Superior Retinal Nerve Fiber Layer Research Articles

Ocular dominance and its association with retinal thickness profile - A cross-sectional study.

The retinal thickness profile is essential for detecting ocular diseases like glaucoma and other optic neuropathies. The retinal nerve fiber layer (RNFL) thickness is affected by age, ethnicity, axial length, optic disc area, and inter-eye differences. Ocular dominance has a strong functional correlation with cerebral cortical activity. However, its relationship with RNFL thickness profile is yet to be fully established. A cross-sectional study was conducted in 136 healthy adults to study the association between ocular dominance and RNFL parameters measured by Spectral domain optical coherence tomography (SD-OCT) and to study the association of ocular dominance with other parameters such as handedness, intraocular pressure, average axial length, average keratometry, and refractive error. Sighting ocular dominance was detected using the Miles test, and sensory ocular dominance was detected using the fogging test. Visual acuity and refraction assessment were done, and the patients underwent ocular biometry using the Lenstar 900 machine to measure the axial length and keratometry. The RNFL thickness was measured using the Cirrus HD optical coherence tomographer. One hundred and thirty-two (97.06%) individuals were right-handed, four (2.94%) were left-handed, 108 (79.41%) participants were right eye dominant, and 28 (20.59%) were left eye dominant. There was 100% agreement between sighting and sensory ocular dominance. The average RNFL thickness and other measured ocular parameters were comparable in the dominant and nondominant eyes. Regardless of dominance, the left eyes in the study cohort had a greater statistically significant difference in superior RNFL thickness (P < 0.05), which correlated with increased central macular thickness. Ocular dominance occurred mostly in the right eye. The RNFL thickness profile is not associated with ocular dominance in emmetropic and mild myopic individuals with normal best corrected visual acuity.

Evaluation of optical coherence tomography findings in patients with multiple sclerosis and glaucoma.

Glaucoma and multiple sclerosis (MS) can cause optic disc pathology and, in this way, affect optical coherence tomography (OCT) data. In this context, the objective of this study is to investigate the changes in the mean, quadrant, and sector data measured by OCT in glaucoma and MS patients. The sample of this prospective cohort study consisted of 42 MS patients (84 eyes), 34 Primary open-angle glaucomas patients (67 eyes), and 24 healthy control subjects (48 eyes). The MS group was divided into two groups according to the presence of a history of optic neuritis. Accordingly, those with a history of optic neuritis were included in the MS ON group, and those without a history of optic neuritis were included in the MS NON group. The differences between these groups in the mean, quadrant, and sector data related to the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) were evaluated. Superior nasal (SN), superior temporal (ST), inferior nasal (IN), and superior quadrant (SUP) values were significantly lower in the glaucoma group than in the MS group (p < 0.05). The mean superior GCC (GCC SUP) value was significantly lower in the MS ON group than in the glaucoma group (p < 0.05). On the other hand, SN, ST, inferior temporal (IT), IN, average RNFL (AVE RNFL), semi-average superior RNFL (SUP AVE RNFL), semi-average inferior RNFL (INF AVE RNFL), SUP, and inferior quadrant RNFL (INF) values were significantly lower in the glaucoma group than in the MS NON group (p < 0.05). RNFL and GCC parameters get thinner in MS and glaucoma patients. While the inferior and superior RNFL quadrants are more frequently affected in glaucoma patients, the affected quadrants vary according to the presence of a history of optic neuritis in MS patients. It is noteworthy that the GCC superior quadrant was thin in MS ON patients. The findings of this study indicate that OCT data may be valuable in the differential diagnosis of glaucoma and MS.

Evaluation of Structural and Functional Retinal Changes in Children With Intermittent Exotropia Versus Healthy Children.

To detect structural and functional changes in children with intermittent exotropia using optical coherence tomography, pattern electroretinography (ERG), and multifocal ERG. The study included 26 patients with intermittent exotropia and 26 healthy individuals matched for age and sex with a mean age of 9.23 and 11.20 years in the intermittent exotropia and control groups, respectively (P = .310). All patients underwent full ophthalmic examination including measurement of the angle of strabismus at near and far, and assessment of the macula and optic nerve using optical coherence tomography, pattern ERG, and multifocal ERG. All patients had 6/6 best corrected visual acuity with no fixation preference. A significantly prolonged P and N wave latency was found in all measured rings of multifocal ERG of patients with intermittent exotropia, P wave amplitude was lower in rings 1 and 5, and N wave amplitude was lower in rings 1 and 2. Regarding pattern ERG, the amplitude of P50 wave was lower and N95 latency was prolonged in the intermittent exotropia group. The upper and lower ganglion cell complex and the superior retinal nerve fiber layer were significantly thinner in the intermittent exotropia group compared to controls. Children with intermittent exotropia without any associated amblyopia or refractive error showed a subnormal pattern and multifocal ERG response in addition to a thinner ganglion cell layer and retinal nerve fiber layer compared to normal controls. This signifies that subtle structural and functional retinal changes are found in patients with intermittent exotropia. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XXX-XXX.].

Risk factors of internal carotid artery stenosis in patients with proliferative diabetic retinopathy: an analysis using optical coherence tomography and optical coherence tomography angiography

BackgroundThis research investigates the correlation between the severity of internal carotid artery (ICA) stenosis and retinal parameters in patients with proliferative diabetic retinopathy (PDR), aiming to uncover potential risk factors.MethodsA retrospective analysis of 68 patients (136 eyes) diagnosed with bilateral PDR from January 1, 2017, to December 31, 2021, was conducted. Carotid artery stenosis (CAS) was assessed using neck computed tomography angiography (CTA) and carotid duplex ultrasound (CDUS), with stenosis classified into two groups: normal (group 1) and mild or above (group 2), based on the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. Optical coherence tomography (OCT) and OCT angiography (OCTA) measured several retinal parameters, including sub foveal choroidal thickness (SFCT), retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GCIPL) thickness, vessel density (VD), and foveal avascular zone (FAZ) area. Statistical analyses determined correlations between ICA degrees and retinal parameters.ResultsThis study showed significant differences between groups in total VD, FAZ area, total RNFL thickness, and temporal RNFL thickness, indicating that patients with more severe ICA stenosis had noticeable retinal changes. Other parameters such as hyperlipidemia, total cholesterol levels, and intraocular pressure (IOP) also differed significantly, while no notable differences were observed in SFCT, central VD, average GCIPL, and superior, nasal, and inferior RNFL thickness.ConclusionThe study findings highlight retinal changes, such as an increased FAZ area, decreased total VD, and a total and thinner temporal RNFL, which suggest the need for carotid artery evaluation in patients. These findings have important clinical implications for the need for carotid work up in patients with PDR.

Influence of age on the thickness of retinal nerve fiber layer in patients with mild-to-moderate stages of Parkinson’s disease: Case series

Abstract Introduction: Parkinson’s disease, a neurodegenerative disease, involves motor and nonmotor components. Vision, a nonmotor component, has been studied by the analysis of the retinal layers by optical coherence tomography (OCT), and the main finding is the thinning of the retinal nerve fiber layer (RNFL). The aim of this study was to verify the influence of age on the thickness of retinal nerve fiber in patients with mild-to-moderate stages of Parkinson’s disease. Materials and Methods: Healthy individuals and patients with Parkinson’s disease were included in this prospective, cross-sectional, and observational study. The patients were recruited according to the clinical criteria from the neurology clinic of two major hospitals, with the description of the Hoehn and Yahr scale score. Healthy subjects were recruited from the general clinic and hospital staff. A comprehensive ophthalmic examination was performed previously on the spectral-domain OCT. Results: There was a significant effect of age in the thickness of the RNFL in patients with Parkinson’s disease, in the right eye in the lower quadrant (P = 0.026) and in the left eye in the upper (P = 0.029) and temporal (P = 0.037) quadrants, as well in the control group in the upper (P = 0.003) and lower quadrant (P = 0.024). Conclusions: This case series could demonstrate that in mild-to-moderate stages of the Hoehn and Yahr Scale, there is an asymmetric correlation between aging and the decrease in superior, inferior, and temporal RNFL between the eyes of patients with Parkinson’s disease, and this finding precedes the decrease in visual acuity.

Comparison of diagnostic capability of macular ganglion cell complex vs retinal fiber layer thickness in primary open angle glaucoma patients of Indian origin.

Comparison of diagnostic capability of macular ganglion cell complex thickness vs. retinal nerve fiber layer (RNFL) thickness in patients of primary open-angle glaucoma (POAG). This cross-sectional observational study was carried out between June 2021 and October 2022 at a tertiary care hospital in North India. A total of 118 eyes were included in the study with 30 control and the rest 88 eyes with POAG were divided into three groups based on visual field loss Group 1 (30 eyes): early field loss with mean deviation (MD) < -6 dB; Group 2 (30 eyes): moderate field loss with MD -6 to -12 dB; and Group 3 (28 eyes): severe field loss with MD > -12 dB. Optical coherence tomography (OCT) scans to measure RNFL loss and ganglion cell inferior plexiform layer (GCIPL) loss were taken for each patient. Categorical variables were analyzed using either the Chi-square test or Fisher's exact test. A receiver operating characteristics analysis was calculated to determine optimal cut-off values of superior, inferior, and average GCIPL and RNFL for determining the severity of field loss as compared to controls (30 normal eyes). In the mild field loss group the sensitivity of superior, inferior, and average GCIPL was 86.7, 96.7, and 96.7%, respectively. Similarly, the specificity was 96.7, 93.3, and 100%, respectively. In the same group, the sensitivity of superior, inferior, and average RNFL was 70, 93, and 66%, respectively. Similarly, the specificity was 46.7, 83.3, and 70%, respectively. In the moderate and severe groups, the results were comparable. The sensitivity and specificity of GCIPL loss are significantly better than that of RNFL parameters in the mild field loss group.

Relationship between Serum Homocysteine Levels and Manganese Superoxide Dismutase (MnSOD) on Retinal Nerve Fiber Layer (RNFL) Thickness in Diabetic Retinopathy and Non-Diabetic Retinopathy Patients

Introduction &amp; ObjectivesDiabetic retinopathy is a visual disorder caused by abnormalities in the retina, where there is aprogressive microangiopathy characterized by damage and blockage of fine blood vessels, resultingin impaired nutrition of the retina. This study is to find out the relationship between serumhomocysteine levels and MnSOD on retinal nerve fiber layer (RNFL) thickness in diabeticretinopathy and non-diabetic retinopathy patients.&#x0D; MethodsThis study is an analytic observational case-control study with a total of 31 subjects for each group.3cc of venous blood samples were taken to assess the serum levels of homocysteine and MnSOD andthen analyzed by ELISA method in the integrated laboratory of the USU Medical Faculty.&#x0D; ResultsThere was a significant difference in Avg RNFL and Nasal RNFL thickness between the two groups(p=0.015) with the mean Avg RNFL thickness being 100.94 (SD=17.04) and the mean RNFL nasalthickness being 90.16 (SD=33.68). The highest MnSOD levels were found in non-diabeticretinopathy subjects with a mean of 142.77 (SD=101.77). There was no significant relationshipbetween homocysteine and thickness of superior RNFL (p=0.346), inferior RNFL (p=0.292),temporal RNFL (p=0.109), nasal RNFL (p=0.190). However, a significant association was foundbetween homocysteine and Avg RNFL (p=0.007).&#x0D; ConclusionIn the group of cases of diabetic retinopathy, a significant relationship was found between Hcy andAvg RNFL (p=0.007). An increase in serum homocysteine levels will be followed by a decrease in thethickness of the Avg RNFL.

Effects of sodium valproate and levetiracetam on posterior segment parameters in children with epilepsy.

To evaluate changes in posterior segment parameters in pediatric patients with epilepsy using sodium valproate or levetiracetam monotherapy for at least 12months. This study included 45 children with generalized epilepsy aged 6-17years and 32 age- and gender-matched healthy subjects. The patients were assigned to three groups: Group 1 included patients using valproate monotherapy at a dose of 20-40mg/kg/day, group 2 included patients using levetiracetam monotherapy at a dose of 20-40mg/kg/day, and group 3 consisted of healthy controls. Peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell layer-inner plexiform layer (mGCIPL) thicknesses were measured using spectral-domain optical coherence tomography (OCT). No significant differences were noted between the groups regarding age, gender distribution, visual acuity, spherical equivalent, and intraocular pressure (p > 0.05). The average and temporal, nasal, and superior quadrants RNFL values were significantly thinner in group 1 than in group 2 (p = 0.001, p = 0.023, p = 0.011, and p = 0.001, respectively) and group 3 (p < 0.001, p = 0.032, p < 0.001, and p = 0.001, respectively). The OCT parameters were similar in groups 2 and 3 (p > 0.05). A negative correlation was observed in group 1 between only the average mGCIPL and the treatment dose (r = - 0.501). In group 2, no significant correlation was found between OCT parameters and the duration of epilepsy treatment, dose of treatment, and age at treatment onset values (p > 0.05). These findings support that there is an association between sodium valproate treatment and the reduction of RNFL thickness in epilepsy. Levetiracetam treatment appears to be a safe option, but care should be taken regarding ocular side effects that may occur with long-term and high-dose use of sodium valproate.

The effect of trifocal and extended-depth-of-focus intraocular lenses on optical coherence tomography parameters.

Optical properties of commonly used multifocal and extended-depth-of-focus (EDOF) intraocular lenses (IOLs) can induce artifacts or changes in optical coherence tomography (OCT) measurements. Our purpose was to investigate the possible effects of different IOLs on peripapillary and macular OCT parameters. The preoperative and postoperative third-month peripapillary OCT and ganglion cell analysis (GCA) parameters of patients having monofocal (Alcon IQ), multifocal (PanOptix), or EDOF (Vivity) IOL implanted during cataract surgery were compared. Sixty-four eyes of 64 patients were included (21 monofocal, 24 multifocal, and 19 EDOF). Although all OCT image qualities increased postoperatively, only GCA image quality changes in the monofocal and multifocal groups reached statistical significance. Most peripapillary retinal nerve fiber layer (RNFL) and GCA parameters were similar preoperatively and postoperatively. The superior RNFL thickness in the monofocal group and the temporal RNFL thickness in the EDOF group were higher postoperatively ( P = 0.04 and P = 0.02, respectively). Most GCA and RNFL value changes between preoperative and postoperative measurements were similar between groups. In the parameters that changed, postoperative values were higher in the monofocal group ( P = 0.02 for minimum ganglion cell layer and inner plexiform layer, P = 0.04 for average RNFL). Trifocal and EDOF IOLs do not seem to have a negative effect on OCT parameters.

Retinal Nerve Fiber Layer Thickness in Patients with Schizophrenia and Its Relation with Cognitive Impairment.

Schizophrenia is a chronic severe mental illness with heterogeneous clinical presentation, course, and outcome. Cognitive impairment is one of its core features. Retinal nerve fiber layer (RNFL) imaging using OCT (optical coherence tomography) could provide easy access for in vivo imaging of the retina, rendering it as a "window to the brain." Studies done on schizophrenia have shown RNFL thinning. This study attempts to look into the association between cognitive impairment, disease duration, and RNFL abnormality in patients with schizophrenia using OCT. Patients diagnosed with schizophrenia meeting DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) criteria and who were confirmed to be in remission for at least six months clinically and scoring less than three on PANSS-8 (positive and negative symptom scale-8) remission scale were included. They were administered the Montreal Cognitive Assessment Scale (MoCA) for cognitive assessment. RNFL measures were taken using spectral domain-OCT. Variables were compared using Pearson's correlation test, one-way ANOVA test, and independent t-test as appropriate. A total of 36 patients were studied. MoCA scores and RNFL thickness showed a positive correlation. Patients with schizophrenia had reduced average RNFL thickness and reduced RNFL thickness in superior, inferior, and temporal quadrants. Average RNFL thickness, Superior and inferior quadrant RNFL thickness showed a positive correlation with MoCA scores. No correlation was obtained between macular volume, macular thickness, duration of illness, and MoCA scores. Patients with schizophrenia have reduced average RNFL thickness. Patients with low MoCA scores have RNFL thinning.

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

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

Early effects of cardiopulmonary bypass surgery on retinal nerve fiber layer and ganglion cell layer

PurposeTo determine the effects of cardiopulmonary bypass surgery on retinal nerve fiber layer, ganglion cell layer, and macula by optic coherens tomography (OCT). MethodSixty-six eyes of 33 patients aged between 44 and 74 who were indicated for cardiopulmonary bypass surgery in the cardiovascular surgery clinic were included in the study. Routine ophthalmologic examinations of all patients were performed before and 1 week after surgery. In addition, 3D(H) Macula+5 Line Cross 12 × 9 mm mod and Peripapilar 3D Disk 6 × 6 mm mod data were analyzed with OCT (Topcon, Triton Swept Source-OKT, Tokyo, Japan) device. Peripapillary total, superior, inferior retinal nerve fiber layer (RNFL), optic disc cavity volume, cup-to-disc ratio, macular ganglion cell layer (GCL), macular thickness were compared before and after surgery. ResultsAfter cardiopulmonary bypass surgery, thickening was detected in the total RNFL (p<0.001), superior RNFL (p = 0.01) and inferior RNFL (p<0.001) layers. There was no change in the values of GCL, macular thickness, optic disc cupping volume, cup-to-disc ratio after surgery (p>0.05).There was a positive correlation (r = 0.392 p<0.05) between the patients' blood oxygen (PO2) values during bypass surgery with their post-surgical GCL+ values, and a negative correlation between optic disc cup volumes (r=-0.349 p<0.05). ConclusionRNFL thickening has been detected in patients undergoing cardiopulmonary bypass surgery. This thickening may occur secondary to ischemic edema that occurs during surgery. Considering the late complications of ischemic edema in the RNFL, oxygen levels should be kept at an optimum level during surgery and long-term ophthalmologic follow-ups should be performed.

OPTIC DISK PIT STUFFING-TO DO OR NOT TO DO.

Optic disk pit (ODP) is a subset of spectrum of congenital cavitary anomalies. Optic disk pit maculopathy causes progressive visual deterioration and is addressed with pars plana vitrectomy (PPV) with or without ODP stuffing. We report a case of progressive ODP maculopathy who was taken up for 23-G 3-port PPV, with complete vitreous removal and stuffing of the ODP with autologous sclera and sequential analysis of change in the retinal nerve fiber layer (RNFL) thickness. Spectral-domain optical coherence tomography RNFL analysis at 1 and 12 months follow-up postoperatively showed total RNFL thickness decrease from 130 µm to 103 µm respectively. Hemiquadrant analysis showed slight reduction of superior RNFL thickness from 142 µm to 139 µm. However, in the inferior hemiquadrant, the reduction in mean RNFL thickness seems to be significant from 133 µm to 100 µm at 1 and 12 months respectively. Sector-wise analysis of the RNFL thickness showed maximum reduction in the inferotemporal quadrant and other sectors seemed to be relatively preserved corresponding to the area of scleral stuffing. Retrospective or prospective analysis of RNFL health of patients undergoing surgery for ODP-M with stuffing needs to evaluated.

Retinal nerve fiber layer and ganglion cell complex thickness in diabetic smokers without diabetic retinopathy

Purpose To compare the thickness of the retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GC-IPL) in smoker and nonsmoker diabetics without diabetic retinopathy. Materials and Methods Patients with diabetes were divided into two groups according to their smoking status: Group 1 consisted of 38 smoker diabetics who had chronically smoked more than 20 cigarettes per day for more than five years; Group 2 consisted of 38 nonsmoker diabetics. After a detailed ophthalmologic examination, the mean and regional (superior, supratemporal, inferior, inferotemporal, temporal, nasal, superonasal, and inferonasal) RNFL and GC-IPL thicknesses were measured with spectral-domain optic coherence tomography (SD-OCT) and compared between groups. Results The mean age was 54.7 ± 10.5 and 51.2 ± 9.7 years in the smoker and nonsmoker groups, respectively (p = 0.14). Gender, duration of diabetes, and the mean axial length were similar between groups (p:0.43, p:0.54, p: 0.52, respectively). Mean RNFL thickness was 89.1 ± 8.0 µm in the smoker group and 93.4 ± 7.0 µm in the nonsmoker group, and it was significantly thinner in the smoker group (p = 0.01). The temporal RNFL thickness in the smoker group was thinner than in the nonsmoker group (p = 0.02). There was no difference in superior, inferior, and nasal RNFL thicknesses between the groups (p = 0.31, p = 0.12, p = 0.39, respectively). The mean macular GC-IPL thickness of the smoker and nonsmoker groups was 78.53 ± 15.74 µm and 83.08 ± 5.85 µm, respectively (p = 0.09). Superior, superonasal, inferonasal, inferior, inferotemporal, and superotemporal quadrant GC-IPL thicknesses were similar between the groups (p = 0.07, p = 0.60, p = 0.55, p = 0.77, p = 0.71, p = 0.08, respectively). The groups showed no difference in minimum GC-IPL thickness (p = 0.43). There was a significant negative correlation between smoking exposure and mean, inferior quadrant RNFL thicknesses in the smoker group (p = 0.04, r= −0.32, and p = 0.01, r= −0.39, respectively). Conclusion Mean RNFL thickness was significantly thinner in smoker diabetics. Although not statistically significant, especially mean, superior, and superotemporal GC-IPL was thinner in smoker diabetics. The results suggest a potential association between the coexistence of diabetes and smoking with alterations in RNFL and GC-IPL thickness.

Evaluation of optical coherence tomography parameters before and after parenteral iron treatment of patients with iron deficiency anemia

PurposeThe aim of our study is to evaluate the relationship between iron deficiency anemia (IDA), which is a common and often chronic condition in young women, and the optical coherence tomography (OCT) findings, which have become an indispensable part of ophthalmology practice. We aim to identify a new biomarker for anemia evaluation by demonstrating the morphological changes in the eye before and after iron replacement treatment through OCT findings. Methods70 eyes of 35 patients diagnosed with IDA and planned to have parenteral iron replacement were included in the study. Patients were evaluated before treatment and between 4–6 weeks and 12–16 weeks after treatment. During visits, peripapillary and macular choroidal thicknesses and retinal nerve fiber layer (RNFL) thicknesses were evaluated with OCT along with serum hemoglobin(Hb) values. ResultsThe mean age of the patients was 36.80 ± 7.25. All 35 patients (100%) were female. The mean baseline Hb values of the patients increased statistically significantly both after 4–6 weeks and after 12–16 weeks (p < 0.05). A statistically significant difference was found between baseline and third visit in OCT findings in subfoveal, temporal, nasal, peripapillary temporal and peripapillary nasal choroidal thicknesses and total, inferior, nasal and temporal RNFL thicknes (p < 0.05). There was no statistically significant difference between the baseline and the third visit in the central macular thickness and superior RNFL thickness. ConclusionSignificant increases in choroidal and RNFL thickness were detected after parenteral iron replacement in patients diagnosed with IDA. Our results demonstrate that the changes induced by IDA on the retina can be reversed with treatment.

Optic Nerve Head Parameters in Saudi Male Young Adults Using Swept-source Optical Coherence Tomography.

To assess the optic nerve head (ONH) parameters in normal male Saudi eyes using swept-source optical coherence tomography (SS-OCT). The study included 86 healthy men with a mean age of 23.6 ± 4.82 years. The metrics collected using SS-OCT from each individual was disk area (DA), rim area (RA), cup volume (CV), linear cup-disk ratio (LCDR), vertical cup-disk ratio (VCDR), and total retinal nerve fiber layer (RNFL) thickness, superior RNFL thickness, and inferior RNFL thickness. All the metrics were correlated with the DA. The right eye data were used for the correlation analysis. The mean DA in OD was 1.78 mm2 (range 1.09-2.70 mm2). The mean RA was 1.28 mm2 (range 0.72-2.47 mm2). The DA showed a significant positive correlation (p < 0.05) with RA, cup area (CA), CV, VCDR, LCDR, and total RNFL thickness. For the first time, using sweeping source OCT (DRI OCT Triton, Topcon Corporation), a normative database of ONH parameters was made accessible to the Saudi male population. While assessing the optic disk for progressive optic neuropathies like glaucoma, disk size should be taken into consideration since the optic DA affects ONH topography, especially in Saudi eyes. Challa NK. Optic Nerve Head Parameters in Saudi Male Young Adults Using Swept-source Optical Coherence Tomography. J Curr Glaucoma Pract 2023;17(2):58-62.

Clinical characteristics of radiation-induced optic neuropathy: A single-center retrospective study

PurposeTo observe the clinical and imaging characteristics of radiation-induced optic neuropathy (RION). MethodsWe retrospectively reviewed the clinical data of 43 patients (69 eyes) who were diagnosed with RION at the Chinese PLA General Hospital from 2010 to 2021. ResultsThe latency from radiotherapy to onset of visual loss ranged from 1 to 132 (36.33 ​± ​30.48) months. Optic disc pallor and optic disc edema were found in 27.0% (10/37) and 8.1% (3/37) of the eyes, respectively, within 2 months. After treatment, the best corrected visual acuity (BCVA) was restored in 24.6% (17/69) of the eyes and the final BCVA improved in 13.0% (9/69) of the eyes. An 82.5% (33/40) of the eyes with magnetic resonance imaging (MRI) showed enhancement of the affected optic nerve, mostly (69.7%) in the intracranial segment, and 36.4% (12/33) of the eyes with expansion and T2-high signals also showed enhancement of the affected optic nerve. The superior retinal nerve fiber layer (RNFL) and the outer circle superior quadrant (OS) of the inner limiting membrane to retinal pigment epithelium (ILM-RPE) layer thinned significantly during the first month. The center of the ILM-RPE layer thickened significantly during the first two months and the inner circle temporal quadrant (IT) of the ILM-RPE layer thickened significantly from the third to sixth month. The RNFL thinned significantly after 6 months except for the temporal quadrant, and the average inner circle superior quadrant (IS) and outer circle of the ILM-RPE layer thinned significantly after 6 months. There was no significant difference between hyperbaric oxygen therapy (HBOT) and high-dose intravenous methylprednisolone (IVMP) therapy in improving BCVA recovery or final BCVA (P ​> ​0.05). ConclusionsThe structural damage of the RNFL and ILM-RPE layer occurred during the first month, the RNFL showed progressive thinning during the follow-up period, while the ILM-RPE layer showed thinning during the first month, thickening from the third to sixth month, and thinning after 6 months. There was a discrete region of enhancement of the optic nerve, often with expansion and high-T2 signals on MRI. HBOT and high-dose IVMP therapy were hardly effective for treating RION in the non-acute stage.

Correlation between visual field and retinal nerve fiber layer thickness in adult north Indian population from Gurugram region with glaucoma suspect

: To find the correlation between visual field and retinal nerve layer thickness in adult North Indian population from Gurugram region with glaucoma suspect. Correlative and quantitative study was carried between the visual field and retinal nerve fiber layer (RNFL) thickness of 400 adult eyes. The age of subjects participating in the study ranged between 18 to 80 years with mean age 45 ± 14years. The standard automated perimetry was acquired by Humphrey visual field analyser using 24-2 SITA standard strategy. Retinal nerve fiber layer thickness was measured by Spectral Domain OCT (3D OCT2000FA). Visual field was performed on the same day or within ± three months of OCT acquisition. Statistical analysis was performed using MS Excel, SPSS (ver.20) and other descriptive statistical tools.: The mean MD and PSD were -2.79 dB ±2.21 and 2.52 dB ±1.49, respectively. The average thickness of RNFL of the four quadrants calculated was 98.40 µm±10.70. RNFL thickness in an inferior and superior quadrant was 122.49µm ± 16.71 and 118.86 µm ±15.21 respectively. The mean cup to disc area ratio (CDAR) in the glaucoma suspect subject was 0.60± 0.10, and the vertical cup to disc ratio (VCDR) was 0.74± 0.074. Correlation of the average RNFL thickness, Inferior RNFL thickness and superior RNFL thickness with GHT was 0.245(P=0.011), 0.19 (P=0.094) and 0.27, (P=0.004), respectively. Superior RNFL thickness showed a more significant Correlation (r= 0.193, P&amp;#60;0.01) with mean deviation (MD) of the visual field. Retinal nerve fiber layer thickness demonstrated a weak to mild and statistically significant correlation with the visual field. The correlation of average RNFL thickness with Visual field global indices and parameters were significant but weaker. Correlation between superior RNFL thicknesses was highest with GHT in adult North India Gurugram subjects with glaucoma suspect. Superior RNFL thickness showed a higher Correlation with Mean deviation (MD) and VFI of the visual field

Leber's hereditary optic neuropathy: Update on current diagnosis and treatment.

Leber's hereditary optic neuropathy (LHON) is a fairly prevalent mitochondrial disorder (1:50,000) arising from the dysfunction of the mitochondrial respiratory chain, which eventually leads to apoptosis of retinal ganglion cells. The usual presentation is that of a young male with a sequential reduction in visual acuity. OCT has been used to study the pattern of optic nerve involvement in LHON, showing early thickening of the inferior and superior retinal nerve fibre layer and ganglion cell layer thinning corresponding with the onset of symptoms. Of the three primary mutations for LHON, the m.14484T>C mutation has the best visual prognosis. Recent emerging therapeutic options for LHON include idebenone and the introduction of genetic vector therapy, which is currently in phase III clinical trials. Screening of family members and adequate advice to avoid environmental triggers, such as smoking and alcohol consumption, are also cornerstones in the management of LHON.

Study of retinal nerve fiber layer thickness in diabetic patients using optical coherence tomography.

This study aimed to assess and compare the changes in peripapillary retinal nerve fiber layer (RNFL) thickness in nondiabetics and diabetics with various stages of diabetic retinopathy (DR). The study subjects were divided into four groups based on their diabetic status and findings, namely, controls (normal subjects without diabetes [NDM]), diabetics without retinopathy (NDR), nonproliferative DR (NPDR), and proliferative DR (PDR). Peripapillary RNFL thickness was assessed using optical coherence tomography. One-way analysis of variance (ANOVA) with the post-Tukey HSD test was done to compare RNFL thickness in different groups. The Pearson coefficient was used to determine the correlation. There was statistically significant difference in measured average RNFL (F = 14.8000, P < 0.05), superior RNFL (F = 11.7768, P < 0.05), inferior RNFL (F = 12.9639, P < 0.05), nasal RNFL (F = 12.2134, P < 0.05), and temporal RNFL (F = 4.2668, P < 0.05) across the different study groups. Pairwise comparison showed that there was a statistically significant difference in RNFL measured (average and all quadrants) in patients with DR (NPDR and PDR) and the NDM control group (P < 0.05). In diabetics without retinopathy, the RNFL measured was reduced compared to controls, but it was statistically significant only in the superior quadrant (P < 0.05). Average RNFL and RNFL in all quadrants showed a small negative correlation with the severity of DR and it was statistically significant (P < 0.001). In our study, peripapillary RNFL thickness was reduced in diabetic retinopathy compared to normal controls and the thinning increased with the severity of DR. This was evident in the superior quadrant even before the fundus signs of DR set in.