Temporal Retinal Nerve Fiber Layer Research Articles

Evaluating retinal thickness classification in children: A comparison between pediatric and adult optical coherence tomography databases.

This study investigates the agreement of children's retinal thickness classification by color category between Topcon 3D OCT-1's built-in adult reference data and our new pediatric database and assesses the correlation of retinal thickness with age and spherical equivalent (SE). 160 eyes of 160 healthy children (74 boys, 86 girls) aged 6-18 years (mean: 11.60 ± 3.28 years) were evaluated in this cross-sectional study. The peripapillary retinal nerve fibre layer (pRNFL) and macular thickness were determined for the 1st, 5th, 95th, and 99th percentile points. Cohen's κ value and specific agreement between pediatric data and adult reference database were estimated. The correlation between retinal thickness with age and SE was also determined. The mean thickness for the total RNFL, average macular, and central macula were 112.05±8.65 μm, 280.24±12.46 μm, and 220.55±17.53 μm, respectively. The overall agreement between the classification of the adult database and pediatric data for pRNFL was ≥90%, with discrepancies in 46 out of 150 eyes (30.67%); for macula, it was above 72%, with discrepancies in 93 out of 153 eyes (60.78%); and for ganglion cell complex and ganglion cell + inner plexiform layer (GCIPL) the agreement was above 84% and 85%, respectively. A significant level of agreement between pediatric data and adult reference data was achieved for temporal RNFL (κ = 0.65), macular perifoveal superior (κ = 0.67), and inferior (κ = 0.63) and inferior GCIPL (κ = 0.67). The correlations between age and retinal thickness were not significant (all p>0.05). Most retinal thickness parameters were positively associated with SE (Pearson's coefficient, r = 0.26 to 0.49, all p<0.05). The overall agreement for pRNFL and macular thickness measurements in children with the adult reference database was between 72% and 90%. Children's retinal thickness was not significantly correlated with age but was positively associated with spherical equivalent.

Clinical efficacy of optical coherence tomography parameters to predict the visual field outcome following pituitary adenoma surgery.

To investigate the factors affecting visual field recovery in patients with pituitary adenoma following surgical removal, both eyes of 35 patients with pituitary adenoma who had been followed up for > six months post-surgery were retrospectively analyzed. Pre- and post-operative visual acuity, visual field test, retinal nerve fiber layer (RNFL), and ganglion cell inner plexiform layer (GCIPL) thickness were investigated. The average age of the 35 patients was 58.3 ± 11.5 years. Preoperatively, 30 eyes (mean average RNFL thickness, 99.73 ± 5.89 μm) and 40 eyes (mean average RNFL thickness, 77.55 ± 8.35 μm) were included in the thick (≥ 90 μm) and thin RNFL group (< 90 μm), respectively. In the thick RNFL group, pre- and post-operative mean deviation (MD) and pattern standard deviation (PSD) were favorable (all p < 0.001), and the proportion of eyes of postoperative MD change which were stable or improved was greater than in the thin RNFL group (p = 0.042). Preoperative MD, RNFL (except nasal quadrant) and GCIPL thickness were positively correlated to postoperative MD values (all, p < 0.05). Preoperative MD and temporal RNFL thickness were significantly correlated with postoperative MD change rate (p = 0.03 and 0.04, respectively). Preoperative GC IPL thickness and postoperative MD change rate were not significantly correlated (p = 0.61). Using univariate regression analysis, preoperative best corrected visual acuity (Odds ratio [OR], 0.050; p < 0.001), tumor volume (OR, 1.110, p = 0.002), higher preoperative MD values (OR, 0.858; p < 0.001), lower preoperative PSD values (OR, 1.169, p = 0.002), thick RNFL (OR, 0.215; p = 0.003) and thick GCIPL (OR, 0.305, p = 0.018) were significantly associated with a good visual field outcome following surgery. According to multivariate analysis, any other parameters were not significant. In patients with thick RNFL, postoperative MD values were better than in the thin RNFL group. Eyes with preoperative higher MD and thick temporal RNFL showed more improvement in their visual fields postoperative. Preoperative thick RNFL could be a potential predictor of visual field recovery following TSA-TR, while macular GCIPL thickness does not appear to be a reliable predictor.

Exploring optical coherence tomography parameters in eyes with myopic tilted disc

BackgroundTo investigate the impact of optic disc torsion (ODT), horizontal disc tilt (HDT) angle, and ovality index (OI) on different retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) segments in healthy myopic eyes.MethodsODT and OI were measured from fundus photographs. HDT angle, peripapillary RNFL, and macular GCIPL were measured by swept-source optical coherence tomography (SS-OCT). The association between optic disc morphology and the RNFL/GCIPL thickness were evaluated, with age and axial length (AL) adjusted.ResultsAmong 530 healthy myopic eyes of 284 participants (mean age: 41.7 years, mean spherical equivalent: − 7.70 D, and mean AL: 26.6 mm), 335 eyes (63.2%) had temporal disc torsion (temporal group) and 195 eyes (36.8%) had nasal disc torsion (nasal group). For the nasal group, a larger OI was associated with thinner superior-to-superonasal GCIPL (β = − 7.465 to − 6.972, both P = 0.024) and temporal RNFL sectors (β = − 49.596 to − 27.748, P ≤ 0.014). For the temporal group, a larger OI was associated with thinner superior-to-nasal (β = − 50.255 to − 22.093, P ≤ 0.006) and thicker temporal RNFL sectors (β = 29.015 to 56.890, P ≤ 0.003). Additionally, a larger HDT angle was associated with thinner superior-to-nasal RNFL sectors (β = − 0.559 to − 0.242, P ≤ 0.036) and thinner superior-to-superotemporal GCIPL sectors (β = − 0.084 to − 0.069, P ≤ 0.037).ConclusionsThe optic disc tortional direction was associated with the measurement of different RNFL and GCIPL sectors independent of the AL and age. These should be considered when constructing a myopic normative database.

Associations of optic nerve head morphology and peripapillary retinal nerve fibre layer thickness with myopic severity and treatment in children

PurposeThis study aimed to investigate the longitudinal associations between myopic optic disc features and optical coherence tomography (OCT) measurements of peripapillary retinal nerve fibre layer (RNFL) thickness in young myopic children in Singapore. MethodsA prospective, single-site cohort study was conducted, involving children aged 7–16 years who participated in the PROM-Kids clinical cohort study from 2019 to 2022. Participants underwent annual assessments, including cycloplegic refraction, axial length measurements, fundus photography, and OCT imaging, with ocular magnification correction. Children were classified into low (LM, 0 to −3D), moderate (MM, −3.01 to −6D), and high (HM, > −6D) myopia, with or without treatment. ResultsData from 1000 children (right eye) were analyzed, including 521 with 2-year follow-up. At baseline, the mean age was 10.2 ± 1.6 years, with 46.4 % male and 90.7 % ethnic Chinese. HM children were older and exhibited greater optic disc tilt (ODT, 92 % vs. 80 %) and more peripapillary atrophy (PPA, 94 % vs. 73 %) compared to LM children. RNFL thickness decreased in the superior, inferior, and nasal quadrants but increased in the temporal quadrant with higher myopia. In the follow-up cohort, myopia progression was associated with thicker temporal quadrant and average RNFL, particularly in younger children. Prior treatment with myopia-control lenses was also associated with increased RNFL thickness in the superior quadrant. ConclusionOptic disc changes occur early in life, even in low myopia. Increasing myopia is linked to varying RNFL thickness across quadrants and may be influenced by age and myopia treatment.

Visual recovery following pituitary adenoma surgery: prognostic value of optical coherence tomography and suprasellar tumour volume

ObjectiveThe aim of this study is to investigate the effects of preoperative parameters such as retinal nerve fiber layer (RNFL) thickness, visual acuity (VA), visual field (VF), and tumour volume on postoperative outcomes in patients with pituitary adenoma. DesignRetrospective study. ParticipantsTwo-hundred and seventy-six eyes from 142 patients were included. MethodsAll patients underwent a comprehensive ophthalmological evaluation both before and 12 months after the surgery. RNFL thickness was analyzed using optical coherence tomography. VF testing was carried out using the automated Humphrey Visual Field Analyzer 3. Two primary visual field (VF) parameters, mean deviation (MD), and pattern standard deviation (PSD), were recorded. Patients were categorized into 2 groups based on their visual field outcomes: the MD recovery group and the nonrecovery group. MD recovery was defined as an MD value greater than −2 dB at the 12-month postoperative follow-up visit. ResultsThe mean BCVA was significantly improved postoperatively compared with the preoperative values (P = 0.001). Preoperatively, the upper, temporal, and inferior RNFL values were significantly higher in patients with normal visual fields compared to those with abnormal visual fields (P = 0.001 for upper and temporal, P = 0.008 for inferior). Preoperative suprasellar tumour volume was found to be lower in the MD recovery group (P = 0.001). Multivariate logistic regression analyses revealed that preoperative inferior RNFL thickness were significantly associated with MD recovery (P = 0.023), and preoperative temporal RNFL thickness were significantly associated with VA recovery (P = 0.047). ConclusionRNFL thickness, VF parameters, and suprasellar tumour volume can serve as important prognostic indicators in patients with pituitary adenoma.

Optic Nerve Head Morphological Variation in Craniosynostosis: A Cohort Study

To evaluate optic nerve head (ONH) morphology in children with craniosynostosis versus healthy controls. Single-center, prospective cohort study. Handheld optical coherence tomography (OCT) was performed in 110 eyes of 58 children (aged 0-13 years) with craniosynostosis. Inclusion criteria were as follows: normal intracranial pressure on invasive overnight monitoring, or clinically stable intracranial pressure. The latter was defined as stable VA within 1 logMAR line and no papilledema on fundoscopy for at least 4 months following OCT, and normal/stable visual evoked potentials. Control data for 218 eyes of 218 children were obtained from a published normative dataset. The main outcome measures were disc width, cup width, rim width, and retinal nerve layer thickness (nasal and temporal). Outcome measures were compared using three-way linear mixed model regression analysis (fibroblast growth factor receptor [FGFR] 1/2-associated craniosynostosis, non-FGFR 1/2-associated craniosynostosis, and controls). Out of 63 eligible children with craniosynostosis, handheld OCT imaging was successful in 110 eyes of 58 children (92%). Of these, 22 (38%) were female. Median subject age at OCT examination was 53 months (range: 2-157; IQR: 39-73). Twelve children (21%) had FGFR1/2-associated syndromes (Crouzon, n = 6; Apert, n = 4; Pfeiffer, n = 2). Control data were available for 218 eyes of 218 healthy children. 122 controls (56%) were female. Median control age at OCT examination was 20 months (range: 0-163; IQR: 6-59). When comparing ONH morphology in craniosynostosis (n = 58) versus controls (n = 218), disc width was 6% greater (P = .001), temporal cup width was 13% smaller (P = .027), rim width was 16% greater (P < .001) and temporal retinal nerve fiber layer was 11% smaller (P = .027). When comparing FGFR1/2-associated syndromes (Crouzon, Apert, and Pfeiffer syndromes, n = 12) to the rest of the craniosynostosis group (n = 46), disc width was 10% smaller (P = .014) and temporal cup width was 38% smaller (P = .044). This cohort demonstrated morphological differences of the ONH in craniosynostosis, most markedly in Crouzon, Apert, and Pfeiffer syndromes. These findings could help improve ophthalmological monitoring and surgical decision-making in children with craniosynostosis. Further work on longitudinal ONH changes in syndromic and nonsyndromic craniosynostosis would be valuable.

Clinical follow-up investigation on thickness changes in the peripapillary retinal nerve fibre layer of patients with Leber hereditary optic neuropathy

BackgroundTo investigate the peripapillary retinal nerve fibre layer (RNFL) thickness changes and analyse factors associated with visual recovery of G11778A Leber hereditary optic neuropathy (LHON) patients.MethodsPatients diagnosed with G11778A LHON between July 2017 and December 2020 in Tongji hospital were included in this follow-up study. Patients were grouped according to disease duration. Variations in the RNFL thickness in each quadrant at different disease stages were characterised using optical coherence tomography. According to the absence or presence of significant visual acuity improvements, LHON patients of disease duration ≥ 6 months were divided into two groups. A bivariate logistic regression model was constructed to analyse the potential factors associated with spontaneous visual recovery.ResultsThis study included 56 G11778A LHON patients (112 eyes) and 25 healthy controls (50 eyes), with a mean follow-up of 5.25 ± 1.42 months. All quadrants and mean RNFL thicknesses of LHON patients first increased and then decreased, except for the temporal RNFL. As the disease progressed, RNFL thinning slowed; however, gradual RNFL thinning occurred. Logistic regression revealed that baseline best corrected visual acuity was related to spontaneous visual recovery of LHON patients with disease duration ≥ 6 months.ConclusionThe pattern of RNFL involvement could be helpful in the differential diagnosis of LHON and other optic neuropathies. LHON patients with better vision are more likely to experience some degree of spontaneous visual acuity recovery after the subacute phase.

A cross-sectional study on the impact of hemodialysis duration on retinal nerve fiber layer thinning in hemodialysis patients

This study aimed to investigate the relationship between hemodialysis duration (HDD) and retinal nerve fiber layer (RNFL) thickness. A total of 60 patients receiving maintenance hemodialysis and 67 healthy controls were analyzed. Spectral domain optical coherence tomography (SD-OCT) was employed to measure annular RNFL thicknesses. The hemodialysis group exhibited reduced temporal and inferior RNFL thicknesses relative to the control group. In hemodialysis patients, the inferior RNFL thickness was negatively correlated with HDD and positively correlated with intraocular pressure (IOP). Moreover, IOP was positively correlated with HDD. Mediation analysis showed that the negative correlation between HDD and inferior RNFL thickness was mediated by IOP. In conclusion, hemodialysis leads to temporal and inferior RNFL thinning, and the thickness reduction is proportional to hemodialysis duration. However, such changes are not induced by an increase in IOP.

EVALUATION OF MACULAR GANGLION CELL COMPLEX USING SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY IN GLAUCOMA SUSPECT PATIENTS AND TO CORRELATE IT WITH NORMAL POPULATION

PURPOSE:. To evaluate macular ganglion cell complex in glaucoma suspect patients and normal population RESULTS The difference between values of neuroretinal rim thickness,rim area,disc area,average CDR,vertical CDR and cup volume among glaucoma suspect and normal (controls) was found to be statistically significant (p value&lt;0.001). The difference between values of superior,nasal,inferior,temporal and average RNFL thickness among glaucoma suspect and normal (controls) was found to be statistically significant(p value&lt;0.001). The difference between values of superotemporal, superior, superonasal, inferonasal, inferior, inferotemporal, average and minimum GCIPL (Ganglion cell Inner plexiform layer) thickness in µm, as estimated on OCT macula, was found to be statistically significant among glaucoma suspect patients and normal (controls) (p value &lt;0.001). Upon applying Spearman’s rho correlation coefficient test in glaucoma suspect patients for GCIPL thickness and RNFL thickness, statistically significant correlation was found between Inferior RNFL thickness with Inferotemporal GCIPL thickness(p value 0.029) and Temporal RNFL thickness with Inferotemporal GCIPL thickness .(p values 0.006). Upon applying Spearman’s rho correlation coefficient test in normal (controls) for GCIPL thickness and RNFL thickness,statistically significant correlation was found between Superior RNFL thickness with Superior GCIPL thickness(p value 0.038), Superior RNFL thickness with Superonasal GCIPL thickness (p values 0.012 ), and Average RNFL thickness with Average GCIPL thickness (p value 0.033) CONCLUSION: In our study we found there is statistically significant reduction in thickness in all measured quadrants of Macular GCIPL and RNFL in glaucoma suspect patients compared to normal. Also, a statistically significant correlation was found between Inferior RNFL thickness with Inferotemporal GCIPL thickness and Temporal RNFL thickness with Inferotemporal GCIPL thickness in glaucoma suspect patients,suggesting good diagnostic ability of inferotemporal macular GCIPL thickness.

Ocular findings in Jansen metaphyseal chondrodysplasia.

Jansen metaphyseal chondrodysplasia (JMC) is an ultra-rare disorder caused by germline heterozygous PTHR1 variants resulting in constitutive activation of parathyroid hormone type 1 receptor. A description of ocular manifestations of the disease is lacking. Six patients with JMC underwent a detailed ophthalmic evaluation, spectral-domain optical coherence tomography (OCT), visual field testing, and craniofacial CT scans. Five of 6 patients had good visual acuity. All patients had widely spaced eyes; 5/6 had downslanted palpebral fissures. One patient had proptosis, and another had bilateral ptosis. Two patients had incomplete closure of the eyelids (lagophthalmos), one had a history of progressive right facial nerve palsy with profuse epiphora, while the second had advanced optic nerve atrophy with corresponding retinal nerve fiber layer (RNFL) thinning on OCT and significant bilateral optic canal narrowing on CT scan. Additionally, this patient also had central visual field defects and abnormal color vision. A third patient had normal visual acuity, subtle temporal pallor of the optic nerve head, normal average RNFL, but decreased temporal RNFL and retinal ganglion cell layer analysis (GCA) on OCT. GCA was decreased in 4/6 patients indicating a subclinical optic nerve atrophic process. None of the patients had glaucoma or high myopia. These data represent the first comprehensive report of ophthalmic findings in JMC. Patients with JMC have significant eye findings associated with optic canal narrowing due to extensive skull base dysplastic bone overgrowth that appear to be more prevalent and pronounced with age. Progressive optic neuropathy from optic canal narrowing may be a feature of JMC, and OCT GCA can serve as a useful biomarker for progression in the setting of optic canal narrowing. We suggest that patients with JMC should undergo regular ophthalmic examination including color vision, OCT, visual field testing, orbital, and craniofacial imaging.

The effect of epilepsy and anti-epileptic drugs on the anterior and posterior segment of the eye

ABSTRACT Clinical relevance Understanding the causes of visual symptoms in epilepsy patients is important for early diagnosis and taking precautions. Background The aim of this study is to evaluate the anterior and posterior segment parameters in patients with generalized tonic-clonic epilepsy (GTCE). Methods This retrospective study included 50 eyes of 50 patients with GTCE and 55 eyes of 55 healthy controls. For all participants, detailed ophthalmic examinations were obtained from the files of patients. Anterior segment parameters were measured using corneal topography and non-contact specular microscopy, and posterior segment parameters were measured using swept-source optical coherence tomography. Results The mean age of the patients with GTCE was 43.3 ± 13.2 years, and in the healthy controls it was 47.6 ± 10.7 years (p = 0.405). In GTCE patients, 34 patients were treated with monotherapy (MT) and 16 patients with polytherapy (PT). Central macular thickness (CMT) was statistically significantly thin in GTCE patients (p = 0.001). The average and four quadrants (superior, inferior, nasal, temporal) retinal nerve fibre layer (RNFL) were thinner in GTCE patients than in the healthy controls, but there was no statistically significant difference (p > 0.05, all). The central corneal thickness was statistically significantly thin in GTCE patients (p = 0.04). Endothelial cell density (ECD), endothelial cell number (ECN), and average cell area (ACA) were statistically significantly lower in GTCE patients than in the healthy controls (p < 0.05, all). Although the CMT, average, and four-quadrants RNFL were thinner in the PT group compared to the MT group, no statistically significant difference was observed (p > 0.05, all). Total high-order aberrations (HOAs) were 0.6 ± 0.4 in the MT group and 0.4 ± 0.1 in the PT group (p = 0.01). ECD, ECN, and ACA measurements were observed to be lower in the PT group compared to the MT group, but no statistically significant difference was detected (p > 0.05, all). Conclusion There could be statistically significant differences between GTCE patients and healthy controls in anterior and posterior segment parameters. This situation may be due to the epilepsy itself or to the antiepileptic drugs.

The Correlation between Body Mass Index and Intraocular pressure, Retinal Nerve Fiber Layer Thickness and Visual Field

Abstract Background Obesity has become a world-wide medical epidemic. it constitutes an important risk for several eye diseases like cataract, diabetic retinopathy, age related macular degeneration (AMD) and glaucoma.Body mass index (BMI) is one of the most specific and objective measurement to define obesity. Obesity has recently been reported to be negatively associated with visual acuity, but the ocular conditions underlying this association and the potential implications are unclear. Amongst different eye diseases, obesity has been associated with cataract, age-related maculopathy, diabetic retinopathy, and glaucoma. Purpose To investigate the relationship between BMI and IOP and correlate it with changes in RNFL thickness and visual field. Materials and Methods 60 participants divided into three groups (normal, overweight, and obese) according to BMI, were included in this Cross-Sectional Study (pilot study). Participants underwent a complete ophthalmologic assessment, measurement of RNFL thickness and ganglion cell complex (GCC) thickness using SD-OCT, IOP with Goldmann applanation tonometry (GAT) and visual field analysis using Humphrey field analyser. Results IOP was significantly higher in obese group than those in healthy weight and overweight group. Also, IOP was statistically significant higher in overweight group compared with those healthy weight group. There were no significant differences between the three groups in average, superior, inferior, nasal, and temporal RNFL thicknesses or in GCC thickness. Yet, GCC thickness in the obese group showed significant negative correlation with BMI.There were no significant differences between the three groups in MD, and VFI. Conclusion IOP was variable according to the degree of obesity with incremental pattern with advance of BMI. BMI of overweight group had no correlation with IOP, average, superior, inferior, nasal, and temporal RNFL thicknesses. While BMI of obese group showed a significant positive correlation with IOP and negative correlation with GCC thickness.

Comparing the morphology of optic nerve head and lamina cribrosa in full-term and preterm school-aged children.

To evaluate the morphology of lamina cribrosa (LC) in preterm school-aged children. A study of 120 eyes from 120 patients, including 42 full-term children (control group), 41 preterm children without retinopathy of prematurity (ROP), 16 children with ROP treated with intravitreal bevacizumab (IVB), and 21 children with ROP treated with laser. Five parameters of LC were measured by optical coherence tomography, including Bruch's membrane opening (BMO) diameter, minimum rim width (MRW), LC depth, prelaminar tissue (PLT) thickness, and LC curvature index (LCCI). The PLT thickness increased with age in full-term and preterm children (β = 30.1, P = 0.003 and β = 19.6, P < 0.001, respectively). LC depth and LCCI showed no differences between full-term and preterm children. Worse refractive errors in preterm children were associated with greater MRW and PLT thickness (β = -17.1, P = 0.001 and β = -5.7, P = 0.03, respectively). However, this relationship was not found in full-term children. Laser-treated children had greater MRW, PLT, temporal peripapillary retinal nerve fibre layer, and foveal thickness than full-term or other preterm children (all P < 0.05). Prematurity and ROP treatment may have an impact on the structural development of the LC. Refractive status plays a vital role in the LC structure of preterm children. This highlights the refractive errors of preterm children at school age that merit greater attention.

Ocular toxicity of daily anti-tubercular treatment regimen: A prospective observational study

Context: India carries a significant burden of TB which is the commonest cause of infectious disease-related mortality. Anti-tubercular drugs can cause serious ocular toxic effects. Optical coherence tomography (OCT) can be used as a valuable tool in the quantitative analysis of anti-tubercular treatment (ATT)-induced toxic optic neuropathy. Aims: To study the changes in visual parameters in patients on ATT and to analyze the OCT changes in patients by taking measurements once before initiation of treatment and once during ongoing treatment (between three and six months). Settings and Design: Tertiary care center, Prospective observational study. Methods and Material: A prospective observational study was conducted in 140 eyes of 70 subjects undergoing ATT as per the latest RNTCP guidelines where the following determinants were examined, and the corresponding values were taken once before initiation of treatment and once during ongoing treatment (between three and six months) and results were analyzed. Around 90% of the subjects were examined at the end fourth month. Visual acuity was taken using the Log Mar chart, color vision using Ishihara’s chart, and slit lamp examination and fundus evaluation using a 90 D lens. OCT was done and average nasal, temporal, superior, and inferior quadrant retinal nerve fiber layer (RNFL) measurements were taken. Perimetry was also done; however, findings were not included in this study. Statistical Analysis Used: Frequency and percentage were applied to study the changes in visual parameters in patients on ATT. A paired t-test was applied for numerical variables to analyze the OCT changes in patients undergoing ATT. A P value &lt; 0.05 was considered statistically significant. Results: Despite a near-normal appearance of the fundus on ophthalmoscopy, OCT clearly demonstrated and quantified the loss of retinal nerve fibers. Statistically significant RNFL thinning (P value &lt; 0.001) was noted in the superior, temporal, and inferior quadrants and least in the nasal quadrant (P = 0.005). Significant deterioration in visual acuity was observed following three months of ATT (P = 0.001). Red-green color vision abnormalities were detected in 14 out of 140 eyes (10%). Conclusions: RNFL thickness was reduced on OCT. RNFL thickness quantification and assessment of other visual parameters especially color vision help in the early diagnosis of ocular toxic effects of ATT. Hence, awareness and active screening are imperative in preventing visual impairment and blindness.

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.

Visual Field and Optical Coherence Tomography Parameters With and Without Positive Family History of Glaucoma.

To evaluate the Retinal Nerve Fiber Layer and Ganglion Cell Complex thickness using Spectral Domain Optical Coherence Tomography with and without positive family history of Primary Open Angle Glaucoma and its relation to visual field. Total 120 eyes with each subjects with positive family history of Primary Open Angle Glaucoma (Group I, n=30) and healthy subjects without positive family history of Primary Open Angle Glaucoma (Group II, n=30) undergone complete ophthalmic evaluation with Retinal Nerve Fiber Layer, Ganglion Cell Complex and VF obtained from Spectral Domain Optical Coherence Tomography RTVue-100 and Humphrey visual field respectively .The measurements were analyzed and compared among two groups using independent-t test by using SPSS version 23.The relationship of Retinal Nerve Fiber Layer with visual field were evaluated with correlation analysis. There were 75 patients included in the study.nasal, temporal RNFL and average Ganglion Cell Complex was significantly lower and thinner in Group I with mean difference of -8.53±2.30 µm (p<0.001), -7.35±3.34 µm (p<0.001), -8.52±3.58µm (p<0.001),-11.87±2.24µm (p<0.001), -5.31±1.95µm (p<0.001) and -8.05±1.52µm (p<0.001) respectively. Correlation plot with Retinal Nerve Fiber Layer thickness as predictor of Mean Deviation and Pattern Standard Deviation indicated statistically significant degree of determination in Group I (r=0.455 and r=0.623, p<0.001 and p<0.001). The Optical Coherence Tomography and visual field Parameters are lower in group I and used as an early predictor, diagnosis, monitoring and management.

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.

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.

DIABETES DURATION AND RETINAL NERVE FIBER LAYER THICKNESS RELATED DEGREE OF DIABETIC RETINOPATHY

Introduction &amp; ObjectivesDiabetic retinopathy is an ocular complication of diabetes mellitus (DM). Several studies have shownthat neurodegenerative changes in the retina occur earlier than microvascular changes.Measurement of retinal nerve fiber layer thickness can detect neurodegeneration at an early stage.This study aims to analyze the relationship of diabetes duration and retinal nerve fiber layerthickness with degree of diabetic retinopathy in type 2 diabetes mellitus patients.&#x0D; MethodsThis research was analytic observational research with cross-sectional design. The sample was type2 diabetes mellitus patients with diabetic retinopathy who visited the eye clinic at the University ofSumatera Utara General Hospital. The sample were then analyzed with the Kruskal Wallis test tofind relationship of diabetes duration and retinal nerve fiber layer thickness with degree of diabeticretinopathy in type 2 diabetes mellitus patients.&#x0D; ResultsThe sample of this study were 20 subjects with diabetic retinopathy and 20 subjects without diabeticretinopathy as the control group. The mean duration of having DM in the group of patients with mildNPDR was 5.33 years, with moderate NPDR was 9.13 years and with PDR was 15.33 years. Usingthe Kruskal Wallis test revealed that there was no significant relationship between degree ofdiabetic retinopathy with Avg RNFL (p=0.495), superior RNFL (p=0.385), inferior RNFL (p=0.111),temporal RNFL (p=0.064), nasal RNFL (p=0.535).&#x0D; ConclusionThere was a significant difference between diabetes duration with degree of diabetic retinopathy butno significant between retinal nerve fiber layer thickness with degree of diabetic retinopathy.

The Correlation between Retinal Nerve Fibre Layer Thickness, Optic Nerve Head Parameter, and Related Risk Factor in Glaucoma Patient

Introduction &amp; ObjectivesTo investigate the correlation between retinal nerve fibre layer (RNFL) thickness and the past RNFLthickness, related risk factor (gender, age, myopia, intraocular pressure (IOP), blood pressure). AndRNFL parameter (symmetricity and four quadrants RNFL thickness) and optic nerve head parameter(rim area and vertical cup disc ratio)&#x0D; Methods39 right eyes of both sex and various age underwent examination including IOP measurement,subjective refraction for determining refractive error, and optical coherence tomography (OCT) forRNFL and ONH analysis. The follow up were done after one year.&#x0D; ResultsThe RNFL symmetricity, superior, nasal, inferior, temporal RNFL thickness showed significancecorrelation with RNFL thickness (R= 0.487, p= 0.002), (R= 0.915, R= 0.749, R= 0.897, R= 0.702with p= &lt;0.001), but not showed significance correlation with rim area and vertical cup disc ratio(R= 0.175, p= 0.286) and (R= -0.093, p= 0.574). A significance correlation also showed withincreasing age, gender, and systolic blood pressure (R= -0.387, p= 0.015), (R= 0.441, p= 0.005) and(R= -0.418, p= 0.008). But not showed significance correlation with history of past RNFL thickness,refractive error, IOP, and diastolic blood pressure (R= 0.258, p= 0.113), (R= 0.005, p= 0.975), (R=-0.234, p=0.152), and (R= 0.060, p=0.717).&#x0D; ConclusionRNFL thickness measurements showed significance correlation with RNFL parameter. It is not clearif past RNFL thickness, refractive error and IOP related with RNFL thickness even showedsignificance correlation with age, gender, and systolic blood pressure.