RNFL Measurements Research Articles

Evaluation of lamina cribrosa curvature index in different types of glaucoma.

The aim of this study was to evaluate the lamina cribrosa curvature index in different types of glaucoma in comparison with clinical findings and conventional measurement methods. Patients older than 18years who were followed up in Glaucoma Unit of Department of Ophthalmology at Fırat University Faculty of Medicine, whose disease had been under control at least for 1year, who had at least three reliable visual fields, whose refractive error was between - 6 and + 5 diopter and who did not have any disease other than glaucoma that would affect the visual field, were included in the study. Clinical and demographic characteristics, visual field, optical coherence tomography and lamina cribrosa curvature index (LCCI) results were evaluated. The study patients were divided into six groups: early-stage primary open-angle glaucoma (POAG) as group 1 and intermediate-advanced stage POAG as group 2, pseudo-exfoliation glaucoma (PEXG) as group 3, normal tension glaucoma (NTG) as group 4, ocular hypertension patients whom subsequently developed POAG as group 5 and healthy control as group 6. A total of 189 eyes of 101 patients were included in our study. Forty-seven patients were male (46.5%) and 54 were female (53.5%). The mean age was 62.43 ± 1.49years. LCCI, mean deviation (MD), visual field index (VFI), pattern standard deviation (PSD) and retinal nerve fiber layer thickness (RNFL) values were analyzed in all groups and Pearson correlation analysis showed statistically significant correlation between PSD and RNFL measurements with LCCI values in all groups. MD value was correlated with LCCI in groups 2, 3 and 4, while VFI value was correlated with LCCI in all groups except group 5. When the groups were compared with each other according to the Post-Hoc Tamhane test, LCCI measurement showed statistically significant results in accordance with MD, VFI, PSD and RNFL values. The LCCI assessment is mostly consistent with conventional tests. In this study, in which different types of glaucoma and healthy subjects were examined simultaneously, LCCI shows promise as a detailed and reliable assessment method.

Assessment of glaucoma severity and deterioration by using Spaeth/Richman contrast sensitivity (SPARCS) and its correlation with retinal nerve fiber layer thickness and perimetry.

To assess the severity of glaucoma and its worsening using Spaeth/Richman contrast sensitivity (SPARCS). To evaluate its correlation with retinal nerve fiber layer thickness (RNFL) and perimetry. In this prospective observational study, 90 eyes of primary open-angle glaucoma were categorized into mild, moderate, and severe glaucoma (30 each). All eyes were subjected to contrast sensitivity measurements by using the Pelli-Robson (PR) chart and SPARCS, Humphrey automated perimetry, and optical coherence tomography (OCT) RNFL, along with routine ophthalmological evaluation at baseline. Contrast sensitivity was repeated at 1, 3, and 6 months. Other investigations were repeated at 6 months. The correlation between contrast sensitivity and other parameters was analyzed at baseline and 6 months. Total SPARCS showed a significant positive correlation with visual field index, pattern standard deviation, mean deviation, OCT RNFL, and a negative correlation with best corrected visual acuity. Central SPARCS and PR scores exhibited strong positive correlations. Both total and quadrantic SPARCS significantly reduced from mild to moderate to severe glaucoma. The quadrant-wise SPARCS also correlated well with opposite-side RNFL thickness. At 6 months, SPARCS showed a significant reduction along with RNFL measurements preceding any significant changes in visual field parameters. This study establishes SPARCS as a reliable and reproducible tool in assessing the deterioration of visual function in glaucoma patients even before significant perimetric changes. The specific relationship of quadrantic SPARCS with opposite-side RNFL is a novel yet expected finding. The findings advocate integrating SPARCS into routine glaucoma assessment for timely detection of any worsening and prompt intervention, improving the visual outcomes in these patients.

Myopia and Rate of Peripapillary Retinal Nerve Fiber Layer Thickness in Diabetic Patients Without Retinopathy: A 2-Year Longitudinal Study

Purpose The aim of this study was to investigate the association between myopia and longitudinal changes in peripapillary retinal nerve fiber layer (pRNFL) thickness in type 2 diabetic patients without diabetic retinopathy (DR). Methods A total of 1069 participants with a median follow-up time of 1.9 years were included in this study. The participants were categorized into four groups based on the presence of myopia (≤ –0.5 diopter [D]) and diabetes without DR, including a control group (n = 412), diabetes group (n = 416), myopia group (n = 115), and diabetes + myopia group (n = 126). Peripapillary average and sectoral RNFL measurements were obtained using 6 × 6 mm swept-source optical coherence tomography (SS-OCT) scans centered at the optic disc. The change rate of pRNFL, adjusted for age and sex, was calculated and compared among the four groups to investigate the impact of myopia and diabetes. Results The baseline estimated pRNFL thickness after adjustment for covariates was 113.7 μm, 116.2 μm, 108.0 μm, and 105.6 μm in the control, diabetes, myopia, and diabetes + myopia group, respectively (diabetes > control > myopia = diabetes + myopia, p < 0.001). The respective average pRNFL loss in the four groups was –0.48 μm/year, –1.11 μm/year, –1.23 μm/year, and -2.62 μm/year (all p < 0.01). The diabetes + myopia group exhibited a greater rate of average pRNFL reduction compared to the other groups (all p < 0.001). Multivariate analysis using a linear mixed-effects model showed that age, diabetes, axial length (AL), and baseline pRNFL thickness were significantly associated with the rate of average pRNFL reduction. Conclusions The diabetes group showed a faster rate of average pRNFL thickness reduction compared to healthy controls, regardless of the presence of myopia. The average pRNFL thickness decreased more rapidly when diabetes and myopia were present simultaneously than in the individual diabetes or myopia group. Both diabetes and myopia were associated with accelerated pRNFL loss.

Accuracy of Bruch’s membrane opening minimum rim width and retinal nerve fiber layer thickness in glaucoma diagnosis depending on optic disc size

Background/aimThe aim of this paper is to compare retinal nerve fiber layer thickness (RNFL) and Bruch’s membrane opening-based minimum rim width (BMO-MRW) in terms of their performance in detecting early and moderate/advanced glaucoma using receiver operating characteristics (ROC) analysis and the classification using the 5th percentile as a cut-off.MethodsOne hundred eyes from 100 patients with early glaucoma (mean deviation (MD): < -5.0 dB) and 100 eyes from 100 patients with moderate/advanced glaucoma (MD: > -5.0 dB) were carefully matched to healthy controls based on optic disc size. Then, the dataset was divided, based on the 50th percentile of the measured Bruch’s membrane opening area (BMO-A), into small (BMO-A < 1.95 mm2) and large optic discs (BMO-A > 1.95 mm2). Finally, the discriminative performance of BMO-MRW and RNFL between glaucoma and controls using ROC analysis and the manufacturer’s classification based on the 5th percentile was analyzed.ResultsIn discriminating between glaucoma and matched healthy controls, global BMO-MRW and global RNFL thickness had comparable areas under the ROC curve for eyes with early glaucoma and both small BMO-As (ROC ± confidence interval [CI] 0.91 [0.87 to 0.95] and 0.88 [0.83 to 0.93]) and large BMO-As (0.86 [0.82 to 0.92] and 0.84 [0.79 to 0.90]), as well as in moderate/advanced glaucoma with small BMO-As (0.99 [0.98 to 1.00] and 0.97 [0.95 to 1.00]) and large BMO-As (0.94 [0.91 to 0.98] and 0.97 [0.94 to 1.00]). Using the calculated 5th percentile as a threshold value, the sensitivities for the detection of early and moderate/advanced glaucoma were comparable for BMO-MRW and RNFL in eyes with small optic discs (early glaucoma: fifty-two percent and 61%; moderate/advanced glaucoma: ninety-one percent and 92%). In eyes with large optic discs, the sensitivity of BMO-MRW was inferior to that of RNFL for both early (38% versus 51%) and moderate/advanced (80% versus 91%) glaucoma.ConclusionBased on an ROC analysis, the discriminative performance of BMO-MRW and RNFL between patients with early and moderate/advanced glaucoma and a healthy control group matched based on optic disc size is comparable in eyes with BMO-As smaller and larger 1.95 mm2. Using a classification based on the 5th percentile, as used in clinical practice, RNFL is shown to be superior to BMO-MRW regarding sensitivity in glaucoma detection with large optic discs. This study underscores the importance of RNFL imaging and measurement in the diagnostic evaluation of glaucoma, especially in cases of large optic discs.

Effects of cataract on peripapillary retinal nerve fibre layer and ganglion cell‐inner plexiform layer thickness measurement by cirrus optical coherence tomography

Aims/Purpose: To assess the effect of cataract on peripapillary retinal nerve fibre layer (pRNFL) thickness and macular ganglion cell‐inner plexiform layer (mGC‐IPL) thickness measured by Cirrus (Carl Zeiss Meditec, Dublin, California, USA) spectral domain–optical coherence tomography (OCT).Methods: Cirrus OCT was used to measure the pRNFL thickness and mGC‐IPL thickness in 44 patients (63 eyes) patients with cataract, including 43 glaucoma eyes. Cataracts were graded according to the Lens Opacities Classification System III. The study aimed to identify factors that could contribute to segmentation errors and variations in the signal strength index (SSI) or average thickness of mGC‐IPL and pRNFL.Results: The prevalence of preoperative segmentation error were higher in pRNFL measurements compared with mGC‐IPL measurements (36.5% vs. 19.0%, p = 0.046). Multivariate analysis showed that segmentation error in RNFL measurements was significantly associated with preoperative SSI. Multivariate analysis indicated that preoperative SSI was highly correlated with changes with average thickness changes of mGC‐IPL and pRNFL.Conclusions: Among eyes with cataract, the occurrence of segmentation errors was more common in measurements of the pRNFL compared to measurements of mGC‐IPL. Following cataract surgery, there was a slight increase in all thickness parameters in both mGC‐IPL and pRNFL measurements, although the differences were not statistically significant (p = 0.102 and p = 0.151, respectively). It is important to identify segmentation errors, particularly in pRNFL measurements of eyes with cataract and low SSI.

The Differences in the Pattern of OCT and OCTA Examinations between Early Normal- and High-Tension Pseudoexfoliative Glaucoma.

Purpose. The aim of this study was to compare the results of optical coherence tomography angiography (OCTA) and optical coherence tomography (OCT) examinations in patients with normal-tension glaucoma (NTG) in comparison to high-tension pseudoexfoliative glaucoma (HTG) patients at the early stage of glaucoma. Material and methods. The studied groups consisted of patients in the early stage of NTG (70 eyes) and the early stage of HTG (71 eyes). In NTG and HTG groups, a detailed ophthalmic examination was performed. Optic disc OCT with peripapillary RNFL measurements and OCTA examination with the evaluation of the macula and optic disc were performed for all participants using Zeiss Cirrus 5000. Results. NTG and HTG groups were statistically similar as far as the MD was concerned, and both groups had early glaucoma. When evaluating the RNFL thickness, the only statistical difference between early NTG and HTG was observed in the thicknesses in the temporal sector of peripapillary RNFL, with thinner values in the NTG group (53.94 vs. 59.94, p = 0.0071). When the OCTA results of the macula and optic disc were evaluated, there were no statistical differences between early NTG and HTG. Conclusions. The vascular density and flow parameters assessed in OCTA were equal between early NTG and HTG, and therefore the involvement of vascular factors in NTG pathogenesis could not be confirmed. Our results confirm the preponderance of more frequent temporal RNFL involvement in early NTG.

Optical Coherence Tomography Angiography in Schizophrenia.

The aim of this study is to investigate the retinovascular structure of schizophrenia patients using optical coherence tomography angiography (OCTA). 47 eyes of schizophrenia patients were compared with 50 eyes of demographically matched healthy controls in terms of OCTA measurements. Schizophrenia patients were evaluated in two groups as short-term (≤ 5years) and long-term (> 5years) according to the time elapsed after the diagnosis of schizophrenia. Schizophrenia patients showed overall thinning of retinal nerve fiber layer and macula, and lower vessel density (VD) compared to controls. The results were significant for thickness measurements of general macula and for VD in specific areas (P < 0.05); however, they were not significant for the RNFL measurements except the mean circumpapillary RNFL, which was noted to approach significance (P = 0.055). Long-term patients showed significantly lower VD in the whole and perifoveal region of superficial capillary plexus, the whole, perifoveal and foveal region of deep capillary plexus, and the whole area and the disc of radial peripapillary capillaries compared to short-term patients (P = 0.014, P = 0.009, P = 0.011, P = 0.010, P = 0.011, P = 0.035, P = 0.030). These findings suggest that schizophrenia may be a neurodegenerative disease with progressive microvascular involvement over the years, and that OCTA has the potential to be a useful tool in detecting retinovascular changes in patients with schizophrenia.

A STUDY TO COMPARE THE RETINAL NERVE FIBER LAYER (RNFL) MEASUREMENTS USING THE TD OCT 'STRATUS' AND THE SD OCT 'RTVUE' IN HEALTHY PARTICIPANTS AND GLAUCOMA PATIENTS

Background: To compare the RNFL measurements using the conventional Time Domain Optical Coherence Tomography (TD-OCT) 'Stratus' and the Spectral Domain Optical Coherence Tomography (SD OCT) 'RTVue' in healthy participants and glaucoma patients. ThisMethods: prospective cross-sectional study included 50 eyes in each of the two study groups as, healthy eyes and eyes of established glaucoma patients. Peripapillary RNFL thickness was measured by both machines in random order by the same operator on the same day with pupils uniformly dilated to over 5.0 mm. Three separate fast RNFL Scans were acquired with Stratus OCT, from which the most reliable scan was chosen for comparison. For RTVue, “RNFL3.45” scan protocol was used, which consists of four sets of 1024 “A-scans” along a 3.45 mm-diameter circle centered on the optic disc. There was a signicant difference in RNFL measurements between the two methods ,which was maximum in the superiorResults: quadrant and minimum in the nasal quadrant in both the groups In both the groups, RTVue RNFL measurements are thicker as. Conclusion: compared to that of Stratus with maximum quadrant mean RNFL measurement in the inferior quadrant and minimum in the nasal quadrant. Maximum difference in RNFL measurement between the two machines was at superior quadrant in both the groups.

OPTIC NERVE AND RETINAL LAYER MEASUREMENTS WITH OPTICAL COHERENCE TOMOGRAPHY IN PCR POSITIVE AND NEGATIVE COVID-19 PATIENTS

Objective and Aim Covid-19 targets all tissue and organ systems, not just the lungs. The optic nerve and retina with extensive microvascular nutrition are prone to viral involvement. Optical coherence tomography is a technology that provides detailed information about both optic nerve and retinal structure. The study was carried out to investigate possible changes in the optic nerve and retinal structure of patients with Covid-19 infection, dividing PCR positivity or negativity. Methods Thirty PCR positive Covid-19 patients with different ages and varying admission complaints were included in the study. Twenty-five Covid-19 patients who were PCR negative with similar age and gender were selected as a secondary group for comparison. All patients underwent ophthalmologic examination, including slit-lamp biomicroscopy, funduscopy, and OCT. These examinations were performed four weeks after the diagnosis of Covid-19 for full compliance with the mandatory isolation. In addition, RNFL, retinal thickness, and retinal volume measurements were performed. Results No statistical significance was observed in any parameter between the PCR positive or negative patients when the comparative analysis for both eyes in RFNL measurements. There was a significant difference in retinal thickness measurements between the PCR positive and negative groups regarding left eye central retinal thickness (p=0.047). However, there was no statistical difference in retinal volume measurements. Conclusion Retinal imaging with optical coherence tomography is a non-invasive, reproducible, and rapid technique in which subclinical or overt retinal pathologies can be detected during COVID-19. Therefore, management of COVID-19 patients should include retinal assessment with close follow-up, especially in patients with headaches and optic pain.

Retinal Nerve Fiber Layer Thickness in Prediabetic Patients.

Diabetic retinopathy is a leading cause of blindness. Diabetic retinopathy is not only seen in diabetic patients with the clinical diagnosis but also in prediabetic patients. The aim of this study is to evaluate the RNFL thickness in prediabetic patients. In this study, 50 prediabetic patients and 50 healthy individuals were included. RNFL measurements were performed with SD-OCT in patients with prediabetes and healthy controls. The mean RNFL thickness for the prediabetic group was 94.7 ± 6.3 μm, inferior quadrant (120 ± 11.6), superior quadrant (112.3 ± 14.13), nasal quadrant (71 ± 12.9), and temporal quadrant (65.3 ± 9.2 μm). The mean RNFL thickness for the control group was 98.9 ± 7.5 μm, inferior quadrant (128 ± 14.7), superior quadrant (116.3 ± 15.12), nasal quadrant (77 ± 15.8), and temporal quadrant (71.2 ± 10.3 μm). Variance analysis demonstrated that the RNFL thickness difference between the groups was significant in all quadrants (P < .001). RNLF thinning can be seen in prediabetic patients before obvious vascular damage has occurred, and it may present in prediabetic patients not only in the temporal quadrant but also in all quadrants. The early retinal neural changes shown in this study in prediabetic patients may help to better understand the process leading to diabetic overt retinopathy.

Retinal nerve fiber layer and optical coherence tomography angiography analysis in fibromyalgia using logistic regression

AbstractPurposeTo evaluate the retinal nerve fiber layer thickness (RNFL) and the vascular density (VD) at the superficial vascular plexus (SVP) of the retina of patients with Fibromyalgia (FM) using Optical coherence tomography‐Angiography (OCT‐A) and to compare results with measurements of healthy eyes.MethodsFifty eyes of 50 patients with FM were included and compared with 232 healthy eyes. All subjects underwent peripapillary and macular RNFL thickness evaluation and macular SVP VD assessment using swept source OCT Triton and its OCTA module (Topcon, Japan). Both groups were compared, and the statistically significant different variables were used to create a logistic regression model. A Linear Discriminant Function (LDF) and its receiver operating characteristic curve (ROC) was obtained from the model.ResultsStatistically significant thinning was found at the peripapillary (temporal, p = 0.006; and supero‐temporal, p = 0.026) and macular (inferior, p = 0.029) RNFL thickness in the FM group compared to healthy controls. The best resultant LDF after logistic regression analysis was (Triton: −9.102 + (0.434 * RNFL macular inferior) + (0.088 * peripapillary RNFL nasal sector) – (0.220 * peripapillary RNFL temporal sector) showing a ROC curve with an area under curve (AUC) equal to 0.758. On the other hand, the SVP VD obtained with OCT‐A showed no statistically significant differences between groups in any of the analyzed areas (central p = 0.788; nasal p = 0.165; inferior p = 0.073; temporal p = 0.250; superior p = 0.538) so the data were not included in the regression analysisConclusionsFM patients present a reduction in the RNFL thickness compared to controls. The RNFL measurements might be a useful biomarker in the diagnosis of FM, complementing the current criteria based on clinical symptoms. However, it is necessary to explore the different imaging protocols to include them into a more robust statistical model.

Retinal Nerve Fibre Layer and Ganglion Cell Complex Measurement and their Correlation with Visual Field Changes among Glaucoma Patients

Introduction: Glaucoma is an optic neuropathy that causes loss of Retinal Ganglion Cell (RGC) and changes in the visual field. The loss in RCG is determined by Optical Coherence Tomography (OCT), and visual field defects are evaluated with perimetry. A study of RGC loss and visual field defects together might help to detect glaucoma earlier. Aim: To determine the relationship between Retinal Nerve Fibre Layer and Ganglion Cell Complex (RNFL-GCC) thickness measured with OCT, and visual field sensitivity evaluated with Standard Automated Perimetry (SAP) in glaucoma patients of varying severity. Materials and Methods: This was a cross-sectional study, conducted in a tertiary care Hospital, Ajmer, Rajasthan from October 2018 to January 2020. Ethics committee clearance was obtained prior to the study. Sixty glaucoma patients were recruited for ophthalmic evaluation. The two test were preformed SAP and SD-OCT were done on all patients. Patients were categorised into three groups i.e., early, moderate and severe, based on severity. The RNFL, Mean Deviation (MD) and Pattern Standard Deviation (PSD) were compared among these three groups. One way ANOVA was used to compare the mean values of RNFL, GCC, MD and PSD across the three glaucoma groups. Post hoc analysis was done by Tukey’s range test. Correlation was assessed using Spearman’s correlation coefficient. Results: The mean (SD) age of participants were 54.43 (10.07) years. About 15% of patients belonged to early stage glaucoma, 40% to moderate and 45% to severe glaucoma. The difference in mean RNFL (both superior and inferior) was found significant among the three groups. In bivariate analysis, MD was found significantly correlated with superior and inferior RNFL (r=0.70, p&lt;0.01 and r=0.47, p&lt;0.01, respectively). The MD was not found to correlate with superior and inferior GCC whereas, PSD was found weakly correlated with GCC superior and inferior (r=-0.26, p=0.04 and r=-0.27, p=0.03, respectively), though there was inverse correlation with both GCC superior and GCC inferior. PSD was not found to correlate with superior and inferior RNFL. Conclusion: Superior and inferior RFNL were associated with MD, an indicator of the severity of glaucoma. The RNFL thickness was the best indicator to differentiate the severity of glaucoma. Further exploration is needed to develop specific indications of RNFL and GCC measurement in the management of glaucoma.

Clinical, neuro ophthalmological and radiological predictors of outcome in cerebral venous sinus thrombosis

CVST, a form of venous stroke affecting younger population unlike arterial strokes, representing an overall of 0.5 to 1%. There is relatively scarce literature concerning predictors in CVST. The available literature mostly focusses on subjective assessments of these patients. Our main aim is to study the clinical, neuro opthalmological (Visual fields, Visual acuity, Grade of papillodema, and SD- OCT based GCL and RNFL measurements) and radiological predictors (CVST scoring, topography of sinus(es) involved, extent of parenchymal involvement, features of raised ICP) of outcomes in patients and finally aim to formulate non-invasive objective parameters to assess visual outcome in these patients.

Choroidal vascularity index and choroidal thickness changes in patients with allergic asthma

BackgroundThis study aimed to investigate whether the choroidal vascularity index (CVI), choroidal thickness (ChT), and retinal nerve fiber thickness (RNFL) of patients with allergic asthma change compared to the healthy control group. MethodsThis cross-sectional, observational study comprised 59 eyes of 59 patients with allergic asthma (Group 1) and 50 eyes of 50 age and sex-matched healthy volunteers as a control group (Group 2). CVI was measured by binarization of images obtained from choroidal enhanced depth imaging (EDI) mode optic coherence tomography. CVI was defined as the ratio of the choroidal luminal area to the total circumscribed choroidal area. ChT was measured manually at 3 points, subfoveal and 1000 microns nasal and temporal to the fovea (SFCT, N1000, and T1000 respectively). RNFL measurements were subdivided as global, nasal, temporal, superonasal, superotemporal, inferonasal, and inferotemporal quadrants. ResultsSubfoveal CVI and ChT were significantly lower in asthma patients (p:0,043 and p: 0.034, respectively). N1000 and T1000 ChT and RNFL thicknesses were lower in asthma patients compared to the control group, though no significant difference was found between them (p> 0.05). ConclusionOur findings suggest that asthma patients have choroidal structural changes. In the literature, there are not enough studies regarding the effects of asthma on ocular parameters.

Evaluation of retinal nerve fiber layer and choroidal thickness with spectral domain optical coherence tomography in children with sickle cell anemia.

The aim of this study is to examine the thickness of choroidal, macular and peripapillary retinal nerve fiber layer by spectral-domain optical coherence tomography (SD-OCT) in pediatric patients with sickle cell anemia (SCA) without retinopathy. A total of 75 children (30 SCA patients (Group 1) and 45 healthy individuals (Group 2) were included in the study. Macular (central, superior, inferior, nasal, temporal), choroidal (subfoveal, at nasal distances from the central fovea of 1000 μm [N1], 2000 μm [N2], 3000 μm [N3], at temporal distances from the central fovea of 1000 μm [T1], 2000 μm [T2], 3000 μm [T3]) and RNFL (average, temporal, superotemporal, inferotemporal, nasal, inferonasal and superonasal) measurements were performed by SD-OCT. These parameters were compared with healthy children with similar demographic characteristics. The mean age was 14.11±3.86 (11-18) in sickle cell anemia patients and 13.15± 2.69 (10-18) in the healthy control group. Of the patients, 56.6% (n=17) of Group 1 and 44.4% (n=20) of Group 2 were male. Choroidal measurements made in the subfoveal, N1, N2, N3, T1, T2 and T3 quadrants showed that the choroid was thinner in 6 quadrants in SCA patients compared to the healthy group (p = 0.003, p = 0.039, p = 0.035, p = 0.595, p = 0.006, p = 0.005, p = 0.047, respectively). In RNFL measurements, there was significant thinning in the temporal, inferotemporal, and nasal quadrants of SCA patients compared to the healthy group. Changes in other quadrants were not significant. SD-OCT is a useful imaging method in the diagnosis and screening in patients with SCA without retinopathy. Early diagnosis of retinopathy during subclinical disease will prevent visual loss in these patients.

Evaluation of the choroidal thickness and retinal nerve fiber layer and visual fields in morbid obesity: Does bariatric surgery affect retinal structure and function?

Purpose:The study aimed to investigate the changes in choroidal thickness (CT), retinal nerve fiber layer thickness (RNFL), and visual field parameters in morbidly obese patients following bariatric surgery.Methods:The study included 40 morbidly obese patients with body mass indexes (BMI) ≥40 who had undergone bariatric surgery (Group 1) and 40 age-and sex-matched healthy subjects with normal BMI values (Group 2). RNFL and CT measurements by optical coherence tomography (OCT) and visual field test were performed preoperatively and the 1st, 6th, and 12th months postoperatively. CT measurements were obtained from the subfoveal, nasal (N), and temporal (T) regions at distances of 500 μm and 1,000 μm from the fovea.Results:No significant pathology was detected during ophthalmological examinations following bariatric surgery. The BMIs were found to be significantly lower in all of the periods after bariatric surgery (P < 0.0001). The CT measurements decreased significantly in all periods after bariatric surgery (P < 0.0001). No differences were found in terms of the mean RNFL thicknesses in all postoperative periods (P = 0.125). Visual field tests showed no significant changes during scheduled visits. (P = 0.877). No visual field defect was detected in any patient during the follow-up periods after bariatric surgery.Conclusion:These results have suggested that CT is positively correlated with BMI and decreased with a reduction in BMI progressively. Nutritional disorders resulting from malabsorption have not caused any nutritional optic neuropathy and visual field defect for at least the first postoperative year after bariatric surgery.

Role of Optical Coherence Tomography in the Prognosis of Vogt–Koyanagi–Harada Disease

ABSTRACT Purpose: To evaluate the prognostic value of OCT in acute VKH disease Methods: Retrospective series of consecutive VKH patients seen with the first presentation, a minimum follow-up of 1 year and serial OCT imaging. The primary outcome was the clinical activity phase at 1, 2 and 3 years. Results: Among 29 subjects, 7 resolved, 17 became chronic, and 5 developed chronic recurrent VKH. Median RNFL measurement obtained 2 months post-treatment was higher among subjects who developed chronic VKH (p-value = 0.03) and chronic recurrent disease (p-value = 0.04). Median CRT 1-week post-treatment was lower among subjects who developed PPA (p-value = 0.03). CRT 2 months post-treatment was higher among subjects who developed vitiligo (p-value = 0.02). Conclusion: OCT is helpful in early recognition of the predominantly optic disc swelling variant which carries a poorer prognosis. Lower CRT reading at 1 week and persistently raised CRT at 2 months post-treatment correlated with chronic recurrent disease.

Handheld Optical Coherence Tomography Normative Inner Retinal Layer Measurements for Children

Measurements of the ganglion cell complex (GCC), comprising the retinal nerve fiber (RNFL), ganglion cell, and inner plexiform layers, can be correlated with vision loss caused by optic nerve disease. Handheld optical coherence tomography (HH-OCT) can be used with sedation in children who are not amenable to traditional imaging. We report GCC and RNFL measurements in normal children using HH-OCT. Prospective observational study of normal children ≤5 years of age. Healthy, full-term children ≤5 years of age undergoing sedation or anesthesia were enrolled. Exclusion criteria included prematurity and pre-existing neurologic, genetic, metabolic, or intraocular pathology. Demographic data, axial length (Master-Vu Sonomed Escalon, Lake Success, New York, USA), and HH-OCT macular and optic nerve volume scans at 0° (Bioptigen, Inc., Morrisville, North Carolina, USA) were obtained. Retinal segmentation was completed with DOCTRAP software, creating average volume thickness maps. Sixty-seven children (67 eyes, 31 males ranging in age from 3.4-70.9months) were enrolled. Average axial length was 21.2 ± 1.0mm with mean spherical equivalent+1.49 ± 1.34 diopters (range-2.25 to 4.25). Average GCC volume for the total retina was 0.28 ± 0.04mm3. Forty-seven of these eyes had RNFL analysis. Average RNFL thickness of the papillomacular bundle was 38.2 ± 9.5μm. There was no correlation between GCC volume, RNFL thickness, patient age, or axial length. Average GCC volume and RNFL thickness was stable from 6months to 5 years of age. This study provides normative data for GCC and RNFL obtained by HH-OCT in healthy eyes of young children, to serve in evaluating those with optic neuropathies.

Reproducibility and reliability of retinal and optic disc measurements obtained with swept-source optical coherence tomography in a healthy population.

To analyze the reproducibility of macular and peripapillary thickness measurements, and optic nerve morphometric data obtained with Triton Optical coherence tomography (OCT) in a healthy population. Observational cross sectional study. A total of 108 eyes underwent evaluation using the Triton Swept Source-OCT. A wide protocol was used and measurements in each eye were repeated three times. Morphometric data of the optic nerve head, full macular thickness, ganglion cell layer (GCL) and retinal nerve fiber layer thickness (RNFL) were analyzed. For each parameter, the coefficient of variation (COV) and the intra-class (ICC) correlation values were calculated. Measurements were highly reproducible for all morphometric measurements of the optic disc, with a mean COV of 6.36%. Macular full thickness showed good COV and ICC coefficients, with a mean COV value of 1.00%. Macular GCL thickness showed a mean COV value of 3.06%, and ICC higher than 0.787. Peripapillary RNFL thickness showed good COV and ICC coefficients, with a mean COV value of 8.31% and ICC higher than 0.684. The inferotemporal sector showed the lowest ICC (0.685). Triton OCT presents good reproducibility values in measurements corresponding to retinal parameters, with macular measurements showing the highest reproducibility rates. Peripapillary RNFL measurements should be evaluated with caution.

The Temporal Retinal Nerve Fiber Layer Thickness Is the Most Important Optical Coherence Tomography Estimate in Multiple Sclerosis.

Reduced peripapillary retinal nerve fiber layer (pRNFL) and combined ganglion cell and inner plexiform layer (GCIP) thicknesses as measured by optical coherence tomography (OCT) have been observed in multiple sclerosis (MS) patients. The purpose was to determine the most associative OCT measure to level of cognitive and physical disability in MS. Data were collected from 546 MS patients and 175 healthy controls (HCs). We compared the average pRNFL, temporal pRNFL (T-pRNFL), overall inner ganglion cell/inner plexiform layer (GCIP), and the overall ganglion cell complex (GCC) including macular RNFL and GCIP thicknesses measurements in differentiating MS subtypes from HCs. The association between OCT measures, Expanded Disability Status Scale (EDSS), and Symbol Digit Modalities Test (SDMT) were assessed using generalized estimating equations models. Both peripapillary and macular OCT measurements could differentiate all MS subtypes from HCs. The SDMT score was significantly associated with reduced thickness of all OCT measures, mostly in average pRNFL (0.14 µm, P = 0.001) and T-pRNFL (0.17 µm, P < 0.001). The EDSS score was significantly associated with reduced inner retinal layer thickness. The largest reduction was seen in T-pRNFL (-1.52 μm, P < 0.001) and inner GCC (-1.78 μm, P < 0.001). The T-pRNFL is highly sensitive and associated with level of both cognitive and physical disability.