Nerve Fiber Layer Thickness Research Articles

Effects of SMILE Surgery on Intraocular Pressure, Central Corneal Thickness, Axial Length, Peripapillary Retinal Nerve Fiber Layer, and Macular Ganglion Cell Complex Thickness

Purpose. To evaluate the change in intraocular pressure (IOP), central corneal thickness (CCT), axial length, peripapillary retinal nerve fiber layer (RNFL) thickness, and macular ganglion cell complex (GCC) thickness after small incision lenticule extraction (SMILE) surgery. Methods. This prospective observational study was conducted in Espace Nouvelle Vision, Ophthalmological Clinic, Paris, France. Fifty eyes of 25 patients were enrolled in this study and underwent SMILE surgeries. IOP, central corneal thickness (CCT), axial length (AL), peripapillary RNFL thickness, and macular GCC thickness were measured before and at 3 months after SMILE. Results. The mean preoperative spherical equivalent was −3.15 ± 1.50 diopters (D), and the mean postoperative value was 0.15 ± 0.28 D. After SMILE surgery, IOP decreased from 15.03 ± 2.79 mmHg to 11.02 ± 2.73 mmHg and 10.02 ± 2.21 mmHg at 1 and 3 months, respectively ( P < 0.01 for both comparisons). The mean decrease in measured IOP as a function of ablation depth was 0.065 ± 0.031 mmHg/μm. CCT decreased from 545.98 ± 26.61 μm to 478.40 ± 30.26 μm after SMILE surgery ( P < 0.01 ). AL decreased from 24.80 ± 0.84 mm to 24.70 ± 0.83 mm ( P < 0.01 ). There was no statistically significant change in mean peripapillary RNFL or mean GCC thickness after SMILE surgery. Conclusions. SMILE surgery modified IOP measurement, CCT, and AL but did not change peripapillary RNFL and macular GCC thicknesses. The postoperative drop in measured IOP might be explained by the decreased CCT. An accurate re-evaluation of AL should be performed before cataract surgery among post-SMILE patients.

Consistency between optical coherence tomography and humphrey visual field for evaluating glaucomatous defects in high myopic eyes

BackgroundThe study is to investigate the influence of high myopia on the consistency between optical coherence tomography (OCT) and visual field in primary open-angle glaucoma (POAG).MethodsWe enrolled 37 patients with POAG with high myopia (POAG-HM group), 27 patients with POAG without high myopia (POAG group), and 29 controls with high myopia (HM group). All subjects underwent Humphrey perimetry (30–2 and 10–2 algorithms). The peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured using Cirrus HD-OCT. Spearman’s rank correlation analysis was used to determine correlations between OCT and perimetric parameters. Agreement was analyzed by cross-classification and weighted κ statistics.ResultsIn POAG group, the cross-classification analysis showed strong agreement between the inferior temporal GCIPL thickness and the mean sensitivity (MS) of 10–2 algorithms (κ = 0.5447, P = 0.0048), and good agreement between the superior and inferior RNFL thicknesses and 30–2 MS (κ = 0.4407 and 0.4815; P < 0.05). In the POAG-HM group, only the inferior temporal GCIPL thickness showed good agreement with 10–2 MS (κ = 0.3155, P = 0.0289) and none of the RNFL sectors were in good agreement with the corresponding MS.ConclusionsIn POAG patients with high myopia, changes in macular measurements were in accordance with visual field defects, and RNFL thickness did not consistently decline with visual field defects due to the effects of high myopia. This study suggests that during diagnosis and follow-up of glaucoma with high myopia, more attention need to be focused on structure and functional defects in macular areas.

Retinal vascularity, nerve fiber, and ganglion cell layer thickness in thyroid eye disease on optical coherence tomography angiography

ABSTRACT Purpose To compare the retinal vascularity, peripapillary vascularity, nerve fiber layer thickness and ganglion cell layer thickness between active, inactive thyroid eye disease (TED) and healthy eyes. Methods Retrospective comparative cross-sectional cohort study. Patients with TED, active and inactive on the VISA score, and healthy eyes were included. All patients underwent optical coherence tomography angiography with detailed demographic and clinical data capture. Using automated software, retinal and peripapillary vascularity index, nerve fiber layer thickness, and ganglion cell layer thickness were calculated and were compared between the groups. Results Twenty-four eyes with active TED, 102 eyes with inactive TED and 52 healthy eyes were included. Independent sample t test was used to compare parametric data and Mann-Whitney test to compare non-parametric data. The age and gender were comparable across groups. The peripapillary vascularity index (26.82 ± 4.13 versus 34.92 ± 5.08, p = .002) and the macular vascularity index (20.32 ± 2.5 versus 31.21 ± 3.89, p < .0001) were reduced in active TED eyes versus inactive eyes. Macular vascularity index was comparable in the inactive versus the healthy eyes. The RNFL thickness was increased in the active TED eyes versus the inactive eyes (45.11 ± 18.3 versus 35.55 ± 7, p = .03) and active versus healthy eyes (45.11 ± 18.3 versus 36.28 ± 7.89, p = .03). Ganglion cell layer thickness between all three groups was comparable. Conclusion Decrease in peripapillary and macular vascular density and increase in RNFL thickness are seen in active TED compared to inactive TED and healthy eyes. In disease inactivity, these parameters are comparable to healthy eyes.

Investigation of associations between Piezo1 mechanoreceptor gain-of-function variants and glaucoma-related phenotypes in humans and mice

Glaucoma disproportionately affects individuals of African descent. Prior studies of the PIEZO1 mechanoreceptor have suggested a possible role in glaucoma pathophysiology. Here, we investigated associations between a Piezo1 gain-of-function variant common in individuals of African descent with glaucoma-related phenotypes. We analyzed whole genome sequences to identify Piezo1 variants and their frequencies among 1565 human participants. For the most common variant (e756del), we compared phenotypes between heterozygotes, homozygotes, and wildtypes. Longitudinal mixed effects models of visual field mean deviation (MD) and retinal nerve fiber layer (RNFL) thickness were used to evaluate progression. Based on trends in the models, further investigation was conducted using Piezo1 gain-of-function mice. About 30% of African descent individuals had at least one e756del allele. There were trends suggesting e756del was associated with higher IOPs, thinner RNFLs, lower optic nerve head capillary densities, and greater decreases in MD and RNFL thickness over time, but these did not reach statistical significance. Among mice, increased Piezo1 activity was not significantly associated with IOP or retinal ganglion cell density. Our study confirms that the Piezo1 e756del gain-of-function variant is a frequent polymorphism present in African descent individuals but is unrelated to examined differences in glaucoma phenotypes. Ongoing work is needed to elucidate the role of Piezo1-mediated mechanotransduction in glaucoma.

The evaluation of juvenile ocular hypertension by optical coherence tomography angiography

BackgroundVessel density (VD) of the elderly ocular hypertension patients measured by optical coherence tomography angiography (OCTA) have been reported. However, the studies of VD in juvenile ocular hypertension (JOHT) are limited. We wished to evaluate VD changes using OCTA in JOHT. We also investigated the potential risk parameters of intraocular pressure (IOP) and vertical cup/disc ratio (CDR) with OCTA for observing the development of JOHT.MethodsWe examined 86 eyes in 45 control (Ctrl) subjects and 65 eyes in 34 patients with JOHT using OCTA at the glaucoma clinic of the Eye, Ear, Nose, and Throat Hospital of Fudan University. The VD of radial peripapillary capillaries (RPC) and the perifoveal superficial vascular plexus (SVP) was compared between the Ctrl and JOHT groups. Other basic study factors such as age, sex, blood pressure, best-corrected visual acuity, central corneal thickness, IOP, CDR, the thickness of the retinal nerve fiber layer, ganglion cell complex, visual field mean deviation, and pattern standard deviation were also recorded.ResultsBare difference was found in the nasal-inferior and temporal RPC-VD between the Ctrl and JOHT groups (P = 0.042 and P = 0.033, respectively) while SVP-VD was not (all P > 0.05). In the mixed linear regression model analysis, temporal RPC-VD was marginally negatively associated with high IOP (r = − 1.379, P = 0.043). Five additional sections of nasal, inferior-nasal, inferior-temporal, superior-temporal, and superior-nasal RPC-VD showed positive correlation with large CDR (all P < 0.05). SVP-VD in the superior and nasal regions was marginally negatively correlated with high IOP (r = − 1.877, P = 0.023; r = − 1.693, P = 0.049). No other regions were found statistical different of relationship between IOP, CDR and VD.ConclusionsNasal-inferior and temporal peripapillary VD was marginally lower in JOHT subjects. Regarding parameters of IOP and CDR, peripapillary temporal VD had a borderline level of negative correlation with IOP more than 21 mmHg while additional five regions were strongly positively correlated with large CDR. Some macular regions only found marginal positive correlation with parameter of high IOP. We conclude that OCTA can be used as a potential technique to evaluate the VD in JOHT and peripapillary scans should be analyzed individually based on different levels of CDR.

Association of Retinal Nerve Fiber Layer (RNFL) Thickness with Smoking Using Optical Coherence Tomography (OCT) in Pakistani Population

Background: Smoking has multisystem effects on human body due to hypoxia and systemic inflammation, which it produces. This contributory effect is observed in ocular tissues as well. The aim of the study was to evaluate retinal nerve fiber layer (RNFL) thickness in healthy individuals with a history of smoking, using optical coherence tomography (OCT). Methods: Patients healthy eyes n=300 were examined. Two groups were made; Group A with history of smoking (n=50) and Group B with no history of smoking (n=250). Subjects with a history of diabetes, hypertension, raised intra ocular pressure (IOP &gt;21 mmHg), any neurological disease or family history of glaucoma were excluded from the study. Independent t-test was used to assess the thickness variation with smoking status. ANOVA was used to analyze the differences in both groups. p value &lt;0.05 was taken as significant. Results: The mean retinal nerve fiber layer (RNFL) thickness was found to be 96.44 ± 9.32 μm in Group A eyes. It was found to be significantly increased (p=0.02) in Group B 99.54 ± 9.32 μm. The mean RNFL thickness 93.52 ± 8.60 μm in smokers with history of more than 10 years was found decreased compared to the thickness 98.66 ± 3.96 μm in those with history of smoking less than 10 years. Conclusion: Retinal nerve fiber layer (RNFL) was found to be decreased in subjects with positive history of smoking. This difference signifies that smoking is associated with ocular pathologies. Future protocols may be included in screening for RNFL thickness in smokers for early detection and prevention of optical diseases. Keywords: Smoking; Retina; Retinal Nerve Fiber Layer (RNFL); Retinal Damage; Optical Coherence Tomography (OCT).

Alcohol consumption is associated with glaucoma severity regardless of ALDH2 polymorphism

The present study investigated the effect of aldehyde dehydrogenase2 (ALDH2) rs671 polymorphism and alcohol consumption on the severity of primary open-angle glaucoma (POAG). The questionnaire for alcohol consumption pattern and targeted genotyping for ALDH2 rs671 polymorphism was performed from 445 Korean POAG patients. Retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured and compared according to alcohol consumption and ALDH2 rs671 genotype. Heavy drinking group eyes had thinner RNFL thickness than did abstinence group eyes (65.0 ± 10.9 vs. 70.9 ± 11.5 µm, P = 0.023). Both mild (65.8 ± 9.6 µm) and heavy (63.8 ± 8.4 µm) drinking group eyes had significantly thinner macular GCIPL thickness than did abstinence group eyes (68.1 ± 8.2 µm, P = 0.003). However, ALDH2 rs671 polymorphism did not show any significant association with RNFL or GCIPL thickness. Alcohol consumption was significantly associated with GCIPL thinning (β = –0.446, P = 0.035) after adjustment for multiple confounding factors. As excessive alcohol consumption was significantly associated with thinner GCIPL thickness while ALDH2 polymorphism had no significant effect on RNFL or GCIPL thickness, glaucoma patients should avoid excessive alcohol consumption regardless of ALDH2 polymorphism.

Neuroprotective role of phosphoserine in primary open-angle glaucoma patients.

To evaluate the neuroprotective role of phosphoserine (P-Ser) in primary open-angle glaucoma (POAG) patients and to compare its therapeutic effectiveness to placebo treatment. Fifty-one patients (24 males and 27 females) between 35 and 61 years (average 46 years ± 3.8 SD) affected by POAG were enrolled in this study. Patients were divided in two groups: group A included 28 subjects that received an oral P-Ser treatment for 12 months; and group B included 23 subjects that received an oral placebo treatment for 12 months. Complete ophthalmological examination, standard automated perimetric examination, analysis of ON fibers via scanning laser polarimetry and glaucoma staging was performed in all patients at enrolment and 1, 3, 6, and 12 months after. Statistical analysis was performed using STATA 14.0 (Collage Station, TX, USA). Mean deviation (MD) and pattern standard deviation (PSD) analysis by means of 30-2 full threshold of the visual fields (VFs), retinal nerve fiber layer (RNFL) thickness by means of GDx, and IOP were considered to evaluate P-Ser therapy effectiveness in both groups. A statistically significant improvement (p<0.05) in VF, RNFL thickness and IOP compared to pre-treatment was found in patients in group A. Our study shows a significant improvement in several variables in patients with glaucoma treated with P-Ser compared to placebo and suggests a potential neuroprotective effect of P-Ser in treating glaucoma patients in association with the traditional hypotonic topical therapy.

What is the accuracy of retinal nerve fiber layer (RNFL) thickness when optical coherence tomography (OCT) is used to diagnose glaucoma?

What is the accuracy of retinal nerve fiber layer (RNFL) thickness when optical coherence tomography (OCT) is used to diagnose glaucoma?

Retinal nerve fiber layer and ganglion cell layer changes using optical coherence tomography in patients with chronic migraine: a case-control study

BackgroundMigraine is a prevalent, chronic, and multifactorial neurovascular disease.ObjectivesOur work aimed to investigate if the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness are affected in patients with chronic migraine to improve the understanding of the etiology and pathophysiology of migraine.Subjects and methodsA case-control study conducted on 30 patients with chronic migraine and 30 aged and sex-matched healthy controls. Subjects underwent full neurological and ophthalmological history, ophthalmological examination, and measuring RNFL and GCL thickness using the spectral domain-optical coherence tomography (SD-OCT).ResultsRNFL thinning (average, superior, inferior, nasal, and temporal) was significantly more in patients with chronic migraine than healthy control (P = 0.001, 0.022, 0.045, 0.034, and 0.001, respectively). No statistically significant difference was found between chronic migraine patients and healthy controls regarding GCL thickness (average, superior, and inferior) (P value ˃ 0.05).The average RNFL thickness was significantly thinner in migraine with aura (MwA) than migraine without aura (MwoA) (P = 0.006). The average GCL thickness was thinner in MwA than MwoA (P = 0.039). No statistically significant difference was found between the eyes on the side of the headache and the eyes of the contralateral side regarding RNFL and GCL thickness (P value ˃ 0.05). Age at onset, disease duration, headache frequency, and headache intensity showed an insignificant correlation with OCT parameters.ConclusionRetinal changes could be an association with chronic migraine that may be used as a biomarker.

Reproducibility of macular retinal nerve fiber layer and ganglion cell layer thickness measurements in a healthy pediatric population.

To evaluate the reproducibility of Spectralis spectral domain-OCT segmented ganglion cell layer (GCL) and macular retinal nerve fiber layer (mRNFL) measurements in a healthy children population. An observational, cross-sectional study was carried out on 79 children to measure the intraobserver reproducibility and the repeatability between a novel and an experienced operator of the segmented macular GCL and mRNFL. Interobserver and intraobserver reproducibility were defined by the intraclass correlation coefficient (ICC) and coefficients of variation (COV). Kruskal-Wallis test was used to determine statistical significance in the COV of three age groups children (younger than 6 years, between 6 and 12, and older than 12 years old). The results from the intraoperator GCL thickness analysis were highly reproducible (COV < 6%) and reliable (ICCs > 0.81). When the measurements were compared between a novel and an experienced examiner lower ICCs and higher COV were found. COVs ranged from 1.85% (total volume area) to 5.57% at the central ETDRS subfield while the ICC vary from 0.632 (outer inferior) to 0.832 (inner inferior). The repeatability and reproducibility of the mRNFL thickness were lower, with ICCs ranging from 0.428 to 0.872 in the interobserver analysis and from 0.897 to 0.346 in the interobserver one. In the present study, we establish substantial reliability of the GCL thickness in children with Spectralis® SD-OCT in all the sectors, albeit lower than the reported in the literature with other SD-OCTs and in adults. The reproducibility and repeatability of the mRNFL were significantly lower. We were unable to find consistent statistical significant differences between the COV of the three age groups.

Age-dependent regional retinal nerve fibre changes in SIX1/SIX6 polymorphism

SIX1/SIX6 polymorphism has been shown to be associated with glaucoma. Studies have also found that, in older adults, retinal nerve fibre layer (RNFL) thickness is significantly thinned with each copy of the risk allele in SIX1/SIX6. However, it is not known whether these genetic variants exert their effects in younger individuals. Comparing a healthy young adult with an older adult cohort (mean age 20 vs 63 years), both of Northern European descent, we found that there was no significant RNFL thinning in each copy of the risk alleles in SIX1/SIX6 in the eyes of younger individuals. The older cohort showed an unexpectedly thicker RNFL in the nasal sector with each copy of the risk allele for both the SIX1 (rs10483727) and SIX6 (rs33912345) variants. In the temporal sector, thinner RNFL was found with each copy of the risk allele in rs33912345 with a decrease trend observed in rs10483727. Our results suggest that SIX1/SIX6 gene variants exert their influence later in adult life.

Detection of serum uric acid in primary open angle glaucoma: A pilot study.

To assess the association between the serum levels of uric acid (UA) and primary open-angle glaucoma (POAG). In this pilot study, 46 eyes of 23 patients with a clinical history of POAG and 30 eyes of 15 healthy subjects were included. All patients underwent a complete ophthalmological examination, including best corrected visual acuity (BCVA), intraocular pressure (IOP), and gonioscopy. Visual field parameters, such as mean deviation (MD) and pattern standard deviation (PSD), and optical coherence tomography (OCT) values of the optic nerve head, including retinal nerve fiber layer (RNFL) thickness and vertical cup/disc ratio (VCDR), were noted. A blood sample was collected from each subject for serum UA measurement. IOP, MD, PSD, RNFL thickness, and VCDR resulted significantly different in POAG patients, when compared with controls (p < 0.05). POAG patients showed significantly lower levels of mean serum UA than healthy controls (4.00 ± 0.66 mg/dL vs 4.95 ± 0.86 mg/dL, respectively, p < 0.0001). Furthermore, severe POAG patients showed mean serum levels of UA lower than mild POAG patients (3.36 ± 0.70 mg/dL vs 4.22 ± 0.51 mg/dL, respectively, p = 0.01). Visual field and OCT parameters were statistically correlated with the mean serum levels of UA in POAG eyes (p < 0.05). Results suggest that in POAG patients, serum UA levels may be decreased and correlated with visual field and OCT parameters worsening. Further larger multi-center prospective studies are necessary to confirm our findings and establish the role of UA in glaucoma.

Subclinical inner retinal layer thickness changes in the fellow eyes of patients with unilateral central retinal artery occlusion: a pilot study.

To investigate microstructural changes in the macular inner retinal layers over time in the fellow eyes of patients with unilateral central retinal artery occlusion (CRAO). Spectral-domain optical coherence tomography scans of 16 patients with CRAO were performed at initial examination (1st day), at 1st month, at 3rd month, at 6th month, and the central macular thickness (CMT) and inner retinal layer thicknesses in the fellow eyes of the patients were compared between each visit. The thicknesses of retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), and inner nuclear layer (INL) were calculated in 9 quadrants according to the definition by the Early Treatment Diabetic Retinopathy Study. CMT decreased over a 6-month period, but the difference was insignificant among visits (p = 0.072). Also, there were no significant differences in the thicknesses of RNFL and GCL among visits (p > 0.05 for all quadrants). But there was thinning in the parafoveal superior and perifoveal superior quadrants of the IPL (p = 0.007, p = 0.01) and in the parafoveal temporal quadrant of the INL (p = 0.033) within 6months of follow-up in the fellow eyes of the patients with CRAO. This study demonstrated subclinical alterations of the macular inner retinal layers over time in the fellow eyes of CRAO patients.

Axial length-related inter-individual variability in the posterior pole morphology of healthy eyes.

To evaluate morphological characteristics of optic nerve head (ONH) and fovea (F) related to axial length (AL) in healthy eyes. This is an observational study. A consecutive series of healthy subjects was enrolled. Demographic and clinical parameters were age, gender, eye, intraocular pressure, spherical equivalent, AL. Tomographic parameters were ONH-F distance, ONH-F angle, horizontal and vertical ONH diameters, retinal nerve fiber layer (RNFL) thickness and foveal profile patterns. One hundred six eyes (56 patients) were recruited. A correlation between AL and ONH-F distance was demonstrated (p = 0.0342). Horizontal diameter decreased with increasing AL (p = 0.0003), conferring to ONH a more oval shape. A significant decrease in RNFL thickness was correlated with AL, except for temporal quadrant. Two foveal profile patterns were described: concave and straight patterns. Eyes with concave pattern were longer than eyes with straight pattern. Eye elongation affects the morphology of the ONH, the fovea and the distribution of retinal nerve fibers.

Early disability in ambulatory patients with multiple sclerosis: optical coherence tomography versus visual evoked potentials, a comparative study

BackgroundMultiple sclerosis (MS) is a common cause of neurological disabilities in adults and commonly affects the visual pathway. The objective of this study is to assess and compare the sensitivity of visual evoked potentials (VEP) and optical coherence tomography (OCT) as measures of early disability in ambulatory patients with MS.MethodsForty-four patients with MS with Expanded Disability Status Scale (EDSS) of ≤ 4.5 (ambulatory patients) and 14 healthy controls participated in this study. Patients were classified into 3 groups according to EDSS. Patients with EDSS of 0–1.5 formed the “No disability,” patients with EDSS of 2–3 formed the “Minimal to mild disability,” and finally patients with EDSS of 3.5–4.5 formed the “Moderate to significant disability” groups. N75/P100 amplitude, P100 latency, retinal nerve fiber layer (RNFL) thickness, and ganglion cell layer complex (GCLC) thickness were measured.ResultsPatients showed significantly lower N75/P100 amplitude, higher P100 latency, lower RNFL, and GCLC thicknesses compared to controls. However, there were non-significant changes in P100 latency, N75/P100 amplitude, and GCLC thickness among the 3 groups for both patients with and without history of optic neuritis (ON). On contrary, RNFL thickness was significantly different between the three groups for both patients with and without history of ON. Factorial ANOVA revealed non-significant disability × History of ON interaction.ConclusionCompared to VEP parameters, RNFL thickness was a sensitive correlate with the various degrees of early disability in fully ambulatory patients with MS whatever the history of ON.

Assessment of macular choroidal thickness, central macular thickness and retinal nerve fiber layer in patients receiving oral isotretinoin treatment

Purpose To investigate the impact of oral isotretinoin therapy in choroidal thickness, central macular thickness (CMT), and retinal nerve fibre layer (RNFL) thickness using optical coherence tomography (OCT). Patients and methods Choroidal thicknesses, CMT, and RNFL thickness of 64 eyes were evaluated at baseline and the end of the third month of isotretinoin therapy by spectral-domain OCT. For assessment of choroidal thickness, OCT measurements were obtained at the fovea with 6 additional measurements at adjacent locations (at 500–1000–1500 µm temporal to the fovea and 500–1000–1500 µm nasal to the fovea). Results There was not a statistically significant difference between the baseline and third-month follow-up measurements of choroidal thicknesses at seven distinct locations (p > 0.05). Similarly, RNFL thickness and CMT did not change with a mean dose of 30 (±6) mg per day isotretinoin therapy during follow-up (101.82 vs 102.24, p = 0.079; 217.77 vs 217.25, p = 0.731, respectively). Conclusion After the use of oral isotretinoin for 3 months, no significant side effects have been observed in choroidal thickness, CMT, and RNFL thickness by OCT.

Can ocular OCT findings be as a predictor for end-organ damage in systemic hypertension?

ABSTRACT Purpose Detection of end-organ damage (EOD) in systemic hypertension is essential for the management of systemic hypertension. We aimed to evaluate subfoveal choroidal thickness (SFCT) and retinal layers’ thicknesses by using spectral domain optical coherence tomography (SD‑OCT) in patients with systemic hypertension and to assess the relationship between EOD and SD-OCT parameters. Methods A total of 189 consecutive patients with systemic hypertension and 100 controls were included. Patients were examined to detect EOD including hypertensive retinopathy (HTRP), left ventricular hypertrophy assessed by transthoracic echocardiography and microalbuminuria assessed by 24-h urine analysis. SFCT, inner plexiform-ganglion cell complex (IP-GCC), peripapillary retinal nerve fiber layer (pRNFL) and central macular thickness (CMT) were measured with SD-OCT. Results Patients with systemic hypertension had significantly lower SFCT and retinal layer thicknesses than controls (P˂0.001). In the dilated fundus photographic evaluation, 94 patients with systemic hypertension had HTRP and these patients had lower SFCT, CMT, IP-GCC and pRNFL thicknesses compared to hypertensive patients without HTRP and healthy controls. Patients with EOD had significantly lower SFCT, CMT, IP-GCC and pRNFL thicknesses and as the number of EOD increased, the SFCT decreased significantly. In the multivariate analysis, SFCT was found as an independent predictor of EOD (P˂0.001, odds ratio: 0.0605). Conclusion Hypertensive patients, especially with EOD had significantly lower SD-OCT parameters compared to controls. It would be rational to add SD-OCT assessment to conventional hypertensive retinopathy evaluation in patients with systemic hypertension for early diagnosis of end-organ damage, burden of target organ involvement and monitoring anti-hypertensive treatment.

Effect of Vitamin D Deficiency on Contrast Sensitivity Function

ABSTRACT Purpose The purpose of this study is to investigate the effects of vitamin D (vit D) deficiency on contrast sensitivity (CS) function and retinal layers. Materials and methods Group 1 consisted of 42 patients aged between 18 and 50 years with vit D deficiency and Group 2 consisted of sex- and age-matched 34 healthy subjects with normal vit D levels. Functional acuity contrast testing (FACT) was performed using the Optec 6500 vision testing system. The average retinal nerve fiber layer (RNFL) thickness and macular thickness (MT) obtained from nine macular areas in the Early Treatment Diabetic Retinopathy Study were evaluated using SD-OCT (RS-3000; Nidek Inc., Fremont, CA, USA) following a detailed ophthalmologic examination. Measurements were performed on both eyes. Results A lower CS was found in Group 1 compared to Group 2 in all spatial frequencies. A statistically significant difference was observed between the groups in 6, 12 and 18 cpd spatial frequencies, respectively. (p = .004, p = .001, p = .042, respectively). There was no statistically significant difference between groups in terms of RNFL thicknesses (p = .200). There was an increase in MT in Group 1. However, this increase was statistically significant in the inferior inner area in the right eye, and in the inferior inner, temporal inner and outer macular areas in the left eye (p = .018, p = .003, p = .033, p = .040, respectively). Conclusion It was observed that vit D deficiency had negative effects on CS function and also caused thickness difference in certain segments of retinal layers.

The Role of Optical Coherence Tomography in Differential Diagnosis of Multiple Sclerosis and Autoimmune Connective Tissue Diseases with CNS Involvement.

The purpose of this study was to examine whether application of optical coherence tomography (OCT) measurements can provide a useful biomarker for distinguishing central nervous system (CNS) involvement in autoimmune connective tissue diseases (CTD) from multiple sclerosis (MS). An observational study included non-optic neuritis eyes of 121 individuals: 59 patients with MS, 30 patients with CNS involvement in CTD, and 32 healthy controls. OCT examination was performed in all subjects to measure retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) thickness, ganglion cell layer-inner plexiform layer (GCIPL) thickness, and volume of the macula. There was a significant group effect with regard to superior optic disc RNFL, macular RNFL, GCC, and GCIPL thickness, and macular volume. Post-hoc analysis revealed that MS patients have significantly smaller macular volume and thinner superior optic disc RNFL, macular RNFL, GCC, and GCIPL compared to healthy controls. CTD patients have significantly smaller superior optic disc RNFL, GCIPL, and GCC thickness compared to healthy controls. However, no significant group differences were observed between the patient groups (MS vs. CTD) on any outcome. Although a prominent retinal thinning may be a useful biomarker in MS patients, in a general population of individuals with a confirmed CNS involvement the use of OCT is not specific enough to discriminate between MS and autoimmune CTD.