Peripapillary Retinal Nerve Fiber Layer Thickness Research Articles

Retina in Clinical High-Risk and First-Episode Psychosis.

Abnormalities in the retina are observed in psychotic disorders, especially in schizophrenia. Using spectral-domain optical coherence tomography, we investigated structural retinal changes in relatively metabolic risk-free youth with clinical high-risk (CHR, n = 34) and first-episode psychosis (FEP, n = 30) compared with healthy controls (HCs, n = 28). Total retinal macular thickness/volume of the right eye increased in FEP (effect sizes, Cohen's d = 0.69/0.66) and CHR (d = 0.67/0.76) compared with HCs. Total retinal thickness/volume was not significantly different between FEP and CHR. Macular retinal nerve fiber layer (RNFL) thickness/volume of the left eye decreased in FEP compared with HCs (d = -0.75/-0.66). Peripapillary RNFL thickness was not different between groups. The ganglion cell (GCL), inner plexiform (IPL), and inner nuclear (INL) layers thicknesses/volumes of both eyes increased in FEP compared with HCs (d = 0.70-1.03). GCL volumes of both eyes, IPL thickness/volume of the left eye, and INL thickness/volume of both eyes increased in CHR compared with HCs (d = 0.64-1.01). In the macula, while central sector thickness/volume decreased (d = -0.62 to -0.72), superior outer (peri-foveal) sector thickness/volume of both eyes increased (d = 0.81 to 0.86) in FEP compared with HCs. The current findings suggest that distinct regions and layers of the retina may be differentially impacted during the emergence and early phase of psychosis. Consequently, oculomics could play significant roles, not only as a diagnostic tool but also as a mirror reflecting neurobiological changes at axonal and cellular levels.

Applicability of ISNT rule to retinal nerve fiber layer thickness by SD-OCT in normal subjects.

The usefulness of the Inferior>Superior>Nasal>Temporal (ISNT) rule for the neuroretinal rim (NRR) has been widely used in differentiating normal eyes from glaucoma, but only a few studies have assessed whether this classical ISNT rule applies to the retinal nerve fibre layer (RNFL). This study aimed to determine the applicability of the ISNT rule for the peripapillary RNFL thickness in normal eyes using Spectral Domain Optical Coherence Tomography (SD-OCT) and assess if variants of the ISNT rule apply. A cross-sectional study was conducted on 120 eyes of 62 healthy subjects who fulfilled the study criteria. Peripapillary RNFL thickness was measured by OCT scan and each eye's global, superior, temporal, nasal, and inferior quadrant thickness was noted. The values obtained were analyzed to determine the percentage of eyes obeying the ISNT rule and its variants. The ISNT rule for RNFL thickness was applicable for normal subjects in only 53.33% of cases. Removing the nasal quadrant from analysis increased the number of eyes obeying the IST rule to 71.66%. Further exclusion of the temporal quadrant showed almost the same results (75%) for the IS rule. The ISNT rule for RNFL thickness could be validated in only 53.33% of normal individuals. Though documented as useful for NRR during ophthalmoscopy in glaucoma diagnosis, the ISNT rule did not apply to the quadrant values on RNFL on SD-OCT examination.

Correlation between glycemic control and retinal nerve fiber layer parameters in type 2 diabetics without retinopathy: a case control study

Background Retinal neurodegenerative changes were found to develop in patients with diabetes mellitus (DM) before the onset of microvascular changes of diabetic retinopathy (DR). Such changes usually affect inner retinal layers in the form of retinal nerve fiber layer (RNFL) thinning. Aim To correlate the degree of glycemic control [in the form of hemoglobin A1c (HBA1c) levels] with changes in peripapillary RNFL thickness in patients with type 2 DM without DR using optical coherence tomography (OCT). Patients and methods Participants are divided into three groups each including 28 eyes: group 1: uncontrolled type 2 DM without DR (HBA1c≥7%), group 2: controlled type 2 DM without DR (HBA1c<7%), group 3: healthy age and sex-matched controls. Peripapillary RNFL and macular ganglion cell complex (GCC) thickness were evaluated in all participants using RTVue spectral domain OCT device (Optovue, Fremont, USA). Results Peripapillary RNFL and macular GCC were significantly thinner in the uncontrolled type 2 DM group in comparison to both the controlled type 2 DM group and the healthy control group. No significant difference in OCT parameters between the controlled type 2 DM group and the healthy control group. HBA1c shows a statistically significant negative correlation with average, superior and inferior RNFL thickness as well as average, superior, and inferior GCC thickness. Conclusion Early and adequate glycemic control, indicated by HBA1c less than 7%, is of critical importance in delaying and reducing early neurodegenerative changes in the form of RNFL and GCC thinning in patients with type 2 DM without DR.

Retinal nerve fiber layer thickness and radial peripapillary capillaries density in myopic adults with optical coherence tomography angiography

PurposeTo evaluate retinal nerve fiber layer thickness (RNFLT) and radial peripapillary capillaries (RPC) density in adults with different degrees of myopia using optical coherence tomography angiography (OCTA) and explore their relationship with ocular factors, such as axial length (AL) and disc area.MethodsA total of 188 subjects were included in this cross-sectional study. The eyes were divided into four groups according to AL. OCTA was used for the assessment of RNFLT, RPC density, and other optic disc measurements, such as disc area. One-way analysis of variance was performed to compare differences between four groups, and P value < 0.01 was considered significant.ResultsThe RNFLT was significantly thinner in high myopia (HM) group at inferior nasal (IN) quadrant (P = 0.004) than low myopia (LM) group, but thicker at temporal inferior (TI) quadrant (P = 0.006). The RPC density of nasal superior (NS) quadrant, nasal inferior (NI) quadrant, and inferior nasal (IN) quadrant significantly decreased as AL increasing. By simple linear regression analysis, the inside disc RPC (iRPC) density tended to be correlated significantly with AL (0.3997%/mm, P < 0.0001). Peripapillary RPC (pRPC) density was in significant correlation with AL (-0.2791%/mm, P = 0.0045), and peripapillary RNFLT (pRNFLT) was in significant correlation with disc area (0.2774%/mm2, P = 0.0001).ConclusionRNFLT and RPC density were closely associated with AL and disc area. They might be new indexes in assessing and detecting myopia development via OCTA.

Association of Lipopolysaccharide-Type Endotoxins with Retinal Neurodegeneration: The Alienor Study

PurposeLipopolysaccharide (LPS) -type endotoxins are naturally found in the gut microbiota and there is emerging evidence linking gut microbiota and neuroinflammation leading to retinal neurodegeneration. Thinning of the retinal nerve fiber layer (RNFL) is a biomarker of retinal neurodegeneration, and a hallmark of glaucoma, the second leading cause of blindness worldwide. We assessed the association of a blood biomarker of LPS with peripapillary RNFL thickness (RNFLT) and its longitudinal evolution up to 11 years. DesignThe Alienor study is a single center prospective population-based cohort study. SubjectsThe studied sample of this study includes 1062 eyes of 548 participants receiving at least one gradable RNFL measurement. MethodsPlasma esterified 3-hydroxy fatty acids (3-OH FAs) were measured as a proxy of LPS burden. RNFLT was acquired using spectral domain optical coherence tomography imaging every two years from 2009 to 2020 (up to 5 visits). Main Outcome MeasureAssociations of plasma esterified 3-OH FAs with RNFLT were assessed using linear mixed models. ResultsMean age of the included 548 participants was 82.4 ± 4.3 years and 62.6 % were women. Higher plasma esterified 3-OH FAs was significantly associated with thinner RNFLT at baseline (Coefficient Beta (ß)= -1.42 microns for 1 SD-increase in 3-OH FAs, 95% confidence interval [-2.56; -0.28], p = 0.02). This association remained stable after multivariate adjustment for potential confounders. No statistically significant association was found between 3-OH FAs and longitudinal RNFLT change. ConclusionsHigher plasma esterified 3-OH FAs were associated with thinner RNFLT at baseline, indicating an involvement of LPS in the early processes of optic nerve neurodegeneration and highlighting the potential importance of the human microbiota in preserving retinal health.

Analysis of macular thickness and peripapillary retinal nerve fiber layer thickness in various ABO and Rh blood groups

PurposeTo determine the association between ABO and Rh blood groups with retinal structural indices including macular thickness and peripapillary retinal nerve fiber layer (RNFL) thickness.MethodsThis cross-sectional study was conducted using convenience sampling in a tertiary referral eye hospital in Tehran, Iran. Study participants were referred to the hospital laboratory to test their blood group. Ocular examinations were performed including measurement of visual acuity, auto-refraction, subjective refraction, and slit-lamp biomicroscopy. Retinal imaging was carried out using Spectral-domain OCT under dilated papillary conditions.ResultsThree hundred and twenty-eight individuals were recruited in this study. Of these, 219 (60.7%) were female and the mean age of the participants was 63.29 ± 5.57 years (range: 56 to 83 years). According to the multiple linear regression model, the global peripapillary RNFL thickness [coefficient: -3.05 (95% CI: -5.30 to -0.74); P = 0.010] and peripapillary RNFL thickness in the superior [coefficient: -4.65 (95% CI: -8.40 to -0.89), P < 0.001] and inferior [coefficient: -4.00 (95% CI: -7.81 to -0.19); P = 0.040] quadrants were significantly thinner in individuals with blood type B compared to those with other ABO blood groups. The average [coefficient: 12.69 (95% CI: 4.12–21.64); P = 0.004) and central [coefficient: 16.21 (95%: 6.44–25.97); P = 0.001) macular thicknesses were significantly thicker in AB group compared to other blood groups. The average macular thickness was significantly thinner in Rh + compared to the Rh- group [coefficient: -8.33 (95% CI: -15.4 to -1.25); P = 0.021].ConclusionRetinal structural indices may be related to blood groups implying a genetic linkage. Considering the lack of consistency among various studies, larger trials are needed to explore the effect of ABO and Rh grouping on peripapillary RNFL and macular thicknesses.

Hyper-reflective foci changes in RRMS under natalizumab therapy.

Microglia (MG) is suggested to play an immunopathological role of in Multiple Sclerosis (MS). Since hyper-reflective foci (HRF) might mark MG activation, in vivo analysis by Optic Coherence Tomography (OCT) in MS patients under disease modifying therapies may help to clarify MS immunopathology as well as drug's mechanism of intrathecal action. To analyze HRF in patients treated with Natalizumab (NTZ), a high efficacy therapy for MS. The effect of NTZ on the retina of 36 Relapsing-Remitting MS patients was investigated in a prospective, single-center study. OCT was performed immediately before the first infusion and then between infusion 3 and 4, infusion 6 and 7, infusion 11 and 13. Peripapillary and macular scans were acquired, evaluating peripapillary RNFL thickness, macular volumes (vertical scans), and HRF count (horizontal scan) in Ganglion Cell Layer (GCL), Inner Plexiform Layer (IPL) and Inner Nuclear Layer (INL). Clinical examination was performed every six months. HRF count significantly increased under NTZ therapy (p<0.001) in both GCL (18.85 ± 6.93 at baseline, 28.24 ± 9.55 after 12 months) and IPL (25.73 ± 7.03 at baseline, 33.21 ± 8.50 after 12 months) but remained stable in INL (33.65 ± 7.76 at baseline, 36.06 ± 6.86 after 12 months, p=0.87), while no relevant modification of pRNFL and macular volumes were observed during the study. EDSS remained stable and no clinical relapse was observed between month 6 and 12. In RRMS NTZ affects HRF count in GCL and IPL, but not in INL, suggesting that NTZ does not impact on some aspects of MS immunopathology.

An assessment of the thickness of the retinal nerve fiber layer around the optic disc using spectral domain optical coherence tomography in myopia patients at an industrial hospital in India

Myopia is rising as a silent epidemic across the globe with marked ocular morbidity and pathological changes. The retinal nerve fiber layer (RNFL) thinning is indicative of glaucomatous damage; it remains uncertain whether RNFL thickness would vary with the refractive status of the eye. It is therefore important to investigate whether any correlation exists between RNFL measurements and axial length/refractive error in myopia. Purpose. To assess the peripapillary RNFL thickness by spectral domain optical coherence tomography (SD-OCT) and to determine the correlation between axial length and peripapillary RNFL thickness in myopia patients. Material and methods. A total of 100 patients (200 eyes) with low, moderate and high myopia (ave -3.58 ± 2.45 D) aged 15 to 40 years were examined to assess the peripapillary RNFL thickness by SD-OCT and to determine the correlation between axial length (AL) and peripapillary RNFL thickness myopia patients. Results. Average 360-degree RNFL thickness (mean ± SD) was 92.25 ± 10.04 μm. In the low myopic group this parameter was 98.82 ± 6.67 μm, in the moderate myopic group — 89.28±5.23 μm, and in the high myopic group — 78.54 ± 7.32 μm. The average 360-degree mean RNFL thickness in patients with AL &lt; 24 mm was 100.06 ± 5.92 μm, in patients with AL between 24–26 mm — 89.48 ± 4.59 μm, and in patients with AL &gt; 26 mm — 78.2 ± 6.77 μm. There was significant association between thinning of the average 360-degree RNFL thickness with increasing degree of myopia and AL (p &lt; 0.0001). Conclusion. The study shows RNFL thickness decreases with increase in refractive error and increase in axial length of myopic eyes. The degree of myopia may affect the RNFL thickness differently.

Peripapillary Microvascular and Structural Parameters in Atrophic Nonarteritic Anterior Ischemic Optic Neuropathy, Unaffected Fellow Eyes and Controls in an Indian Population

ABSTRACT Nonarteritic ischemic optic neuropathy (NAION) is believed to be an ischemic insult to the optic nerve head and is one of the most common acute optic neuropathies of adulthood. Prevention of NAION in the fellow eye has not yet been accomplished. Optical coherence tomography angiography (OCTA) is a new and emerging non-invasive technology that provides microvascular information that complements the structural data. This prospective study is aimed to fill the lacunae in data that is available in the Indian population. We included 36 patients with NAION, their 36 fellow eyes and 37 healthy controls. The peripapillary perfusion index, peripapillary flux, peripapillary retinal nerve fibre layer (RNFL) thickness values and disc volumes of eyes were evaluated. The NAION eyes had lower peripapillary perfusion index, flux and RNFL thickness values in all sectors compared with both the fellow and the healthy control eyes (p = < .05). A statistically significant difference was found in disc volume between control eyes and fellow eyes, which included eyes with disc at risk configuration as well as normal disc configuration. Eyes with disc at risk configuration had a numerically lower disc volume than eyes with normal disc configuration. Fellow eyes overall had numerically lower perfusion index, higher RNFL thickness, and similar flux which was statistically non-significant compared with the healthy eyes. Correlation between the localization of visual field defects and the quadrants showing impairments of perfusion index and peripapillary RNFL were also assessed. These findings may indicate the potential vascular risk factors for the development of NAION in fellow eyes.

PallorMetrics: Software for Automatically Quantifying Optic Disc Pallor in Fundus Photographs, and Associations With Peripapillary RNFL Thickness.

We sough to develop an automatic method of quantifying optic disc pallor in fundus photographs and determine associations with peripapillary retinal nerve fiber layer (pRNFL) thickness. We used deep learning to segment the optic disc, fovea, and vessels in fundus photographs, and measured pallor. We assessed the relationship between pallor and pRNFL thickness derived from optical coherence tomography scans in 118 participants. Separately, we used images diagnosed by clinical inspection as pale (n = 45) and assessed how measurements compared with healthy controls (n = 46). We also developed automatic rejection thresholds and tested the software for robustness to camera type, image format, and resolution. We developed software that automatically quantified disc pallor across several zones in fundus photographs. Pallor was associated with pRNFL thickness globally (β = -9.81; standard error [SE] = 3.16; P < 0.05), in the temporal inferior zone (β = -29.78; SE = 8.32; P < 0.01), with the nasal/temporal ratio (β = 0.88; SE = 0.34; P < 0.05), and in the whole disc (β = -8.22; SE = 2.92; P < 0.05). Furthermore, pallor was significantly higher in the patient group. Last, we demonstrate the analysis to be robust to camera type, image format, and resolution. We developed software that automatically locates and quantifies disc pallor in fundus photographs and found associations between pallor measurements and pRNFL thickness. We think our method will be useful for the identification, monitoring, and progression of diseases characterized by disc pallor and optic atrophy, including glaucoma, compression, and potentially in neurodegenerative disorders.

To evaluate macular thickness and peripapillary retinal nerve fibre layer (pRNFL) thickness in primary open angle glaucoma (POAG) patients using optical coherence tomography (OCT) in semi-urban population of eastern U.P

To evaluate macular thickness and peripapillary retinal nerve fibre (pRNFL) layer thickness in primary open angle glaucoma (POAG) patients using optical coherence tomography (OCT) in semi-urban population of eastern U.P. : Cross-sectional observational study carried out on 72eyes of 42 POAG patients and 72 eyes of 36 normal individuals above 40 years from January 2023 – August 2023 in eye OPD of Hind Institute of Medical Sciences, Barabanki. Best corrected visual acuity, anterior segment examination, Gonioscopy, tonometry, Central corneal thickness, perimetry, fundoscopy, peripapillary RNFL and macular thickness using OCT was done in all patients. POAG patients had significantly lower mean pRNFL quadrant measurements in superior, inferior and temporal quadrants when compared with controls. 83.68 ± 13.55 vs.140.01 ± 4.53; p=0.001 for superior quadrant; 76.33 ± 12.96 vs. 141.99 ± 4.51; p=0.001 for inferior quadrant; 52.31 ± 8.67 vs. 74.36 ± 3.56; p=0.001 for temporal quadrant. Mean pRNFL thickness in the nasal quadrant was not found significant in our study (55.53±7.08 vs. 80.85±5.24; p=0.295). Significant differences in thickness in foveal, inferior outer, temporal inner and nasal inner sector between POAG and control patients (p&amp;#60;0.05) were found. Superior, inferior and temporal pRNFL quadrants thickness and foveal, inferior outer, temporal inner and nasal inner macular thickness were found to be the best parameters to diagnose POAG at early stage.

The Relationship between Lumbar Puncture Opening Pressure and Retinal Nerve Fiber Layer Thickness in the Diagnosis of Idiopathic Intracranial Hypertension: Is a Lumbar Puncture Always Necessary?

Idiopathic intracranial hypertension (IIH), is characterized by elevated intracranial pressure (ICP) without an identified cause. Today, lumbar puncture (LP) is the most common method used for diagnosis by measuring cerebrospinal fluid (CSF) pressure to reflect intracranial pressure. This invasive examination has significant disadvantages, such as complications and negative experiences for patients. Therefore, noninvasive methods for ICP measurement are desired. Optical coherence tomography (OCT) is widely used for the diagnosis and follow-up of IIH patients as it reflects papilledema. The aim of this study is to investigate the relationship between CSF pressure and OCT parameters and the ability of OCT in the diagnostic approach. In our study, patients who were followed up with a diagnosis of IIH with complete neuro-ophthalmological examinations, including visual acuity (VA), visual field, and OCT imaging within 24 hours before lumbar puncture, were retrospectively evaluated. CSF pressure, visual acuity LogMAR, mean deviation of visual fields, retinal nerve fiber layer (RNFL) thickness measured by OCT, and treatment protocols were obtained from our hospital data system. A total of 42 eyes of 21 patients were enrolled in the study. A statistically significant positive and moderate correlation was found between CSF pressure values and average RNFL thickness (r=0.507; P=0.001). The same relationship was demonstrated in all 4 quadrants: inferior, superior, nasal, and temporal. Increased peripapillary RNFL thickness in optic nerve head OCT may be correlated with increased ICP in IIH patients. A larger number of patients are needed to better understand the correlation between OCT parameters and CSF pressure in patients with IIH.

Optical coherence tomography detection of retinal neural loss in patients with tuberous sclerosis

PurposeTuberous Sclerosis (TS) is a rare, multisystem genetic disease caused by mutations in the TSC1 and TSC2 genes, leading to abnormalities in cell differentiation and proliferation. This study aimed to evaluate the neural integrity of individuals with TS by using Optical Coherence Tomography (OCT) to examine the peripapillary retinal nerve fiber layer (RNFL) thickness and the macular thickness in patients with TS and to compare with healthy controls.MethodsPeripapillary and macular OCT scans (Optopol Revo NX SD OCT) were performed on 41 eyes from 22 TS patients, divided into two groups based on the presence of retinal hamartomas, and compared to 20 eyes from a control group. The average peripapillary RNFL thickness was measured for each quadrant. The macular total thickness and ganglion cell layer (GCL) + inner plexiform layer (IPL) thickness were measured based on the Early Treatment Diabetic Retinopathy Study (ETDRS) map. All measurements were then compared between the groups and controls.ResultsThe TS group showed significantly reduced RNFL thickness and macular thickness when compared to the control group. Specifically, patients with retinal hamartomas exhibited an even more pronounced thinning of both RNFL and macular thickness.ConclusionsThese findings suggest that TS patients undergo significant changes in retinal neurodevelopment and experience axonal loss. This finding may have significant prognostic utility regarding central nervous system degeneration in TS, particularly among patients with retinal hamartomas. OCT may serve as a valuable tool for assessing axonal structural abnormalities in TS patients.Trial Registration Number: Not applicable.

Changes in Neurodegeneration and Visual Prognosis in Branch Retinal Vein Occlusion after Resolution of Macular Edema

This study aimed to examine the thicknesses of the ganglion cell layer (GCL) and peripapillary retinal nerve fiber layer (RNFL) in eyes with resolved macular edema (ME) in branch retinal vein occlusion (BRVO) and determine their relationship with visual acuity (VA). This retrospective observational case–control study included 57 eyes of BRVO patients with resolved ME after treatment. The macular GCL thickness, peripapillary RNFL thickness, and central macular thickness (CMT) measured on swept-source optical coherence tomography scans with the contralateral eyes used as controls were evaluated. The mean CMT was 270.48 ± 32.7 μm; the mean RNFL thickness was 105.46 ± 25.94 μm in BRVO eyes. Although the average RNFL thickness was decreased in BRVO eyes compared to unaffected eyes, there was no significant difference between the groups. However, the temporal and nasal RNFL thicknesses were significantly different between the groups. The mean affected quadrant had a significantly thinner GCL compared to the corresponding opposite unaffected quadrant (p = 0.02). Final VA was significantly correlated with nasal and middle GCL thicknesses in the affected area (r = −0.512, p = 0.003 and r = −0.537, p = 0.001, respectively); no correlation was found between the average RNFL thickness and mean CMT. The peripapillary RNFL and GCL thicknesses of the affected area were reduced in BRVO eyes compared to unaffected eyes. VA significantly correlated with nasal and middle GCL thicknesses in the affected area. Inner retinal damage occurring in patients with ME secondary to BRVO may be related to the visual prognosis.

Impaired brachial flow-mediated dilation may predict choroidal and retinal nerve fibre layer thickness changes in people with obesity

ABSTRACT Clinical relevance Choroidal thickness and peripapillary retinal nerve fibre layer (RNFL) changes are known to occur in obesity. Endothelial dysfunction and systemic atherosclerosis may play a role in the pathophysiology of these differences. Background Flow-mediated dilation (FMD) is reduced in patients with endothelial dysfunction, and the ankle-brachial index is a surrogate marker for atherosclerosis. This study was conducted to examine the relationship between systemic vascular parameters (FMD, and ankle-brachial index), subfoveal choroidal thickness, and peripapillary RNFL thickness in obese individuals. Methods This observational, cross-sectional study involved 108 total participants who were divided into two groups. One group consisted of 54 obese subjects who each had a body mass index of 30 kg/m2 or more. The other control group contained 54 participants who each had a body mass index of 25 kg/m2 or less but higher than 20 kg/m2 . For each participant, only one eye was examined in this study. Subfoveal choroidal thickness, RNFL thickness, ankle-brachial index, and ultrasound measurement of the brachial artery FMD were performed. FMD was categorised according to receiver operating characteristic analysis, and endothelial dysfunction was defined as an FMD ≤ 7.29%. Results Subfoveal choroidal and RNFL thicknesses in the temporal quadrant were significantly lower in the obese group (p < 0.05). Lower mean values of subfoveal choroidal and RNFL thicknesses in the temporal and inferior quadrants were observed in subjects with an FMD ≤ 7.29% (p < 0.05). In people with obesity, FMD was positively correlated with subfoveal choroidal thickness (r = 0.322, p = 0.001), inferior RNFL thickness (r = 0.259, p = 0.007), and temporal RNFL thickness (r = 0.297, p = 0.002). However, the ankle-brachial index was not correlated with obesity. Conclusions Impaired FMD was associated with reduced subfoveal choroidal and RNFL thicknesses in the temporal and inferior quadrants of people with obesity.

Optic Disc Hypoplasia Assessment in PAX6 -Related Aniridia.

This study aims to characterize optic disc hypoplasia in congenital aniridia using ultra-wide-field imaging (UWFI) and nonmydriatic retinal photography (NMRP). We also investigated the relation between optic disc hypoplasia and foveal hypoplasia. This is a retrospective case series of patients diagnosed with PAX6 -related aniridia in a National Referral Center, who underwent UWFI, NMRP, and spectral-domain optical coherence tomography (SD-OCT) . The disc diameter (DD) and the disc-to-fovea distance (DF) were measured. The DD:DF ratio was used to assess the relative size of the optic disc. The analyses were carried with respect to paired age- and sex-matched healthy controls. SD-OCT was used for foveal hypoplasia grading (from 1 to 4) and retinal nerve fiber layer (RNFL) analysis. Mean manual DD:DF ratio was 0.33 (95% CI: 0.31-0.35) in aniridia patients versus 0.37 (95% CI: 0.36-0.39) in control patients (n = 20, P = 0.005) measured on NMRP and 0.32 (95% CI: 0.30-0.35) in aniridia patients versus 0.37 (95% CI: 0.37-0.39) in control patients (n = 26, P < 0.0001) when assessed on UWFI. Mean semiautomated DD:DF ratio measured on UWFI in aniridia patients was 0.31 (95% CI: 0.29-0.33) versus 0.37 (95% CI: 0.36-0.38) in control patients ( P < 0.0001). Also, a negative correlation was found significant between the grade of foveal hypoplasia and the mean semiautomated DD:DF ratio (r = -0.52, 95% CI: -0.76 to -0.15, P = 0.0067). Finally, a significant negative correlation was found between the peripapillary temporal RNFL thickness and the grade of foveal hypoplasia ( P = 0.0034). The DD:DF ratio is significantly reduced in PAX6 -related aniridia patients and correlates with the severity of foveal hypoplasia. This ratio is a valuable tool for optic disc hypoplasia assessment in congenital aniridia, especially when provided semiautomatically by UWFI.

Normative retinal nerve fiber layer thickness in a healthy pediatric South Asian cohort: a spectral-domain optical coherence tomography study.

Currently, the normative values for retinal nerve fiber layer (RNFL) thickness in our population have not been widely studied. Our study aimed to assess the peripapillary RNFL thickness (RNFLT) with Optopol Copernicus REVO80® spectral-domain optical coherence tomography (SD-OCT) amongst healthy children and its associations. One hundred eighty-two eyes of 91 consecutive healthy children 3 to 16 years of age with a refractive error ≤ ± 5 D were included after a thorough eye exam including visual acuity, refraction, tonometry, pachymetry, axial length estimation, and slit lamp exam including fundus assessment. RNFLT was measured via Optopol Copernicus REVO80® high resolution SD-OCT by a single experienced observer with 3D disc mode within a circular area of diameter 3.45 mm and the ring further divided into four quadrants: inferior, superior, nasal, and temporal. The mean age was 11.12 ± 3.12 years (range, 3-16). The average RNFLT was 120.13 ± 12.6 μm. The mean superior RNFL was the thickest at 138.21 ± 16.6 μm, next was the mean inferior RNFLT at 137.62 ± 17.2 μm, followed by the nasal 91.61 ± 18.5 μm and then the temporalat 74.58 ± 11.7 μm. No significant differences in RNFLT were noted between the two eyes. The mean RNFLT was significantly higher in males as compared to females, in vertical quadrants and at an average (p < 0.05). No significant relationship was found between the average RNFLT and factors such as age, axial length, corneal thickness, cup-to-disc ratio, intraocular pressure, or refractive error. This study establishes normative values of RNFLT for this subgroup of Pakistani children for the Optopol Copernicus REVO80® SD-OCT device.

Clinical Characteristics and Associated Factors to the Development of Glaucoma in Eyes With Myopic Optic Neuropathy

PurposeTo observe the development of glaucoma in myopic eyes with and without myopic optic neuropathy (MON) and analyze associated factors to the development of typical glaucomatous damage. DesignA prospective, observational, cohort study MethodsA total of 233 myopic eyes with no definite evidence of glaucomatous damage were included in the study. Myopic patients without any retinal nerve fiber layer (RNFL) or visual field (VF) abnormalities were classified as myopic eyes without MON. Myopic patients with decreased RNFL at the superonasal (SN) or nasal area, and with corresponding VF defects either in the temporal or inferotemporal (IT) region, which is different from glaucomatous damage, were classified as myopic eyes with MON. Myopic eyes that developed glaucoma were defined by the presence of glaucomatous VF in the SN region including defects in Bjerrum area, or a new localized RNFL defect in the IT region on red-free photography or RNFL OCT. Disc morphological features and optic nerve head (ONH) parameters of two groups were compared. Hazard ratios for the association between baseline factors and conversion to glaucoma were obtained using Cox regression analysis. ResultsMean follow-up period was 11.66 ± 2.86 years. Myopic eyes with MON had a thinner average peripapillary RNFL thickness (P < 0.001), worse MD of the VF (P = 0.031), a higher percentage of IT VF defects (P < 0.001), smaller torsion degree (P = 0.047), and greater LCD (P = 0.022). Myopic eyes with MON who developed glaucoma had a thinner average peripapillary RNFL thickness (P = 0.009), greater PPA area (P = 0.049), greater LCD (P < 0.001), and thinner LCT (P < 0.001). Thinner baseline temporal RNFL thickness (HR, 0.956; 95% CI, 0.928–0.986; P = 0.004), greater baseline LCD (HR, 1.003; 95% CI, 1.000–1.005; P = 0.022), and greater PPA area (HR, 1.000; 95% CI, 1.000–1.003; P = 0.050) were significantly associated factors with glaucoma development in the Cox regression analysis. ConclusionMyopic eyes with MON have a greater risk to develop glaucoma compared to myopic eyes without MON. Myopic eyes with MON had larger PPA area, greater LCD, and thinner temporal peripapillary RNFL, indicating that accompanying structural weakness due to myopia, especially at the temporal side of the optic nerve head and the peripapillary sclera, increases the risk of glaucoma in myopic eyes with MON.

Functional and Morphological Outcomes after Trabeculectomy and Deep Sclerectomy-Results from a Monocentric Registry Study.

The aim of this study was to compare the effectiveness of trabeculectomy (TE) and deep sclerectomy (DS) in lowering intraocular pressure (IOP) and thereby preserving visual field and peripapillary retinal nerve fiber layer (RNFL) tissue in primary open-angle glaucoma (POAG) cases. IOP, number of IOP-lowering medications, visual acuity, mean defect of standard automated perimetry, and mean peripapillary RNFL thickness were retrospectively collected and followed up for 3 years after surgery. TE was performed in 104 eyes and DS in 183 eyes. Age, gender, laterality, IOP, number of medications, visual acuity, perimetry mean defect, and peripapillary RNFL thickness were equally distributed at baseline. Mean IOP decreased from 23.8 ± 1.4 mmHg and 23.1 ± 0.4 mmHg to 13.4 ± 0.6 mmHg (p < 0.001) and 15.4 ± 0.7 mmHg (p = 0.001) in the TE and DS groups, respectively. Mean defect remained stable (TE: -11.5 ± 0.9 dB to -12.0 ± 1.1 (p = 0.090); DS: -10.5 ± 0.9 dB to -11.0 ± 1.0 dB (p = 0.302)), while mean peripapillary RNFL thickness showed further deterioration during follow-up (TE group: 64.4 ± 2.1 μm to 59.7 ± 3.5 μm (p < 0.001); DS group: 64.9 ± 1.9 μm to 58.4 ± 2.1 μm (p < 0.001)). Both TE and DS were comparably effective concerning postoperative reduction in IOP and medication. However, glaucoma disease further progressed during follow-up.

An Analysis of Optic Disc Parameters in Patients with Peripheral Retinal Tears Following Acute Posterior Vitreous Detachment: A Cross-Sectional Study.

To investigate association between optic disc parameters analyzed by optical coherence tomography (OCT) and occurrence of peripheral retinal tears in patients with symptomatic posterior vitreous detachment (PVD). This cross-sectional study enrolled 75 patients with symptoms of acute PVD, who were allocated into two groups based on whether a peripheral retinal tear occurred or not. When comparing the average retinal nerve fiber layer (RNFL) thickness (μm) between retinal tear and control groups, it was shown that patients with a retinal tear have a significantly higher (87.18 [95% confidence interval (CI), 84.47 to 89.9] vs 81.14 [95% CI, 77.81 to 84.46], P = 0.005) average RNFL thickness. Furthermore, we observed a significant difference (0.13, 0.06 to 0.22 vs 0.07, 0.04 to 0.1, P = 0.036, Mann-Whitney U-test) in the size of cup volume (mm3) between the tear and control groups, respectively. Linear regression showed a significant decrease (P = 0.029) in average RNFL thickness with increasing age, but without a significant difference between the two groups. There was no statistically significant difference between the tear and control groups in terms of rim area, disc area, and average cup-to-disc ratio. Patients with a higher average RNFL thickness and larger cup volume measured by OCT were more prone to develop a peripheral retinal tear. Increased peripapillary average RNFL thickness due to trauma and subsequent inflammation, possibly related to the more adherent posterior hyaloid membrane to the retina, may also indicate strengthened adhesions in the areas of the peripheral retina where retinal tears occur. OCT analysis of the optic nerve head may be used in everyday clinical practice as a predictor of the development of peripheral retinal tears in patients with symptomatic PVD.