (inferior and total) thickness at each follow-up was increased significantly from baseline to 1 month and 6 months post-PRP then decreased significantly from 1 month to 6 months follow up (p 0.05). Conclusion: Increase in the macular Ganglion cell (GC) thickness and RNFL at 1 month of follow-up that may be related to laser induced intraretinal inflammation which triggers increased capillary permeability and ensuing axonal edema due to the cytokine release.

Effect of Diabetic Retinopathy on Retinal Nerve Fiber Layer Thickness

Background: Diabetic retinopathy is one of the most common causes of vision loss in developed countries. Objective: The objective of this study was to assess the effect of diabetic retinopathy (DR) on the retinal nerve fiber layer (RNFL) thickness. Patients and methods: This study was carried out on 55 eyes of 35 patients designed as a prospective, interventional case series at Sohag Hospital from January, 2016 to December, 2016. A complete ophthalmologic examination was performed including best-corrected visual acuity (BCVA) using the ETDRS charts, intraocular pressure (IOP) measurement, slit-lamp biomicroscopic examination, fundus examination and fluorescein angiography. Results: The RNFL (inferior and total) thickness at each follow-up was increased significantly from baseline to 1 month and 6 months post-PRP then decreased significantly from 1 month to 6 months follow up (p 0.05). Conclusion: Increase in the macular Ganglion cell (GC) thickness and RNFL at 1 month of follow-up that may be related to laser induced intraretinal inflammation which triggers increased capillary permeability and ensuing axonal edema due to the cytokine release.

VISUAL FUNCTION AND RETINAL CHANGES IN PATIENTS WITH BIPOLAR DISORDER.

To evaluate visual and retinal changes in patients with bipolar disorder. To analyze the correlation between structural changes and visual function parameters. Thirty patients with bipolar disorder and 80 healthy controls underwent visual function evaluation with Early Treatment Diabetic Retinopathy Study charts at 100%, 2.50%, and 1.25% contrast, Pelli-Robson chart, and color vision Farnsworth and Lanthony tests. Analysis of the different retinal layers was performed using Spectralis optical coherence tomography with automated segmentation software. Correlation analysis between structural and functional parameters was conducted. Patients with bipolar disorder presented worse color vision compared with controls (Lanthony's index, P = 0.002). Full macular thickness, the retinal nerve fiber layer (RNFL), ganglion cell layer, and inner plexiform layer were reduced in patients compared with healthy individuals (P < 0.005). The inner nuclear layer was significantly thickened in patients (P < 0.005). Peripapillary RNFL thickness was reduced in all temporal sectors (P < 0.005). Significant correlations were found between visual acuity and the RNFL thickness, the Pelli-Robson score and the inner plexiform layer, and between the Lanthony's color index and the ganglion cell layer thickness. Patients with bipolar disorder present quantifiable thinning of the macular RNFL, ganglion cell layer, and inner plexiform layer, as well as in the peripapillary RNFL thickness, and increasing thinning in the inner nuclear layer.

Vascular Patterns in Retinitis Pigmentosa on Swept-Source Optical Coherence Tomography Angiography.

Background: Retinitis Pigmentosa (RP) represents a retinal dystrophy with an extremely complex pathogenesis further worsened by the impairment of the retinal vascular supply. The main goal of this study was to identify different vascular patterns in RP, by means of optical coherence tomography angiography (OCTA). Methods: A total of 32 RP patients (16 males, 50%; mean age 45.93 ± 11.4) and 32 healthy age-matched controls (16 males, 50%; age 42.8 ± 11.2). High resolution OCT and OCTA images were obtained from all participants. Several quantitative parameters were extracted both from structural OCT and OCTA images. A post-hoc analysis assessed the relationship between the quantitative OCTA parameters adopted and the following measures: best corrected visual acuity (BCVA), central macular thickness (CMT) and retinal nerve fiber layer (RNFL). Results: Mean LogMAR BCVA was 0.24 ± 0.32 for RP patients and 0.0 ± 0.0 for controls (p < 0.01). CMT, choroidal thickness and RNFL were statistically different between RP and controls (p < 0.01). OCTA parameters showed strong alterations of the retinal vascular network in RP (all p < 0.01). Several statistically significant correlations were also found. Furthermore, a vessel tortuosity cut-off of 4.80 and a vessel rarefaction cut-off of 0.62 enabled the RP cohort to be divided into two significantly different sub-groups in terms of BCVA, RNFL and CMT. Conclusions: Quantitative OCTA parameters help identify vascular abnormalities in RP, separating two different vascular patterns.

Optical Coherence Tomography Assessment of Risk Factors for Visual Acuity Decline After Trabeculectomy in Patients With Advanced Open-Angle Glaucoma.

To identify structural parameters that could predict VA decline after trabeculectomy in patients with advanced open-angle glaucoma. Retrospective review of 74 eyes of 74 patients with advanced glaucoma (defined as mean deviation -12 dB or worse) and best-corrected VA (BCVA) of ≥40/200. All patients underwent trabeculectomy between 2013 and 2016. Measurements included intraocular pressure, BCVA, visual field parameters, and optical coherence tomography-derived parameters [(in both the overall macula and within the papillomacular bundle (PMB)], including mRNFL thickness (mRNFLT), ganglion cell layer/inner plexiform layer thickness, and ganglion cell complex thickness. Measurements were obtained before and after surgery, and follow-up was at least 6 months. We grouped the patients according to whether they underwent VA decline of >3 lines of BCVA after 6 months. We then compared the VA-decline group and the stable-VA group and performed a receiver operating characteristic analysis to determine optimal cut-off values for predicting VA decline. The VA-decline group comprised 7 eyes (9.5%) and had lower preoperative mean deviation (P=0.021) and thinner mRNFL, ganglion cell layer/inner plexiform layer, and ganglion cell complex in the PMB (P=0.003, 0.135, and 0.023, respectively) than the stable-VA group. The cut-off values for predicting VA decline were 9.5 μm for mRNFLT in the PMB. This study found that thin mRNFLT in the PMB were risk factors for VA decline after trabeculectomy.

Outer Retinal Dysfunction on Multifocal Electroretinography May Help Differentiating Multiple Sclerosis From Neuromyelitis Optica Spectrum Disorder.

Purpose: To evaluate the intermediate and outer retina of patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) using OCT and multifocal electroretinography (mf-ERG).Methods: Patients with MS (n = 30), NMOSD (n = 30), and healthy controls (n = 29) underwent visual field (VF), OCT, and mf-ERG testing. The eyes were distributed into 5 groups: MS with or without history of ON (MS+ON, MS–ON), NMOSD with or without ON (NMOSD+ON, NMOSD–ON), and controls. The thickness of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer, outer plexiform layer, outer nuclear layer, and photoreceptor layer was measured. mf-ERG P1 and N1 responses were registered and grouped in 3 sets of rings. The groups were compared using GEE models, and effect size (ES) calculated.Results: Compared to controls, GCL and IPL thickness was significantly smaller in MS+ON (both p < 0.01), MS–ON (p < 0.01 and p = 0.015, respectively), NMOSD+ON (both p < 0.01) and NMOSD–ON (p = 0.03 and p = 0.018, respectively). ES was >0.80. mRNFL was smaller in three of the above groups (p < 0.01, p < 0.001, and p = 0.028; ES > 0.80) but not in MS–ON eyes (p = 0.18). No significant difference was observed for the remaining layers. Compared to controls, P1 and N1 peak times were shorter in MS (p-values in the range 0.049–0.002, ES < 0.50; and 0.049–0.010; ES < 0.50, respectively) but not in NMOSD. These abnormalities were strongly correlated with intermediate and outer retinal layer thickness.Conclusions: mf-ERG data suggest outer retinal abnormalities in MS, but not in NMOSD. Our results may help understand how the two conditions differ regarding retinal damage.

Correlación entre el grosor de las capas internas de la retina y el defecto medio del campo visual en pacientes con glaucoma congénito primario

PurposeTo analyse the association between the thickness of the circumpapillary retinal nerve fibre layer (cpRNFL) and the thickness of the inner macular layers with the mean deviation of the visual field (MD) in children with primary congenital glaucoma (PCG). Material and methodsA total of 41 children with PGC were included in the study. They all had a complete ophthalmological examination, including visual acuity, intraocular pressure, funduscopy, Octopus™ visual field, as well as circumpapillar and macular spectral domain optical coherence tomography (SD-OCT). SD-OCT with automated segmentation was used to measure the thicknesses and volumes of the macular retinal nerve fibre layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer. ResultsThe mean age was 11.2±3.86 years, and the mean MD was 8.85±6.76dB. The visual field was classified as normal in 46% of the patients, and 20% of the patients had a concentrical restriction of the visual field. A positive correlation was found between between the cup-to-disc ratio and the MD, r=0.51 (P=.004). The correlation between the MD and the cpRNFL was r=-0.63 (P<.001), and r=–0.69 (P<.001) with the GCL. ConclusionsInner macular layers thickness and cpRNFL thickness show a good correlation with the mean deviation of the visual field in children with primary congenital glaucoma.

Comparison of Associations with Different Macular Inner Retinal Thickness Parameters in a Large Cohort: The UK Biobank

To describe and compare associations with macular retinal nerve fiber layer (mRNFL), ganglion cell complex (GCC), and ganglion cell-inner plexiform layer (GCIPL) thicknesses in a large cohort. Cross-sectional study. We included 42 044 participants in the UK Biobank. The mean age was 56 years. Spectral-domain OCT macular images were segmented and analyzed. Corneal-compensated intraocular pressure (IOPcc) was measured with the Ocular Response Analyzer (Reichert, Corp., Buffalo, NY). Multivariable linear regression was used to examine associations with mean mRNFL, GCC, and GCIPL thicknesses. Factors examined were age, sex, ethnicity, height, body mass index (BMI), smoking status, alcohol intake, Townsend deprivation index, education level, diabetes status, spherical equivalent, and IOPcc. Thicknesses of mRNFL, GCC, and GCIPL. We identified several novel independent associations with thinner inner retinal thickness. Thinner inner retina was associated with alcohol intake (most significant for GCIPL: -0.46 μm for daily or almost daily intake compared with special occasion only or never [95% confidence interval (CI), 0.61-0.30]; P= 1.1×10-8), greater social deprivation (most significant for GCIPL: -0.28 μm for most deprived quartile compared with least deprived quartile [95% CI, -0.42 to -0.14]; P= 6.6×10-5), lower educational attainment (most significant for mRNFL: -0.36 μm for less than O level compared with degree level [95% CI, -0.45 to 0.26]; P= 2.3×10-14), and nonwhite ethnicity (most significant for mRNFL comparing blacks with whites: -1.65 μm [95% CI, -1.86 to -1.43]; P= 2.4×10-50). Corneal-compensated intraocular pressure was associated most significantly with GCIPL (-0.04 μm/mmHg [95% CI, -0.05 to -0.03]; P= 4.0×10-10) and was not associated significantly with mRNFL (0.00 μm/mmHg [95% CI, -0.01 to 0.01]; P= 0.77). The variables examined explained a greater proportion of the variance of GCIPL (11%) than GCC (6%) or mRNFL (7%). The novel associations we identified may be important to consider when using inner retinal parameters as a diagnostic tool. Associations generally were strongest with GCIPL, particularly for IOP. This suggests that GCIPL may be the superior inner retinal biomarker for macular pathophysiologic processes and especially for glaucoma.