Retinal Nerve Fiber Layer Thickness Parameters Research Articles

Optic Nerve Head and Retinal Nerve Fiber Layer Analysis in Emmetropic Malay Children.

The study aims to investigate the normal reference values for optic nerve head (ONH) and retinal nerve fiber layer (RNFL) parameters in emmetropic Malay children, utilizing measurements obtained through Cirrus SD-OCT (Carl Zeiss Meditec, Dublin, CA). A cross-sectional study was conducted on 95 Malay children, aged between seven and 17 years, with no ocular abnormalities. It was held at Hospital Universiti Sains Malaysia, Malaysia, from January 2014 to December 2015. All children underwent a full ocular examination, including refraction and calculation of axial length. ONH and retinal nerve fiber layer thickness (RNFLT) parameters were measured using the Cirrus SD-OCT machine. One eye of each subject was selected randomly for study. The associations between the parameters and the effect of age, gender,axial length, and spherical equivalent (SE) on the measurements were statistically validated. Ninety-five children were involved in the study, with 65 females (68.4%) and 30 males (31.6%). The mean age was 10.6 (2.82) years, the mean intraocular pressure (IOP) was 14.8 (2.81) mmHg, the mean SE-refraction was 0.12 (0.28) diopters, and the mean axial length was 23.03 (0.76) mm. The mean disc area, rim area, and cup volume were 2.32 (0.40) mm2, 1.53 (0.33) mm2, and 0.204 (0.16) mm3, respectively. The average cup-to-disc ratio (SD) (CDR) and the vertical CDR were 0.55 (0.13) and 0.50(0.14). Mean (SD) RNFLT was 102.08 (11.08) μm for all patients. There was a strong positive correlation between the average, superior, and inferior RNFLT with the optical disc area. The rim area and the average, superior, inferior, and nasal RNFLT alsoshowed a significant correlation. The inferiorRNFLT was negatively correlated with the average CDR. There was also a major influence of gender on the disc area. There were no major age, axial length, and SE influences on the measurements. This study provided normative information for ONH and RNFLT parameters in emmetropic Malay children. It was observed that emmetropic Malay males exhibited a significantly larger optical disc area. The increase in RNFLT is correlated with a significant increase in disc and rim areas.

Optical coherence tomography angiography analysis in patients with intracranial hypertension.

Evidence on peripapillary microvasculature in intracranial hypertension (IH) after the regression of papilledema is still scarce. The aim of this preliminary study was to determine the association between structural changes in the optic nerve and the retina and peripapillary microvasculature in patients with IIH. We conducted a retrospective study. The study included 39 eyes of 21 patients with IIH. Treatment for IIH and history of obesity were registered from each patient. Moreover, OCT analysis including retinal nerve fiber layer (RNFL) thickness and ganglion cell-inner plexiform layer (GCIPL) thickness, and OCTA analysis including perfusion density (PD) and flux index (FI) of the radial peripapillary capillary plexus were performed. Correlation analysis revealed a high correlation between GCIPL thickness and peripapillary PD and FI (p < 0,05, r > 0,7), whereas the degree of correlation between RNFL thickness and peripapillary microvascular parameters was low (p < 0,05, r < 0,7). Patients with regressed papilledema had significantly lower GCIPL thickness and peripapillary PD than control subjects (p < 0,05). Peripapillary microvascular measurements are highly correlated with GCIPL thickness in patients with IIH. Moreover, GCIPL thickness and peripapillary PD are significantly inferior in patients with regressed papilledema compared to control group. Thus, we suggested that peripapillary microvascular parameters may be an early indicator of optic nerve atrophy in patients with IIH.

Evaluation of choroidal thickness and retinal nerve fiber layer thickness in Chinese pregnant women and healthy non-pregnant women

PurposeTo evaluate choroidal thickness and retinal nerve fiber layer (RNFL) thickness in different trimesters using enhanced depth imaging optical coherence tomography (EDI-OCT). MethodsA prospective comparative study included 45 healthy pregnant women in the first trimester, 45 women in the second, 45 women in the third and 45 healthy non-pregnant women as the control group. Macular choroidal thickness was measured at three locations: The subfoveal, 1 ​mm temporal, and 1 ​mm nasal from the fovea with EDI-OCT. Peripapillary choroidal thickness (PPCT) and RNFL thickness parameters were automatically calculated by the Spectralis OCT. ResultsThe subfoveal, temporal and nasal macular choroidal thickness were all significantly thicker in the second trimester, compared with those parameters in the first, the third trimesters and the control group (all P ​< ​0.05). The PPCT was significantly increased in the second trimeter compared with the control group at global, temporal, temporal inferior, nasal and nasal inferior positions (all P ​< ​0.05). The RNFL thickness was also significantly increased in pregnant women at nasal superior and nasal inferior quadrants (all P ​< ​0.05). ConclusionsThe choroidal thickness in pregnant women was found to be thicker than the control group, regardless of macular or optic disc location. Findings of RNFL thickening might indicate subclinical involvement of the central nervous system.

Comparison of Optical Coherence Tomography Structural Parameters for Diagnosis of Glaucoma in High Myopia

Diagnosis of glaucoma in highly myopic eyes is challenging. This study compared the glaucoma detection utility of various optical coherence tomography (OCT) parameters for high myopia. To compare the diagnostic accuracy of single OCT parameters, the University of North Carolina (UNC) OCT Index, and the temporal raphe sign for discrimination of glaucoma in patients with high myopia. This was a retrospective cross-sectional study conducted from January 1, 2014, and January 1, 2022. Participants with high myopia (axial length ≥26.0 mm or spherical equivalent ≤-6 diopters) plus glaucoma and participants with high myopia without glaucoma were recruited from a single tertiary hospital in South Korea. Macular ganglion cell-inner plexiform layer (GCIPL) thickness, peripapillary retinal nerve fiber layer (RNFL) thickness, and optic nerve head (ONH) parameters were measured in each participant. The UNC OCT scores and the temporal raphe sign were checked to compare diagnostic utility. Decision tree analysis with single OCT parameters, the UNC OCT Index, and the temporal raphe sign were also applied. Area under the receiver operating characteristic curve (AUROC). A total of 132 individuals with high myopia and glaucoma (mean [SD] age, 50.0 [11.7] years; 78 male [59.1%]) along with 142 individuals with high myopia without glaucoma (mean [SD] age, 50.0 [11.3] years; 79 female [55.6%]) were included in the study. The AUROC of the UNC OCT Index was 0.891 (95% CI, 0.848-0.925). The AUROC of temporal raphe sign positivity was 0.922 (95% CI, 0.883-0.950). The best single OCT parameter was inferotemporal GCIPL thickness (AUROC, 0.951; 95% CI, 0.918-0.973), and its AUROC difference from the UNC OCT Index, temporal raphe sign, mean RNFL thickness, and ONH rim area was 0.060 (95% CI, 0.016-0.103; P = .007); 0.029 (95% CI, -0.009 to 0.068; P = .13), 0.022 (95% CI, -0.012-0.055; P = .21), and 0.075 (95% CI, 0.031-0.118; P < .001), respectively. Results of this cross-sectional study suggest that in discriminating glaucomatous eyes in patients with high myopia, inferotemporal GCIPL thickness yielded the highest AUROC value. The RNFL thickness and GCIPL thickness parameters may play a greater role in glaucoma diagnosis than the ONH parameters in high myopia.

The Effects of Long-term Growth Hormone Treatment on Ocular Findings.

This study aimed to examine the long-term changes in anterior chamber depth (ACD), central corneal thickness (CCT), axial length (AxL), peripapillary retinal nerve fibre layer thickness (RNFLT), peripapillary ganglion cell layer - inner plexiform layer (GCL-IPL) thickness, and peripapillary choroidal thickness (ChT) after rhGH replacement treatment in paediatric patients with IGHD, compared to healthy controls. Twenty-two children with IGHD including 12 girls and 10 boys were enrolled in the study group, and 30 (16 girls, 14 boys) healthy children composed the control group. A detailed ophthalmological examination was performed for each participant. ACD, CCT, AxL, peripapillary RNFLT, GCL-IPL thickness and ChT measurements were performed before the rhGH replacement treatment and in the 12th month of the post-treatment period, as well as the corresponding visits in the control group. AxL ultrasound pachymetry (CCT), peripapillary RNFL thickness, peripapillary RNFLT, GCL-IPL thickness, and peripapillary ChT parameters were measured by spectral-domain optical coherence tomography. The mean age of the groups were similar (p = 0.143). 12-month CCT, ACD, and AxL measurements of the study group showed significantly higher results than the pre-treatment measurements (p = 0.005, p = 0.024, and p = 0.002, respectively). Similarly, the mean RNFLT and ChT measurements of the study group obtained from all sectors were significantly higher in the 12th-month visit (p < 0.001 for both) other than the RNFLT, and GCL-IPL thickness measurements (p > 0.05 for all). However, all these parameters were similar at pre- and post-treatment visits in the control group (p > 0.05 for all). The mean pre-treatment values of all these parameters were significantly lower in the study group compared to the control group (p < 0.05 for all), other than the RNFLT, GCL-IPL thickness measurements (p > 0.05 for all), while the mean post-treatment values of all these parameters in both groups were similar at month 12 (p > 0.05 for all). GH replacement treatment in childhood may play an important role in the development of the neural retina and can be effective on the anterior segment, RNFLT and ChT measurements.

Optical coherence tomography analysis of the optic nerve head and macula of the fellow eye in acute unilateral nonarteritic anterior ischemic optic neuropathy

The objective of the study was to compare the thickness of the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) of the fellow eyes of patients with acute nonarteritic anterior ischemic optic neuropathy (NAAION) to those of control subjects. This study included 46 patients with NAAION matched for age, sex and refraction data (spherical equivalent and/or axial length) to 46 control subjects. The anatomical parameters assessed using the Cirrus SD-OCT were the mean RNFL thickness, in the 4 quadrants (inferior, nasal, temporal, superior) and according to the 12 hourly meridians, GCC mean and in 6 quadrants centered on the fovea (infero-nasal, supero-nasal, infero-temporal, supero-temporal, superior and inferior) and parameters of the optic disc (Cup ratio - Vertical and Average Disc, Rim Area, Disc Area, Cup Volume). Compared to the control group, the eyes contralateral to those affected by NAAION showed a greater value of the area of the neuro-retinal rim (rim area), and a smaller vertical cup/disc (C/D) ratio, mean C/D, and cup volume than the control group. There was no significant difference between the two groups for peripapillary RNFL thickness and GCC parameters. The absence of damage to the RNFL or GCC of the unaffected fellow eyes of patients with NAAION does not explain the perimetric damage. The eyes contralateral to those affected by NAAION are characterized by an overall size of the optic disc identical to those of the control subjects, but a smaller cup, a recognized risk factor for NAAION.

Combined Model of OCT Angiography and Structural OCT Parameters to Predict Paracentral Visual Field Loss in Primary Open-Angle Glaucoma

To assess a model combining OCT angiography (OCTA) and OCT parameters to predict the severity of paracentral visual field (VF) loss in primary open-angle glaucoma (POAG). Cross-sectional study. Forty-four patients with POAG and 42 control subjects underwent OCTA and OCT imaging with a swept-source OCT device. The circumpapillary microvasculature was quantified for vessel density (cpVD) and flow (cpFlow) after delineation of Bruch's membrane opening and removal of large vessels. Retinal nerve fiber layer thickness (RNFLT) and Bruch's membrane opening-minimum rim width (BMO-MRW) were measured from structural OCT. Paracentral total deviation (PaTD) was defined as the average of the total deviation values within the central 10 degrees on Humphrey VF testing (24-2) for upper and lower hemifields. The OCT and OCTA parameters were measured in the affected hemisphere corresponding to the hemifield with lower PaTD for POAG patients. Models were created to predict affected PaTD based on RNFLT alone; RNFLT and BMO-MRW; OCTA alone; or RNFLT, BMO-MRW and OCTA parameters. The models were compared using coefficient of determination (r2) and Bayesian information criterion (BIC) score. Bayesian information criterion decrease of ≥6 indicates strong evidence for model improvement. Performance of models containing OCT and OCTA parameters in predicting PaTD. Patients with POAG and controls were similar in age and sex (65.9 ± 9.5 years and 38.4% male overall, P ≥ 0.56 for both). Average RNFLT, minimum RNFLT, average BMO-MRW, minimum BMO-MRW, cpVD, and cpFlow were all significantly lower (all P < 0.001) in the affected hemisphere in patients with POAG than in controls. In patients with POAG, the average mean deviation was -4.33 ± 3.25 dB; the PaTD of the affected hemifield averaged -4.55 ± 5.26 dB and correlated significantly with both OCTA and structural OCT parameters (r ≥ 0.43, P ≤ 0.004 for all). The model containing RNFLT, BMO-MRW, and OCTA parameters was superior in predicting affected PaTD (r2= 0.47, BIC= 290.7), with higher r2 and lower BIC compared with all 3 other models. A combined model of OCTA and structural OCT parameters can predict the severity of paracentral VF loss of the affected hemifield, supporting clinical utility of OCTA in patients with POAG with paracentral VF loss. Proprietary or commercial disclosure may be found after the references.

Corneal endothelium, retinal nerve fiber layer, ganglion cell complex, and perimetry measurements in normal eyes and those with primary open-angle glaucoma.

Corneal endothelial cell (CEC) loss in glaucoma can be attributed to the direct compressive effect of elevated intraocular pressure. Herein, we aimed to evaluate specular microscopic changes in CEC count and morphology in correlation to retinal nerve fiber layer (RNFL) changes detected by spectral-domain optical coherence tomography (SD-OCT) in early and advanced primary open-angle glaucoma (POAG). This descriptive-analytical study involved patients with medically controlled POAG versus non-glaucomatous patients of the same age group. Specular microscopy, visual field testing, and SD-OCT of the RNFL and macular ganglion cell complex (GCC) were performed. Eyes with POAG were further subcategorized into early and advanced stages. The study included 130 eyes of 130 participants; 70 were eyes with POAG (40 eyes with early-stage POAG, 30 eyes with advanced-stage POAG), and 60 were healthy eyes. The groups were comparable regarding mean age and sex. No significant difference was found in corneal parameters between healthy eyes, eyes with early POAG, and eyes with advanced POAG (all P > 0.05). In eyes with early-stage POAG, a significant negative correlation was found between the coefficient of variation (CV) and superior RNFL thickness (r = - 0.5; P = 0.018), and between the percentage of hexagonal cells (hexagonality) and vertical cup-to-disc ratio (r = - 0.43; P = 0.035). A significant positive correlation was found between hexagonality and superior as well as inferior RNFL thickness (r = + 0.53; P = 0.008 and r = + 0.50; P = 0.015, respectively). However, in the advanced glaucomatous eyes, no significant correlation was found between RNFL thickness and CEC parameters. CEC parameters were not affected in eyes with early or advanced POAG compared with healthy eyes, despite a significant thinning of RNFL and macular GCC. In eyes with early-stage POAG, a significant correlation was found between morphological characteristics of CECs, such as CV and hexagonality, with superior and inferior RNFL thickness in the optic nerve head on SD-OCT images. Future longitudinal studies with larger sample sizes are needed to verify our results.

Macular Ganglion Cell Complex and Peripapillary Retinal Nerve Fiber Layer Thicknesses in Hydroxychloroquine Retinopathy

To investigate macular ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thicknesses in patients with hydroxychloroquine retinopathy of differing severity. Cross-sectional, case-control comparison study. From patients screened for hydroxychloroquine retinopathy between January 2016 and October 2021 using swept-source optical coherence tomography (SS-OCT), fundus autofluorescence (FAF), and standard automated perimetry, 66 patients with retinopathy and 66 without retinopathy were included by 1:1 propensity score matching based on age, sex, systemic diseases, history of tamoxifen and pentosan use, and kidney disease. Eyes with hydroxychloroquine retinopathy were divided into early, moderate, and severe stages. Inner-retinal thickness parameters, including macular GCC (RNFL + ganglion cell layer + inner plexiform layer) and peripapillary RNFL thicknesses, were automatically obtained using SS-OCT (DRI-OCT Triton, Topcon Inc., Japan) and compared between patients with and without retinopathy and between severity subgroups. The structure-function relationships between GCC or peripapillary RNFL thicknesses and perimetric parameters including mean deviation (MD) and visual field index (VFI) of Humphrey 30-2 test were evaluated. Macular GCC and peripapillary RNFL thickness parameters. The average macular GCC and peripapillary RNFL thicknesses were significantly decreased in patients with hydroxychloroquine retinopathy relative to those without retinopathy. Macular GCC thicknesses in 4 of 6 macular sectors and peripapillary RNFL thicknesses in 9 of 12 clock-hour sectors were significantly different between the groups. The differences in the average and sectoral macular GCC parameters were statistically significant among the severity subgroups, particularly between severe and earlier stages. Average macular GCC and peripapillary RNFL thicknesses significantly correlated with MD and VFI in all patients (all P < .001). Macular GCC and peripapillary RNFL thinning was more prominent in eyes with severe hydroxychloroquine retinopathy, as indicative of inner-retinal thinning in eyes with advanced-stage disease. Further, as inner-retinal thinning showed a significant correlation with worse perimetric function, cautious evaluation of the inner retina may be required for eyes with advanced hydroxychloroquine retinopathy.

Diurnal changes of retinal microvascular circulation and RNFL thickness measured by optical coherence tomography angiography in patients with obstructive sleep apnea-hypopnea.

PurposeTo evaluate capillaries perfusion and retinal nerve fiber layer (RNFL) thickness diurnal changes of macular/optic disc regions among participants with or without obstructive sleep apnea-hypopnea (OSA) using spectral-domain optical coherence tomography angiography (OCTA).MethodsIn this study, we enrolled a cohort of 35 participants including 14 patients with mild-to-moderate OSA, 12 patients with severe OSA, and 9 healthy individuals. All participants had Berlin questionnaire filled. At 20:00 and 6:30, right before and after the polysomnography examination, a comprehensive ocular examination was conducted. The systemic and ocular clinical characteristics were collected, and OCTA scans were performed repeatedly. Blood flow and RNFL thickness parameters were then exported using built-in software and analyzed accordingly.ResultsAfter sleep, the overall vessel density (VD) variables, especially macular and choriocapillaris VDs, were relatively comparative and stable. One exception was the RPC vessel density at the inside-disc region with a decreasing trend in the mild-to-moderate group (p=0.023). RNFL changes before and after sleep in the nasal-inferior and peripapillary region were statistically significant (p=0.003; p=0.043) among three groups. And multiple testing correction verified the significant difference in diurnal changes between the mild-to-moderate group and the control group in pairwise comparisons (p=0.006; p=0.02).ConclusionsThe changes of imperceptible blood flow and RNFL thickness overnight around optic disc areas could be observed in OSA patients. Despite physiological fluctuations, aberrant diurnal changes might be useful for identifying a decrease in micro-environmental stability associated with the development of various ocular diseases such as glaucoma. Other VD variables, especially macular and choriocapillaris VDs, are relatively stable in eyes of patients having OSA with different severity.

Comparison of early-stage SD-OCT findings in patients with primer open angle glaucoma and Parkinson’s disease

AIM: To provide an insight to the common pathophysiology of both most frequent and neurodegenerative diseases by comparing thickness parameters of macula and retinal nerve fiber layer (RNFL) by using spectral-domain optical coherence tomography (SD-OCT) in patients with early stage of Parkinson’s disease (PD), and early stage of primary open angle glaucoma (POAG). METHODS: A retrospective review was conducted of 48 patients with an early stage of POAG, 34 patients with an early stage of PD and 37 age- and gender-matched healthy eyes as a control group. The RNFL and macular thicknesses in the nine macular quadrants according to the ETDRS were measured with an SD-OCT and Mean Deviation (MD) values by a visual field analyzer. POAG patients were selected only MD smaller than -6 dB. Patients with MD values below -6 dB were considered as early-stage glaucoma. PD severity was assessed using Hoehn and Yahr (H&amp;Y) and Unified Parkinson’s Disease Rating Scale (UPDRS). The PD group selected only H&amp;Y Stage I-III patients. RESULTS: Statistically significant difference was determined between all groups RNFL measurements except temporal RNFL (P&lt;0.05). Statistically significant difference was determined between all groups including fovea, mean macula thickness and macula outer quadrant thickness evaluations (P&lt;0.05). There was not any significant difference between thickness evaluation of macula inner quadrant for POAG and PD groups (P&gt;0.05). A weak negative correlation was determined between duration of disease and UPDRS score together with macula and RNFL thickness parameters in PD group. CONCLUSION: Similar thinning was detected by using SD-OCT for thickness parameters of macula and RNFL in early stage of POAG and early stage of PD group. However this thinning was more significant in early stage of POAG group. It can be declared that neurodegeneration on the macula which is caused by glaucoma is more destructive than PD. Thinning on foveal region is remarkable for PD patients.

Evaluation of peripapillary retinal nerve fiber layer thickness in patients with primary open-angle glaucoma

Introduction/Objective. The objective of the study was to determine the difference in peripapillary retinal nerve fiber layer (RNFL) thickness in patients with open-angle glaucoma (POAG) in comparison to the healthy population and according to the progression of the disease. Methods. Four groups were formed among 120 patients: group without glaucoma, early, moderate POAG, and preperimetric glaucoma group. Visual field and optical coherent tomography were performed. Results. RNFL thickness value was found to be the highest in the inferior quadrant, the second highest in the superior one, the third highest in the nasal one, and the lowest value was found to be in the temporal quadrant. The highest average value of RNFL thickness was in the superior quadrant of the healthy group (124.3 ? 17.8 ?m), and the lowest one was in the temporal quadrant of the moderate group (46.5 ? 10.8 ?m). Other RNFL thickness values per quadrants among groups were distributed between these two endpoints. Mean value of peripapillary RNFL thickness (AvgThic) in patients with moderate POAG was lesser than in patients with early POAG, which, in turn, was lesser than that in the healthy subjects (59.6 ? 10.6 ?m vs. 73.4 ? 12.1 ?m vs. 105.5 ? 11.3 ?m). AvgThic in the preperimetric glaucoma group was 83.6 ? 9.2 ?m. Pearson correlation showed a high positive correlation between mean deviation values and the following parameters: AvgThic, S, I, Smax, Imax, Savg, Iavg. Receiver operating characteristic curves found that the parameter with the best diagnostic ability was AvgThic, with the area of 0.803 (&lt; 0.0005), sensitivity of 67%, and specificity of 83.3%. Conclusion. Peripapillary RNFL thickness parameters AvgThic, S, I, Smax, Savg, Iavg, Imax have an excellent ability to discriminate between healthy eyes and eyes with POAG. The parameter with the highest specificity and sensitivity is AvgThic, which makes it the best for early detection and monitoring of POAG.

Spectral domain optical coherence tomography for detecting glaucoma

Purpose: To evaluate the diagnostic ability of macular thickness parameters and peripapillary retinal nerve fiber layer (RNFL) thickness parameters for detecting glaucoma using spectral domain optical coherence tomography (SD–OCT).&#x0D; Methods: 37 eyes of 20 glaucoma patients and 30 eyes of 16 healthy subjects included in this study underwent macular and peripapillary RNFL scans with SD–OCT using standard scanning parameters. The ”Macular Cube 512x128” scan protocol was used to measure the macular thickness. The ”Optic Disc Cube 200x200” scan protocol was used for assessing the peripapillary region. The discrimination power of all parameters for detecting glaucoma was determined by the Area under Receiver Operating Characteristics (AROC) curve and sensitivity at fixed specificity, followed by a comparison of the best macular thickness and peripapillary RNFL thickness parameters.&#x0D; Results: Significant differences between glaucoma patients and healthy subjects were found in all peripapillary RNFL thickness parameters and all macular thickness parameters, except in the fovea (p=0.322). The largest AROC with sensitivity at &gt;90% specificity among the peripapillary RNFL thickness parameters was found for the average peripapillary RNFL thickness (AROC 0.95, sensitivity 76%). The largest AROC with sensitivity at &gt;90% specificity among the macular parameters was found for the inferior inner macular thickness (AROC 0.90, sensitivity 78%). There was no statistically significant difference between the AROCs of these two parameters (p=0.208).&#x0D; Conclusion: To discriminate glaucoma patients from healthy subjects using SD–OCT, macular thickness parameters had high diagnostic ability which was comparable to that of the peripapillary RNFL thickness parameters.

Repeatability of Bruch’s Membrane Opening-minimum Rim Width in Age-related Macular Degeneration and Diabetic Macular Edema

Purpose: To evaluate the repeatability of retinal nerve fiber layer (RNFL) thickness and Bruch’s membrane opening-minimum rim width (BMO-MRW) measurements by spectral-domain optical coherence tomography (SD-OCT) in wet age-related macular degeneration (wAMD) and diabetic macular edema (DME).Methods: This was a prospective study. The RNFL thickness and BMO-MRW parameters for each sector and global average were measured twice by SD-OCT. Repeatability was evaluated using the intraclass correlation coefficient (ICC) and coefficient of variation (CV). If the optic disc membrane was confirmed, it was analyzed by dividing it into three groups based on severity.Results: A total of 99 eyes (48 with wAMD, 51 with DME) were included in the analysis. The ICCs of the global RNFL thickness and global BMO-MRW measurements were 0.996 and 0.997, respectively, in wAMD and 0.994 and 0.996, respectively, in DME eyes. The CV values of global RNFL thickness and BMO-MRW were 0.60% and 0.73%, respectively, in wAMD eyes and 1.10% and 1.21%, respectively, in DME eyes. The disc membrane on the optic nerve head significantly affected global BMO-MRW repeatability (B = 0.814, &lt;i&gt;p&lt;/i&gt; &lt; 0.001).Conclusions: Both RNFL thickness and BMO-MRW measurements showed good repeatability in eyes with wAMD and DME. The severity of the optic disc membrane significantly affected the repeatability of BMO-MRW measurements in eyes with wAMD and DME. Therefore, physicians should examine the BMO-MRW in eyes with severe optic disc membrane.

Relationship between Retinal Nerve Fiber Layer Thickness and Aortic Distensibility in Peripheral Arterial Disease Patients.

Aim and objectiveTo evaluate the relationship between aortic distensibility (AD) and aortic stiffness B index (ASBI) with retinal nerve fiber layer (RNFL) thickness measured with HD-OCT in peripheral arterial disease (PAD) patients.Materials and methodsTwenty-six PAD patients and 22 age-matched healthy control were enrolled. Subjects with PAD were classified into two groups. Patients with diabetes (DM) or hypertension (HT) comprised group I (n = 18) and without DM or HT comprised group II (n = 8). Color Doppler imaging was performed on all patients and PAD was diagnosed by using the ankle-brachial index (ABI). Retinal nerve fiber layer thickness values between control and PAD patients and correlations between RNFL thickness and aortic stiffness parameters (AD and ASBI) were evaluated.ResultsThe inferior-nasal and inferior-temporal quadrant were the thickest in healthy subjects and the PAD group. Retinal nerve fiber layer thickness significantly decreased in superior-nasal, temporal, inferior-nasal quadrants in group I than healthy subjects (p < 0.001, p = 0.005, p < 0.001). Temporal and inferior-nasal quadrant thicknesses were statistically significantly thinner in group II than controls (p = 0.02, p < 0.001). The nasal RNFL quadrant was significantly thinner in group I than group II (p = 0.014). The correlation between RNFL thickness and aortic elasticity parameters in each group was not found to be significant.Conclusion and clinical significanceIsolated PAD without DM or HT may lead to localized RNFL loss in temporal and inferior-nasal quadrants. Aortic elasticity parameters did not seem to be correlated with RNFL thickness in PAD.How to cite this articleKumova D, Aktas Z, Eyiol A, et al. Relationship between Retinal Nerve Fiber Layer Thickness and Aortic Distensibility in Peripheral Arterial Disease Patients. J Curr Glaucoma Pract 2021;15(2):86–90.

Clinical Features of Advanced Glaucoma With Optic Nerve Head Prelaminar Schisis

To investigate the clinical characteristics of optic nerve head (ONH) prelaminar schisis in eyes with advanced glaucoma. Cross-sectional study. One hundred sixteen eyes with advanced glaucoma (30-2 mean deviation <-12 dB) were included. ONH prelaminar schisis was identified using the spectral-domain optical coherence tomography independently by 2 evaluators and only eyes that reached consensus for the presence of ONH prelaminar schisis were included. Bruch membrane opening-minimum rim width (BMO-MRW), thickness and depth of lamina cribrosa (LC), peripapillary retinal nerve fiber layer (RNFL) thickness, macular thickness (total, RNFL, ganglion cell layer, inner plexiform layer), and peripapillary and subfoveal choroidal thickness were additionally obtained. Clinical characteristics were compared between the 2 groups based on the presence of ONH prelaminar schisis. ONH prelaminar schisis was identified in 48 of 116 eyes. Multivariate logistic regression analysis revealed that short axial length, thin and deep LC, and thick macula were associated with the presence of ONH prelaminar schisis. When the structure-function relationships were determined, macular structural parameters tended to have a better relationship with functional parameters than the BMO-MRW and peripapillary RNFL thickness parameters in eyes with ONH prelaminar schisis. The ONH prelaminar schisis was associated with thin and deep LC, short axial length, and generally thick macula. In patients with this features, the macular measurements, rather than peripapillary or ONH measurements, better predict the functional status of the eye. Our findings may have significant clinical implications for management of advanced glaucoma eyes with and without ONH prelaminar schisis.

Long term predictive ability of preoperative retinal nerve fiber layer thickness in visual prognosis after chiasmal decompression surgery

ObjectiveTo investigate the relationship between preoperative retinal nerve fiber layer (RNFL) thickness and the recovery of visual field (VF) and visual acuity (VA) 1 year after surgery in chiasmal compression patients presenting with visual impairment. Patients and methodsTwenty-nine eyes of 16 patients with chiasmal compression and 14 eyes of 14 control subjects were enrolled. All patients undergoing chiasmal decompression surgery via a transsphenoidal approach were prospectively evaluated before and 1 year after surgery with best corrected visual acuity (BCVA, logMAR), mean deviation (MD) value with standard automated perimetry (SAP) and RNFL thickness with optical coherence tomography. Eyes with chiasmal compression were divided into two groups according to the mean preoperative RNFL thickness: ≥ 100 µm (Group 1) and < 100 µm (Group 2). The relationship between the mean preoperative RNFL thickness and visual prognosis parameters (VF, VA) was analyzed. ResultsThe mean preoperative RNFL thickness was 115.92 ± 8.97 µm, 84.0 ± 8.85 µm, and 114.21 ± 7.75 µm in Group 1 (n = 15 eyes), Group 2 (n = 14 eyes) and the control group (n = 14 eyes), respectively. The mean preoperative BCVA was 0.15 ± 0.3 in Group 1, and 0.41 ± 0.39 in Group 2. The mean BCVA increased to 0.03 ± 0.1 in Group 1 in the postoperative period but did not change in Group 2. MD value was − 6.10 ± 5.54 in the preoperative period and − 2.59 ± 2.23 in the postoperative period for Group 1 (p = 0.014), while it was − 18.97 ± 4.14 in the preoperative period and − 18.57 ± 4.51 in the postoperative period in Group 2 (p = 0.24). ConclusionsThis study suggests that lower mean preoperative RNFL thickness was associated with poorer long-term visual prognosis. Preoperative RNFL thickness measurements may be helpful in predicting the recovery of VF and VA after decompression surgery in patients with chiasmal lesion presenting with visual impairment.

A Simple Subjective Evaluation of Enface OCT Reflectance Images Distinguishes Glaucoma From Healthy Eyes.

PurposeWe present a subjective approach to detecting glaucomatous defects in enface images and assess its diagnostic performance. We also test the hypothesis that if reflectivity changes precede thickness changes in glaucoma there should be reduced correlation between the modalities in glaucoma compared to controls.MethodsTwenty glaucoma participants and 20 age-matched controls underwent high-resolution OCT scans of one eye. 4 µm-thick enface slabs were constructed through the retina. Enface indices were depths of first gap in visible retinal nerve fiber bundles (RNFBs) and last visible bundle, subjectively evaluated in six sectors of a 3.5 mm circle around the optic disc. Retinal nerve fiber layer thickness (RNFLT) along the same circle was extracted at angles corresponding to enface indices. Between-group differences were tested by linear mixed models. Diagnostic performance was measured by partial receiver operating characteristic area (pAUC).Results First gap and last visible bundle were closer to the inner limiting membrane in glaucoma eyes (both P < 0.0001). Enface indices showed excellent diagnostic performance (pAUCs 0.63–1.00), similar to RNFLT (pAUCs 0.63–0.95). Correlation between enface and RNFLT parameters was strong in healthy (r = 0.81–0.92) and glaucoma eyes (r = 0.73–0.80).ConclusionsThis simple subjective method reliably identifies glaucomatous defects in enface images with diagnostic performance at least as good as existing thickness indices. Thickness and reflectivity were similarly related in healthy and glaucoma eyes, providing no strong evidence of reflectivity loss preceding thinning. Objective analyses may realize further potential of enface OCT images in glaucoma.Translational RelevanceNovel enface OCT indices may aid glaucoma diagnosis.

Optical coherence tomography measurements in patients with systemic hypertension.

To evaluate the effect of systemic arterial hypertension (SAH) on retinal optical coherence tomography (OCT) parameters and investigate whether a correlation exists between ambulatory blood pressure monitoring (ABPM) and OCT measurements.Material-methods: 115 SAH patients (225 eyes) and 123 healthy control cases (234 eyes) were included. ABPM was performed on 89 of 115 SAH patients. All patients underwent detailed ophthalmologic examination including imaging with OCT. SAH patients were divided into two groups (dippers, non-dippers) according to their nocturnal blood pressure (BP) reduction, and OCT measurements were compared. Average and superior retinal nerve fiber layer (RNFL) quadrants were significantly thin in hypertensive cases (p:0.002, p < 0.001, respectively). Cup area, cup/disk (c/d) area, and c/d horizontal ratios were wider; the rim area was smaller in hypertensive cases (respectively: p:0.024, p:0.017, p:0.003, p < 0.001). Total macular volume (TMV), the thicknesses in 1-3 and 1-6 mm of the macula were less in hypertensives (p < 0.001). There was no significant difference between dippers and non-dippers in RNFL thickness, macula and optic nerve head (ONH) parameters. There were statistically significant differences between healthy cases and patients with SAH in terms of RNFL, macula thicknesses and ONH parameters.

Detecting Progression in Patients With Different Clinical Presentations of Primary Open-angle Glaucoma.

Précis:Glaucoma progression was more frequently identified by assessing retinal fiber layer thickness than by monitoring visual field (VF) loss for different baseline classifications in primary open-angle glaucoma.Purpose:The aim was to compare the detection of glaucoma progression by retinal nerve fiber layer thickness (RNFLT) and VF assessments for different baseline classifications of primary open-angle glaucoma.Methods:This study included 194 eyes from 194 patients with a minimum of 9 follow-up visits selected from the Diagnostic Innovation in Glaucoma Study (DIGS) and the African Descent and Glaucoma Evaluation Study (ADAGES). Each eye was classified according to baseline clinical signs: ocular hypertension (n=39), glaucomatous optic neuropathy only (n=60), glaucomatous visual field loss only (GVF, n=39) and definite glaucoma (concurrent optic disc and VF defect, n=56). We assessed progression by performing simple linear regression on global and sectorial mean deviations values generated for RNFLT (RNFLT-MD) and VF data (VF-MD). The proportion of eyes identified as progressing (positive rate) by RNFLT-MD and by VF-MD were compared within each classification.Results:Whereas both parameters performed similarly among glaucomatous optic neuropathy only and definite glaucoma eyes, the positive rate obtained with global RNFLT-MD was significantly greater compared with global VF-MD by 33.3% and 30.8% among ocular hypertension eyes and GVF eyes, respectively. This finding was consistent in the inferotemporal sector; however, similar positive rates were obtained for both parameters in the superotemporal sector.Conclusions:While both RNFLT and VF parameters showed comparable abilities to identify progression across the different classifications, RNFLT assessment may be better suited to monitor progression, particularly among patients with elevated intraocular pressure and those who present with only GVF defect at baseline.