Retinal Nerve Fiber Layer Thickness Research Articles

Retinal and Vascular Findings in Optical Coherence Tomography in Healthy Cognitive Patients With Alzheimer Disease Biomarkers: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to explore differences in optical coherence tomography (OCT) findings between cognitively healthy individuals with Alzheimer disease (AD) biomarkers and healthy controls. A thorough literature review was conducted on February 6, 2023, in PubMed, Embase, Cochrane Library, LILACS, and DANS EASY Archive. Studies that involved cognitively healthy individuals with AD biomarkers undergoing OCT or OCT angiography were included. The risk of bias was assessed using validated tools. A narrative synthesis and meta-analysis were performed with standardized mean differences and I2 heterogeneity assessments. Seventeen studies comprising 601 participants with positive AD biomarkers and 881 controls were included. The reviewed studies varied in design, with notable findings indicating a reduction in retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness, alongside an increase in inner plexiform layer (IPL) thickness. In addition, OCT angiography revealed reduced vascular density and an enlarged foveal avascular zone-however, variations and inconsistencies in results led to inconclusive outcomes for RNFL and GCL-IPL meta-analyses. In summary, cognitively healthy individuals with positive AD biomarkers demonstrated RNFL, GCL thinning, and IPL thickening trends. Future longitudinal studies using standardized methods are critical to validate these OCT changes as potential early indicators for AD.

Bright light therapy in Parkinson’s disease: a pilot study on visual pathway improvements

BackgroundBright light therapy (BLT) has been proved to have beneficial effects on Parkinson’s disease (PD), the mechanisms remained unclear. Improvements of visual pathways might be key to BLT.ObjectiveThe aim of this study is to validate whether BLT improves clinical symptoms in PD and explore the possible mechanisms of visual pathways evaluated by optical coherence tomography (OCT), pattern electroretinogram (PERG) and visual evoked potentials (VEP).MethodsTwenty-three PD patients were enrolled in this crossover randomized placebo-controlled study. Participants received either one month of BLT or dim light therapy (DLT), separated by one-month wash-out period, followed by another intervention. Participants underwent clinical scales, and visual-related evaluations including OCT, PERG and VEP before and after each intervention. Mixed-effects regression models were used to determine the effect between BLT and DLT on improving the differentials of clinical scales (Δscales), OCT (Δretinal thickness), PERG (ΔPERG values) and VEP (ΔP100 latencies). Correlations between clinical symptoms and visual evaluations improvements were analyzed in PD patients receiving BLT.ResultsExcessive daytime sleepiness, anxiety, life quality and autonomic function were improved after BLT. Compared with DLT, bilateral ΔN95 latencies for PERG and ΔP100 latencies for VEP were improved after BLT. We did not observe the changes of four quadrants retinal nerve fiber layer (RNFL) thickness after BLT or DLT.ConclusionsBLT is a valuable and safe non-pharmacological intervention for improving visual function in PD patients.SignificanceThese findings extend neural mechanisms of BLT to visual pathways improvements.

Effect of cataract surgery on macular and peripapillary optical coherence tomography values.

To evaluate the effects of cataract surgery on peripapillary retinal nerve fiber layer (pp-RNFL) and macular thickness measurements, obtained by optical coherence tomography (OCT). In this prospective before-after study, both pp- and macular scans were obtained within two days before and then two weeks after surgery. Cataract density was graded using the Lens Opacities Classification System (LOCS) III. Pre- and postoperative quality scores and thicknesses were compared. In 100 studied eyes of 100 patients, quality scores and thickness values increased postoperatively. (all P < 0.001). The greatest change was observed at the nasal superior sector of pp-OCT (5.28 ± 11.11µm) and the temporal quadrant of 3-mm-diameter circle (7.40 ± 9.13 µm) of macular scans. Changes in the quality score were significantly correlated with changes in global, nasal, and temporal-inferior pp-RNFL thicknesses and none of macular sectors. The greatest changes in pp-RNFL and macular thicknesses were observed with posterior subcapsular and the least with cortical cataracts. In 14 eyes, the increase in pp-RNFL thickness measurements resulted in a change in color display of pie charts. In this subset of patients, significant positive correlation was observed between global thickness change and quality change. (r = 0.217, P = 0.033). Cataract surgery significantly improves the quality score and thickness values of both pp- and macular OCT. Correcting OCT-derived pp-RNFL thicknesses in eyes with significant cataracts is needed to prevent misdiagnosis of glaucoma.

Evaluation of visual function and morphological changes in patients with adrenoleukodystrophy using SS-OCT and PVEP.

This study aims to evaluate visual function and morphological changes in patients with adrenoleukodystrophy (ALD) through sweep-source optical coherence tomography (SS-OCT) and patterned visual evoked potentials (PVEP), with the goal of providing more accurate and comprehensive data for the diagnosis, monitoring, and assessment of treatment efficacy in patients with ALD. This study included 46 ALD patients and 44 healthy controls. The thickness of the retinal nerve fiber layer (RNFL) around the optic disc, as well as the macular RNFL and ganglion cell-inner plexiform layer (GCIPL) thickness, was assessed using SS-OCT. The peak time and amplitude of the P100 wave were also measured using PVEP. Factors that were statistically significant in the univariate analysis were subjected to stepwise binary logistic regression analysis for further investigation. Predictive performance was evaluated by constructing receiver operating characteristic (ROC) curves and compared using DeLong's test. Compared with the control patients, ALD patients presented a significant increase in the peak time of the P100 wave (P < 0.05); however, no notable difference in amplitude was observed (P > 0.05). Additionally, substantial decreases in the RNFL and GCIPL thicknesses were observed within the parafoveal ring, especially in the superior and nasal quadrants (P < 0.05). The area under the curve for the binary logistic stepwise regression model was 0.883, with a sensitivity of 0.95, which surpassed the performance of the individual parameters. ALD patients present with abnormal retinal structures and a PVEP peak time delay. Combining these two parameters could increase the accuracy of an early ALD diagnosis.

Evaluation of Retinal and Optic Nerve Parameters in Recovered COVID-19 Patients: Potential Neurodegenerative Impact on the Ganglion Cell Layer

Background/Objectives: This study aimed to analyze optic nerve parameters, retinal nerve fiber layer thickness (RNFLT), ganglion cell layer thickness (GCLT), and subfoveal choroidal thickness (ChT) in patients who have recovered from coronavirus disease 2019 (COVID-19). Methods: This comparative study included 78 recovered COVID-19 patients (16 men, 62 women) and 56 age- and sex-matched healthy controls (18 men, 38 women). COVID-19 was confirmed in all patients, either through the detection of viral RNA in nasopharyngeal swabs via reverse transcriptase polymerase chain reaction or by serological testing for SARS-CoV-2 antibodies. Spectral-domain optical coherence tomography (SD-OCT) was used to assess optic nerve parameters, RNFLT, GCLT, and ChT. Results: The mean age was 35.0 ± 8.3 years in the COVID-19 group and 31.5 ± 8.3 years in the control group, with no statistically significant differences in age or sex distribution between groups (p = 0.41 and p = 0.16, respectively). Optic nerve parameters and RNFLT (overall and across the four peripapillary quadrants) did not differ significantly between the COVID-19 and control groups. However, the mean ganglion cell–inner plexiform layer (GC-IPL) thickness was significantly reduced in all quadrants in the COVID-19 group compared to the controls. No significant difference was observed in mean subfoveal ChT between groups. Conclusions: A significant reduction in ganglion GCLT was observed in recovered COVID-19 patients compared to healthy controls, suggesting a potential neurodegenerative effect of the disease on the optic nerve.

Impact of compressive neuropathy on peripapillary retinal nerve fiber layer thickness in pediatric patients after craniopharyngioma surgery

Impact of compressive neuropathy on peripapillary retinal nerve fiber layer thickness in pediatric patients after craniopharyngioma surgery

Cognitive test performance and disease progression in primary and secondary progressive MS: An analysis of the SPRINT-MS study.

Clinical trials of disease-modifying therapies (DMTs) for multiple sclerosis (MS) increasingly incorporate cognitive outcomes, although effects of DMTs on cognition remain unknown. In this secondary analysis of data from SPRINT-MS, a phase 2 randomized, placebo-controlled trial of ibudilast for progressive MS, we evaluated performance on Symbol Digit Modalities Test (SDMT) and Selective Reminding Test (SRT) in relation to physical disability, brain volume assessed with magnetic resonance imaging, and retinal nerve fiber layer (RNFL) thickness over 96-week follow-up. We hypothesize that trial participants would show a decline in cognitive test scores over 96 weeks of follow-up, with a possible between-group difference in favor of ibudilast. Data from 255 participants were analyzed. On average, physical outcome measures, brain parenchymal fraction, and RNFL thickness worsened; average SDMT and SRT scores remained largely unchanged. There were no differences between treatment groups in cognitive outcomes at 96-week follow-up. Practice effects likely contributed to results. Observed stability of cognitive scores in individuals with progressive MS over 96-week follow-up may reflect true cognitive stability. However, the possibility that current cognitive measurement instruments are psychometrically flawed remains, warranting further research.

Comparison of long-term changes in peripapillary RNFL thickness between macula-on and macula-off rhegmatogenous retinal detachment

To compare postoperative changes in peripapillary retinal nerve fiber layer (pRNFL) thickness between macula-off and macula-on rhegmatogenous retinal detachment (RRD). Patients with RRD who had undergone a single, uncomplicated vitrectomy and been followed for ≥ 3 years postoperatively were included. Based on preoperative status, patients were categorized into a macula-on group (Group 1) and a macula-off group (Group 2). The baseline was established after complete gas dissipation from the vitreous cavity, followed by three additional examinations at 1-year intervals. In total, 62 eyes were analyzed: 30 in Group 1 and 32 in Group 2. Global pRNFL thicknesses in Group 1 were 100.0 ± 19.5, 99.4 ± 19.6, 98.4 ± 19.4, and 97.0 ± 20.3 μm at baseline, 1 year, 2 years, and 3 years, respectively (P = 0.001). In Group 2, the corresponding values were 99.6 ± 15.0, 96.2 ± 16.4, 95.4 ± 16.3, and 94.1 ± 17.6 μm (P < 0.001). Sectoral analysis showed statistically significant changes in the inferotemporal (P < 0.001) and inferonasal (P = 0.003) sectors in Group 2. The reduction rates of global pRNFL thickness were − 0.89 μm/y in Group 1 and − 1.81 μm/y in Group 2; these rates significantly differed between the groups (P = 0.026). Among RRD patients, pRNFL thickness gradually declined over time, with a more pronounced reduction in the macula-off group. A substantial decrease in inferior pRNFL thickness was observed in macula-off patients.

Assessment of choriocapillary flow deficits in myopic children by optical coherence tomography angiography

To assess macular and optic disc choriocapillary flow deficit (CCFD) and vessel density (VD) in myopic children by OCT-angiography. 280 eyes of 280 subjects were included and divided into the non-myopia (n = 96), low myopia (n = 95), and moderate myopia (n = 89) groups. We analyzed the following factors: CCFD density and size, choroidal vascularity index, choriocapillary VD, retinal VD. The moderate myopia group showed significantly higher CCFD density and size (p < 0.05). There were significant linear correlations between CCFD density and axial length (AL), spherical equivalent (SE), average corneal curvature (AVK), and CCFD size and SE (all p < 0.05). Breakpoints were identified at SE values of −1.25 and −1.14D in relation to CCFD density and CCFD size (all p < 0.05). The moderate myopia group exhibited significantly increased and decreased radial peripapillary capillaries VD and retinal nerve fiber layer thickness in the temporal and nasal optic disc regions respectively (all p < 0.05). CCFD demonstrated a significant increase and correlation with AL and SE, suggesting that CCFD may serve as a more sensitive indicator of alternations in choroidal blood flow. It offers a novel perspective for investigating myopia progression associated with alterations in choroidal blood flow.Trial registration number ChiCTR2400087513.

Independent Evaluation of RETFound Foundation Model's Performance on Optic Nerve Analysis Using Fundus Photography.

Independent Evaluation of RETFound Foundation Model's Performance on Optic Nerve Analysis Using Fundus Photography.

Structural and functional assessment of ganglion cell complex in patients on long-term hydroxychloroquine.

Long-term hydroxychloroquine (HCQ) treatment has been shown to be associated with structural changes (reduced thickness) of ganglion cell complex (GCC). This study evaluated if these structural changes of GCC translate to functional deficits and if they represent true retinal toxicity. This was a cross-sectional study. Fifteen patients aged ≥18 years who had been on HCQ treatment for >5 years were recruited as cases, and 15 age- and gender-matched healthy individuals were recruited as controls. All cases underwent visual fields (central 10-2 SITA standard), pattern electroretinogram (ERG), spectral-domain optical coherence tomography (OCT), and widefield autofluorescence. Controls underwent pattern ERG and spectral-domain OCT. A significantly lower average (77.0 ± 5.5 µm vs. 82.0 ± 5.3 µm, P = 0.017) and minimum ganglion cell-inner plexiform layer (GC-IPL) thickness (71.0 ± 8.1 µm vs. 76.6 ± 6.3 µm, P = 0.041) were noted among cases compared to controls. Similarly, average retinal nerve fiber layer (RNFL) thickness (86.7 ± 9.6 µm vs. 94.8 ± 7.6 µm, P = 0.015) and superior quadrant RNFL thickness (105.2 µm ± 16.7 µm vs. 120.0 µm ± 15.6 µm, P = 0.018) were lower in cases than in controls. Average RNFL thickness and GC-IPL thickness were negatively correlated with the mean deviation (MD), the pattern standard deviation (PSD) scores, and implicit times of P50 and N95 waveforms, respectively, but none were statistically significant. Long-term HCQ use is associated with structural changes in the GCC, manifested as lower GC-IPL and RNFL thickness. Although there was a trend suggesting ganglion cell dysfunction (prolonged implicit times) and possible deficits in RNFL function (MD and PSD scores), statistically significant correlations could not be established with GC-IPL and RNFL thickness, respectively. GC-IPL/RNFL thickness assessment can be a part of the screening. Mere GC-IPL thickness reduction should not be a criterion to recommend HCQ cessation in the absence of abnormality on routinely recommended screening tests.

Evaluation of optical coherence tomography changes in amblyopia.

To study the Central Macular Thickness (CMT) and Retinal nerve fiber layer (RNFL) thickness (RNFLT) using Optical Coherence Tomography (OCT) in cases of amblyopia. The study was conducted on 30 patients of unilateral amblyopia having vision of less than 6/12 (30 amblyopic eyes and 30 fellow eyes) and age matched 30 eyes of normal controls aged between 5-30 years. Vision, Refraction and ophthalmological examination was done. OCT changes in macula and RNFL layer were evaluated in both eyes of each patient and controls. The data was statistically analyzed using SPSS version 22. Out of 30 patients 14 were anisomyopic and 16 were anisohyperopics. The mean central macular thickness among amblyopic eyes was significantly increased (238.77±3.64 µm) a.c.t fellow eyes (218.73±4.71µm). Average retinal nerve fibre layer thickness among amblyopic eyes was significantly increased (100.50±7.70 µm) a.c.t fellow eyes (95.67±6.38) (P<0.001). The eyes with unilateral anisometropic amblyopia were associated with higher Central Macular Thickness (CMT) and thicker global Retinal Nerve Fibre Layer (RNFL) when compared to normal fellow eyes.

Normative Variability in Retinal Nerve Fiber Layer Thickness: Does It Matter Where the Peaks Are?

Retinal nerve fiber layer thickness (RNFLT), a glaucoma biomarker, has a wide normative range affecting its sensitivity and specificity for abnormality detection. The interindividual RNFLT peak location variability contribution to this wide normative range has not been directly evaluated. The purpose of this study is to assess the effect of RNFLT peak normalization (PN) on normative variability. Circumpapillary RNFLT profiles at 1.7mm radius from the optic nerve head (ONH) were re-sampled from optical coherence tomography (OCT) volumes (Cirrus HD-OCT, 200 × 200) obtained from one eye of 83 healthy individuals. Fovea-ONH axis (FOA) was calculated from corresponding scanning laser ophthalmoscope images. Supratemporal (ST) and infratemporal (IT) RNFLT peaks of each profile were aligned to respective average peak locations. Normative ranges were calculated by averaging individual profiles before and after PN (with and without FOA to horizontal image axis (HA) alignment). RNFLT-PN resulted in an overall decrease in coefficient of variation (CoV) of the normative range by 4.2% (P = 0.02). CoV was reduced by more than 10% in clock-hours 10 (11.9%), 8 (10.6%), 6 (10.4%) after PN, and 7 (16.3%), 10 (11.4%), and 12 (10.4%) after PN with FOA-HA alignment. RNFLT-PN corrected for abnormality categorization because of peak misalignment in RNFLT profiles of healthy and glaucoma suspect subjects. RNFLT-PN reduces normative variability, especially in the ST and IT regions. RNFLT-PN reduces normative variability and improves sectoral abnormality categorization, potentially leading to better sensitivity and specificity of RNFLT measure in glaucoma detection.

OCT Angiography Analysis of Retinal and Choroidal Flow after Proton Beam Therapy for Choroidal Melanoma.

OCT Angiography Analysis of Retinal and Choroidal Flow after Proton Beam Therapy for Choroidal Melanoma.

The Relationship Between the Ganglion Cell–Inner Plexiform Layer, Retinal Nerve Fiber Layer, and Photopic Negative Response in Newly Diagnosed Pituitary Macroadenoma: 12-Month Prospective Follow-Up Study

Background/Objectives: This prospective study evaluates the relationship between the ganglion cell–inner plexiform layer (GCIPL), retinal nerve fiber layer (RNFL), and photopic negative response (PhNR) in patients with newly diagnosed pituitary macroadenomas over 12 months. Methods: A total of 40 patients (80 eyes) were included, divided into a treatment group of 27 patients (54 eyes), receiving pharmacological and/or surgical intervention, and an observation group of 13 patients (26 eyes), with non-functional pituitary adenomas (NFPAs) that did not require treatment. Results: Key findings indicate a significant improvement in best corrected visual acuity (BCVA) after 12 months in the treatment group (p = 0.02) and a significant reduction in RNFL thickness in multiple quadrants (p &lt; 0.01). Moreover, PhNR amplitude and W-ratio significantly increased in the treatment group (p &lt; 0.0001). In the observation group, only GCIPL Inferior (p = 0.0470) and PhNR W-ratio (p = 0.0015) showed significant differences. Between-group comparisons showed significant differences in RNFL Nasal quadrant at baseline (p = 0.0017) and after 12 months (p = 0.0150). PhNR amplitude and W-ratio also differed significantly between groups at 12 months (p = 0.0012 and p = 0.0016, respectively). Correlations between OCT and ERG parameters were weak at baseline and diminished over time. Conclusions: These findings suggest that GCIPL, RNFL, and PhNR analyses may be useful for monitoring disease progression and guiding treatment decisions in patients with pituitary macroadenomas.

Peripapillary vessel wall changes correlate with disease severity in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).

Peripapillary vessel wall changes correlate with disease severity in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).

Idebenone vs. rAAV2-ND4 gene therapy in the treatment of Leber's hereditary optic neuropathy: An indirect comparison meta-analysis.

To compare the outcomes between idebenone oral therapy and rAAV2-ND4 intravitreal injection in the treatment of Leber's hereditary optic neuropathy. A systematic literature review was performed of publications from 1990 to 2023 in PubMed, Ovid MEDLINE, Cochrane CENTRAL, Google Scholar, Embase, CrossRef, OpenAlex, and Web of Science for studies evaluating the outcomes of idebenone or rAAV2-ND4 therapy in Leber's hereditary optic neuropathy. The primary outcome measure was improvement in visual acuity. Secondary outcome measures were improvement of retinal nerve fiber layer thickness, ganglion cell layer volume, and visual field mean deviation. There are no studies directly comparing the two interventions. Our analysis included 645 patients from 17 studies; 338 patients from nine studies received idebenone, and 307 patients from eight studies received rAAV2-ND4. When compared to each other, rAAV2-ND4 provided better visual improvement at 6 months with a mean difference of 0.07 (P = 0.8289), but idebenone provided better visual improvement at 1 year with a mean difference of 0.35 (P < 0.0001). At 2 years, the rAAV2-ND4 group's visual acuity improved from baseline by 0.18 (P = 0.08). There was no data for improvement at 2 years for idebenone, only for rAAV2-ND4. rAAV2-ND4 provides better visual acuity results at 6 months, and idebenone provides better visual acuity results at 1 year. Further studies are recommended to formulate a complete idea about the long-term results (>2 years).

Evaluation of retinal vascular parameters in bipolar disorder using optical coherence tomography angiography.

Evaluation of retinal vascular parameters in bipolar disorder using optical coherence tomography angiography.

Structural-Functional Correlation in Non-Arteritic Acute Ischemic Optic Neuropathy.

This study investigated the relationships between structural and functional parameters in non-arteritic ischemic optic neuropathy (NAION). This retrospective study enrolled 29 patients (58.2 ± 10.4 years old) with unilateral NAION. During the acute phase, we performed comprehensive evaluations including best-corrected visual acuity (BCVA), optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), visual fields (VF), visual evoked potentials (VEP), electroretinography (ERG), and multifocal ERG (mf-ERG). At three months post-presentation, patients underwent follow-up assessments comprising visual acuity testing, perimetry, and advanced retinal imaging. During the acute phase, affected eyes demonstrated increased mean retinal nerve fiber layer (RNFL) thickness, while ganglion cell-inner plexiform layer (GCIPL) thickness decreased. Both visual fields mean deviation (MD) and VEP P100 amplitude were reduced, accompanied by prolonged peak latency. We also observed decreased P1 response density in mf-ERG. Analysis revealed significant direct correlations between GCIPL parameters and electrophysiological measurements, particularly VEP P100 amplitude and mf-ERG P1 response density. Mean GCIPL thickness, VF MD, and VEP P100 amplitude showed negative correlations with baseline logMAR VA. Baseline VF MD, VEP P100 amplitude, and minimum GCIPL thickness showed negative correlations with logMAR VA at 3-month follow-up. Retinal ganglion cell layer thickness serves as a valuable indicator to objective evaluate optic nerve function in acute NAION patients. Decreases in both VEP amplitude and mf-ERG response density showed significant correlations with retinal ganglion cell layer thickness. Baseline visual field performance, VEP measurements, and minimum GCIPL thickness exhibited negative correlations visual acuity at 3-month follow-up. Clinical Research Ethics Committee of Xi'an People's Hospital (NO. 20220018). Registered 27 September 2022-Retrospectively registered, https://www.medicalresearch.org.cn/. Informed consent was obtained from each participant.

Novel 2D/3D vascular biomarkers reveal association between fundus changes and coronary heart disease.

Novel 2D/3D vascular biomarkers reveal association between fundus changes and coronary heart disease.