Quadrant Thickness Research Articles

Applicability of ISNT rule to retinal nerve fiber layer thickness by SD-OCT in normal subjects.

The usefulness of the Inferior>Superior>Nasal>Temporal (ISNT) rule for the neuroretinal rim (NRR) has been widely used in differentiating normal eyes from glaucoma, but only a few studies have assessed whether this classical ISNT rule applies to the retinal nerve fibre layer (RNFL). This study aimed to determine the applicability of the ISNT rule for the peripapillary RNFL thickness in normal eyes using Spectral Domain Optical Coherence Tomography (SD-OCT) and assess if variants of the ISNT rule apply. A cross-sectional study was conducted on 120 eyes of 62 healthy subjects who fulfilled the study criteria. Peripapillary RNFL thickness was measured by OCT scan and each eye's global, superior, temporal, nasal, and inferior quadrant thickness was noted. The values obtained were analyzed to determine the percentage of eyes obeying the ISNT rule and its variants. The ISNT rule for RNFL thickness was applicable for normal subjects in only 53.33% of cases. Removing the nasal quadrant from analysis increased the number of eyes obeying the IST rule to 71.66%. Further exclusion of the temporal quadrant showed almost the same results (75%) for the IS rule. The ISNT rule for RNFL thickness could be validated in only 53.33% of normal individuals. Though documented as useful for NRR during ophthalmoscopy in glaucoma diagnosis, the ISNT rule did not apply to the quadrant values on RNFL on SD-OCT examination.

Characterization of Vortex Vein Drainage System in Healthy Individuals Imaged by Ultra-Widefield Optical Coherence Tomography Angiography.

The purpose of this study was to investigate the choroidal characteristics of vortex vein (VV) drainage systems in healthy individuals using ultra-widefield optical coherence tomography angiography. The mean choroidal thickness (ChT) and choroidal vascularity index (CVI) of each VV quadrant (24 × 20 mm2 scan mode; superotemporal [ST], superonasal [SN], inferonasal [IN], and inferotemporal [IT] quadrants) were calculated. Furthermore, intervortex venous anastomosis (IVA) was classified into temporal, superior, inferior, and nasal types. A total of 207 healthy eyes were analyzed to find that the ST quadrant had the thickest choroidal layer and highest CVI (all P < 0.05). Among the four VV drainage quadrants, the mean ChT and CVI decreased in the sequence of ST, SN, IT, and IN (all P < 0.05). Moreover, men had a higher CVI than women in all VV quadrants (all P < 0.05). IVA was observed in all VV quadrants of 91 eyes (43.96%), and in the macular region of 33 eyes (15.94%). The ST drainage system was identified as the preferred VV drainage route in healthy eyes. Among the four VV drainage quadrants, the drainage system adhered to the ST-SN-IT-IN order of descending perfusion. Furthermore, age- and sex-related differences were noted in the choroidal VV drainage systems of healthy eyes. Additionally, almost half of the healthy eyes had IVA in their choroidal vessel networks. The VV drainage system may be considered a novel imaging biomarker for ocular diseases.

CORRELATION OF VISUAL FIELD CHANGES WITH OPTICAL COHERENCE TOMOGRAPHY IN PRIMARY OPEN ANGLE GLAUCOMA

PURPOSE: To detect morphological changes in Optic Nerve Head (ONH), macula and Retinal nerve fibre layer (RNFL) using spectral domain optical coherence tomography (SDOCT) and to correlate them with functional loss (Visual field changes) using 24-2 and 10-2 standard automated perimetry in Primary open angle glaucoma patients. RESULTS: Mean value of 90D cup to disc ratio (CDR) of study subjects was 0.64 ± 0.13 with median (25th-75th percentile) of 0.7(0.6-0.7). Mean value of average RNFL thickness(microns), superior quadrant thickness (micron), inferior quadrant thickness (micron), nasal quadrant thickness (micron) and temporal quadrant thickness (micron) of study subjects was 62.35 ± 14.43, 77.96 ± 14.29, 81.41 ± 22.84, 51.33 ± 21.14 and 50.71 ± 17.71 with median(25th-75th percentile) of 63(52-75), 78(66.25-89), 81.5(64.25-93.75), 54(46-63) and 50.5(39-57.75) respectively. Mean value of average macular thickness (micron), macular GCL-IPL thickness -Superior quadrant (micron) and macular GCL-IPL thickness -Inferior quadrant (micron) of study subjects was 65.6 ± 11.7, 76.49 ± 11.63 and 76.76 ± 16.86 with median (25th-75th percentile) of 64(56-75), 75(67-87.75) and 75.5(65.25-93) respectively. Mean value of MD and PSD of study subjects was -7.34 ± 4.47 and 6.8 ± 3.11 with median (25th-75th percentile) of -7.65(-11--3.1) and 6.9(3.9-9.1) respectively. 57(41.3%) eyes had early glaucoma, 51(37%) eyes had moderate glaucoma and 30(21.7%) eyes had advanced glaucoma. CONCLUSION: In present study, ONH parameters (rim area), RNFL parameter (inferior quadrant thickness) and macula parameters (average macular GCLIPL thickness) showed statistically significant correlation with VF MD. Correlation between VF parameters i.e. MD and PSD with OCT parameters shown that there was a relation between Macular GCLIPL thickness ,RNFL thickness and ONH with the changes in the results of VF.

Anatomical Features can Affect OCT Measures Used for Clinical Decisions and Clinical Trial Endpoints.

To understand the association between anatomical parameters of healthy eyes and optical coherence tomography (OCT) circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurements. OCT cpRNFL thickness was obtained from 396 healthy eyes in a commercial reference database (RDB). The temporal quadrant (TQ), superior quadrant (SQ), inferior quadrant (IQ), and global (G) cpRNFL thicknesses were analyzed. The commercial OCT devices code these values based on percentiles (red, <1%; yellow, ≥1% and <5%), after taking age and disc area into consideration. Four anatomical parameters were assessed: fovea-to-disc distance, an estimate of axial length, and the locations of the superior and the inferior peaks of the cpRNFL thickness curve. Pearson correlation values were obtained for the parameters and the thickness measures of each of the four cpRNFL regions, and t-tests were performed between the cpRNFL thicknesses coded as abnormal (red or yellow, <5%) versus normal (≥5%). For each of the four anatomical parameters, the correlation with the thickness of one or more of the TQ, SQ, IQ, and G regions exceeded the correlation with age or disc area. All four parameters were significantly (P < 0.001) associated with the abnormal cpRNFL values. The significant parameters were not the same for the different regions; for example, a parameter could be negatively correlated for the TQ but positively correlated with the SQ or IQ. In addition to age and disc area, which are used for inferences in normative databases, four anatomical parameters are associated with cpRNFL thickness. Taking these additional anatomical parameters into consideration should aid diagnostic accuracy.

Attention flexibility is associated with retinal cup-to-disk ratio in patients with schizophrenia spectrum disorders

IntroductionIn recent years, there has been increasing interest in the potential use of retinal imaging as a non-invasive and easily accessible tool for investigating the neurobiological underpinnings of schizophrenia. Studies have suggested that patients with schizophrenia spectrum disorders (SSD) have structural abnormalities in the retina, including changes in retinal thickness and the ratio of the retinal cup-to-disk ratio.ObjectivesTo investigate the relationship between retinal cup-to-disk ratio and cognitive performance in patients with SSD using a high-definition retinal imaging device – optical coherence tomography (OCT) scanner.MethodsThe sample was comprised of twenty patients with SSD (F20-F29 according to ICD-10 criteria). All diagnoses were confirmed by a researcher using the Mini International Psychiatric Interview. All patients underwent complete ophthalmological examination, excluding any ocular pathology. Retinal thickness was measured in both eyes of all patients with a high-definition spectral-domain OCT device. Examined retinal parameters were: total retinal nerve fiber layer thickness (RNFL); RNFL thickness in all eye quadrants (nasal, temporal, superior, inferior); RNFL symmetry; average macular volume (MV); average macular thickness (MT); ganglion cell layer thickness (GC); average retinal cup-to-disk (C/D) ratio, vertical C/D ratio. Cognitive performance of all patients was tested using the Intra/Extradimensional Set Shift Task (IED). IED is a component of a state-of-the-art computerized battery for cognitive assessment – Cambridge Neuropsychological Automated Test Battery. IED is a measure of maintenance, shifting and flexibility of attention. Associations between retinal variables and IED measures were determined with Pearson correlation analyses.ResultsMean age of patients was 33 ± 7.5 years. Fifty five percent of the sample was male, illness duration was 6.2 ± 3.9 years. Daily dosage of chlorpromazine was 225.7 ± 108.8 mg. Retinal C/D ratio in the right eye was positively associated with IED total errors (r=0.50; p=0.02) and negatively with IED stage progression (r=-0.52, p=0.18). Likewise, vertical C/D ratio was positively associated with IED total errors (r=0.49; p=0.02) and negatively with IED stage progression (r=-0.52, p=0.18).ConclusionsPrevious analyses of retinal parameters in patients with schizophrenia point towards enlargement of retinal cup-to-disk ratio, irrespective of any underlying somatic comorbidities. Our data shows worsening of attention flexibility in association with the increase of cup-to-disk ratio in patients with schizophrenia spectrum disorders. The significance of cup-to-disk retinal disturbance in schizophrenia spectrum disorders and its connection with cognitive performance should be further evaluated and supplemented with measurements of functional adaptation in these patients.Disclosure of InterestNone Declared

Comparison of Smartphone and internet addiction and Optical Coherence Tomography findings among University students

IntroductionInternet and smartphone use that reaches the level of addiction often leads to deterioration in the quality of life and functionality of individuals.ObjectivesIn our study, we aimed to investigate possible differences in retinal nerve fiber layer (RNFL) thickness and central macular thickness obtained by optical coherence tomography in internet and smartphone addiction.MethodsA total of 212 volunteer university students participated in our study. All participants were administered the Sociodemographic Information Form, Chen Internet Addiction Scale, Smartphone Addiction Scale-Short Form. Participants who completed the scales underwent routine eye examinations by experienced physicians in the ophthalmology outpatient clinic. Retinal nerve fiber layer (RNFL) thickness and central macular thickness were measured by optical coherence tomography (OCT).ResultsIn our study, internet addiction rate was 17% and smartphone addiction rate was 38.2%. RNFL thickness was found to be statistically significantly increased in the temporal superior and temporal inferior quadrants in those with internet addiction compared to healthy subjects (p&lt;0.05). In smartphone addiction, RNFL thickness was found to be statistically significantly increased in the temporal inferior quadrant compared to healthy subjects (p&lt;0.05). In the analyses comparing OCT measurements according to sex, it was found that nasal inferior (p&lt;0.01) and global (p&lt;0.05) quadrants in women and central macular thickness (p&lt;0.01) in men were statistically significantly increased.The correlation analyses in our study revealed statistically significant positive correlations between internet addiction scale scores (p&lt;0.01) and smartphone addiction scale scores (p&lt;0.01), RNFL temporal superior quadrant thickness (p&lt;0.01); smartphone addiction scale scores and RNFL temporal superior quadrant thickness (p&lt;0.05).ConclusionsInternet and smartphone addiction are seen considerable rates among university students. In OCT measurements, RNFL thickness was found to be increased in various quadrants in patients with addiction. In addition, RNFL thickness was found to be increased in all quadrants in female gender and central macular thickness was found to be increased in male gender. Correlation analysis revealed that internet addiction scale scores, smartphone addiction scale scores, and RNFL temporal superior quadrant thickness were positively correlated. In addition, there was a positive correlation between smartphone addiction scale scores, and RNFL temporal superior quadrant thicknessDisclosure of InterestNone Declared

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.

Comparison of ocular changes in multiple sclerosis and neuromyelitis optica spectrum disorder patients.

To explore ocular changes in patients with MS and NMOSD via SD-OCT and PVEP analysis. From August 2020 to July 2021, 82 patients (164 eyes) diagnosed with MS, 59 patients (118 eyes) diagnosed with NMOSD and 50 healthy controls (100 eyes) were retrospectively selected. SD-OCT and PVEP were performed to compare retinal nerve fibre layer (RNFL) thickness around the optic disc, ganglion cell inner plexiform layer (GCIPL) thickness in the macula and P100 latency and amplitude between the disease groups and the control group. In the NMOSD and MS groups, the thickness of the GCIPL quadrants in eyes with optic neuritis was thinner than that in eyes without optic neuritis, and the amplitude of the P100 wave decreased. In addition, in eyes with optic neuritis, patients with NMOSD have thinner RNFL thicknesses in the temporal and superior quadrants than patients with MS, and the thickness of the GCIPL is thinner in each region. In eyes without optic neuritis, patients with MS have thinner nasal RNFL than do those with NMOSD. SD-OCT and VEP may be useful for monitoring and distinguishing pathological changes in MS and NMOSD patients.

Assessment of conjunctival, episcleral and scleral thickness in healthy individuals using anterior segment optical coherence tomography.

To determine the thickness of the conjunctiva, episclera and sclera in healthy individuals using anterior segment optical coherence tomography (AS-OCT). We prospectively included 107 healthy individuals of different age groups (18-39 years, 40-54 years, 55-69 years and ≥70 years). For each eye, AS-OCT scans of four quadrants (temporal, nasal, superior and inferior) were acquired. The thickness of the conjunctiva, episclera and sclera was measured for each scan. In addition, the axial length of both eyes was measured, and general characteristics, including smoking, allergies and contact lens use, were collected. The mean conjunctival thickness was significantly different between the nasal and superior quadrants (87 ± 30 μm vs. 77 ± 16 μm; p < 0.001), as well as the superior and inferior quadrants (77 ± 16 μm vs. 86 ± 19 μm; p = 0.001). The mean episcleral thickness was larger in the superior (174 ± 54 μm) and inferior (141 ± 43 μm) quadrants, compared to the nasal (83 ± 38 μm) and temporal quadrants (90 ± 44 μm). The mean scleral thickness of the inferior quadrant was the largest (596 ± 64 μm), followed by the nasal (567 ± 76 μm), temporal (516 ± 67 μm) and superior (467 ± 52 μm) quadrants (all p < 0.001). The averaged scleral thickness increased 0.96 μm per age year (0.41-1.47 μm, p < 0.001). This study provides an assessment of the thickness of scleral and adjacent superficial layers in healthy individuals determined on AS-OCT, which could enable future research into the use of AS-OCT in diseases affecting the anterior eye wall.

Central retinal vessel trunk exit location: An important factor while evaluating the neuroretinal rim.

Optic nerve head (ONH) evaluation plays a key role in differentiating normal from glaucomatous disk. Thinning of the inferior neuroretinal rim (NRR) has been noted in early glaucoma. However, NRR thickness in different quadrants appears to depend on various factors including central retinal vessel trunk exit (CRVT) position. We evaluated ocular parameters that determined the NRR thickness in the different quadrants of normal eyes. Retrospective review of demographic and ocular data from 773 eyes of 388 subjects with normal ONH over one year was undertaken. Nearly 54% were males, and the mean age was 43.2 years. The CRVT exit was central in 50% (773). The common site for noncentral CRVT was superotemporal (ST) [37%, 141/384] followed by inferotemporal (IT) [35%, 135/384]. With noncentral CRVT, the probability that the inferior, superior, nasal and temporal (ISNT) rule was not followed was 1.42 times ( P < 0.001). The thinnest rim quadrant (TRQ) was mostly ST (69%) irrespective of CRVT location. The TRQ was IT in 40% when CRVT was noncentral and 82% with IT CRVT exit. With noncentral CRVT, round disks favored noncompliance [132 (54.1%), odds ratio (OR) 2.56] with the ISNT rule. The OR of noncompliance with the ISNT rule increases 1.89 times with inferonasal CRVT and 1.22 times with a unit increase in the axial length. TRQ was IT in IT CRVT, and noncompliance with the ISNT rule was observed with large disks, longer axial length, and noncentral CRVT. This implies that despite the ISNT rule being violated these eyes do not have optic nerve pathology and should not be subjected to unnecessary diagnostic tests.

Subclinical damage to the contralateral eye in unilateral optic neuritis: A longitudinal study.

Early detection of subclinical injuries can lead to a correct diagnosis and help control the advancement of the condition. This study aims to investigate the presence of subclinical damage and silent progression to the contralateral eye's visual function and structure in patients experiencing their first episode of unilateral optic neuritis (ON). Fifty patients with first-onset unilateral ON were enrolled in this study. Based on etiology, they were classified as having neuromyelitis optica spectrum disorder-related ON (NMOSD-ON), myelin oligodendrocyte glycoprotein antibody-associated ON (MOG-ON), idiopathic ON (IDON), or multiple sclerosis-related ON (MS-ON). These cases were followed up for one year to determine whether there was any silent progression of visual function and structure in the contralateral non-ON (NON) eye. A gender- and age-matched healthy control (HC) group was included to compare the differences in visual function and structure between the patients with NON eyes and the HC group. Within two weeks of onset, best-corrected visual acuity (BCVA; P=0.008), mean deviation (MD) of the visual field (VF) (P=0.001), and peripapillary retinal nerve fiber layer (pRNFL; P=0.019) thickness were significantly worse in the NMOSD-NON patients than those in the HC group, while there were no differences in the pRNFL and the ganglion cell-inner plexiform layer (GCIPL) thicknesses and quadrant thicknesses (P > 0.05) of the groups. IDON-NON only showed subclinical damage in VF (P=0.001) and temporal pRNFL (P=0.042), while the BCVA, VF, and optic nerve structure (pRNFL, GCIPL) of the MOG-NON patients showed no subclinical damage (P > 0.05). In addition, the one-year follow-up of each NON eye type showed that there was no silent progression in NMOSD-NON, MOG-NON, or IDON-NON. A pairwise comparison of the different types of NON eyes revealed no statistical differences (P > 0.05). Among the patients with unilateral ON, NMOSD-NON and IDON-NON resulted in subclinical damage to the visual function and structure of the contralateral eye within two weeks of onset, whereas MOG-NON did not show any subclinical damage to visual function or structure. Furthermore, these subclinical damages did not show any silent progression during the one-year follow-up period.

Association of macular pigment optical density with retinal layer thicknesses in eyes with and without manifest primary open-angle glaucoma

ObjectiveTo investigate associations between baseline macular pigment optical density (MPOD) and retinal layer thicknesses in eyes with and without manifest primary open-angle glaucoma (POAG) in the Carotenoids in Age-Related Eye...

Retinal and peripapillary vascular density in episodic and chronic migraine cases without aura

BackgroundMigraine is a neurovascular disease that can cause ocular and systemic ischemic damage. Despite from aura, a limited number of studies have considered the effect of the chronic migraine in cases without aura. Our aim was to evaluate the differences in the retinal and optic disk microvasculature among episodic and chronic migraine cases without aura using optical coherence tomography angiography (OCTA) imaging. Methods45 cases with migraine, and 25 control subjects were included in this prospective, cross-sectional study. OCTA was performed at 3 × 3 mm and 6 × 6 mm of the macula and at 4.5 × 4.5 mm of the optic disk. Retinal nerve fiber layer (RNFL) thickness, ganglion cell complex thickness, and vessel densities of the optic nerve and macula were compared among the three groups: a control group, an episodic migraine without aura (EMWOA) group, and a chronic migraine without aura (CMWOA) group. ResultsIn EMWOA group, circumpapillary vascular density (cpVD) was not decreased significantly in any quadrants (all, p>0.05). Compared to the control group, CMWOA group had significantly lower RNFL thickness in superior-temporal quadrants (p = 0.002 and 0.006, respectively), while cpVD differed only in the temporal quadrant and temporal inferior sector (p = 0.002 and p = 0.009, respectively). ConclusionsTemporal peripapillary perfusion is valuable in the follow-up of chronic migraine cases. Longitudinal studies are needed to determine the place of OCTA in the follow-up of migraine.

Evaluation of Retinal Toxicity by SD-OCT due to Long-Term Exposure to Hydroxycholorquine among Rheumatoid Arthritis Patients

Background Hydroxychloroquine is used increasingly in the management of a variety of autoimmune disorders, with well-established roles in dermatology and rheumatology and emerging roles in oncology. However, Hydroxychloroquine and chloroquine (CQ) have been associated with irreversible visual loss due to retinal toxicity. Cessation of the use of hydroxychloroquine at an early stage of damage might prevent functional loss; however, after maculopathy has developed, cessation of the drug does not show clinical recovery. Because discontinuation of Therapy may reverse retinal toxicity, early detection of toxicity changes is vitally important. Objective to evaluate the involvement of retina in hydroxychloroquine (HCQ) retinopathy among rheumatoid arthritis patients using data from spectral domain optical coherence tomography (SDOCT) and to correlate toxicity with dose, duration of use and cumulative effect of HCQ. Patients and Methods Cross sectional Study. In total 13 patients (26 eyes) attending the rheumatological outpatient clinic of El Demerdash hospital, from October 2019 to February 2020 were enrolled in the study after the approval of the research ethical committee in the Faculty of Medicine, Ain Shams University. A full history was taken from the patients and full ophthalmological examination was done. In our study we perform OCT for all patients by using the Nidek RS-3,000 Advance SD-OCT with the “Macula Map” protocol that imaged a 6 × 6 mm area with 64 raster B-scans, each composed of 1024 A-scans. Results The study showed that was highly significant negative correlation between duration of exposure and CMT (p-value =0.008) and highly significant negative correlation between cumulative dose and CMT (p-value =0.005). Also, there was statistically significant negative correlation between age and thickness of inner and outer nasal quadrant (p-value= 0.015, p-value= 0.001) respectively and between age and inner and outer superior quadrant (p-value= 0.048, p-value= 0.000) respectively, in ETDRS thickness map. It also found statistically significant negative correlation between daily dose and thickness of outer nasal quadrant of thickness map (p-value= 0.045). Conclusion The present study show the presence / absence of retinal toxicity in rheumatoid arthritis patients use hydroxychloroquine for 5years or more using SD-OCT and found a statistically significant negative correlation between central macular thickness and cumulative dose of HCQ and between central macular thickness and duration of HCQ use.

Effect of Cigarette Smoking on Macular, Choroidal, and Retinal Nerve Fiber Layer Thickness: A Systematic Review and Meta-Analysis

Background Smoking is one of the most significant and preventable health problems of our time causing various chronic illnesses including ocular problems; however, its effect on thickness of the retinal layers or choroid is still unknown. Aim of the Work to conduct a systematic review and attempt a meta-analysis to determine the effect of tobacco smoking on central macular (CMT), choroidal (CT), and retinal nerve fiber layer thickness (RNFL). Materials and Methods comprehensive literature search was conducted using the databases Google scholar, PubMed, web of science, EMBASE and Cochrane Library for published studies from 1 January 2000 to 1 June 2021.This meta-analysis included thirteen studies. They were Observational studies. Results This study demonstrated no significant effect of tobacco smoking on central macular, choroidal or retinal nerve fibre layer thickness. However, advanced analyses showed that smoking has acute effect on choroidal thickness and would influence the thickness of superior and inferior RNFL quadrants. Conclusion There was no evidence of an association between tobacco smoking and changes in choroidal, central foveal or retinal nerve fibre layer thickness. Future research on this interesting and important topic could aid in the prevention and treatment of smoking-related illnesses.

Differences in structural parameters in patients with open-angle glaucoma, high myopia and both diseases concurrently. A pilot study.

To evaluate the differences in structural parameters in patients with open-angle glaucoma (OAG), high myopia (M), and both diseases (OAG-M) concurrently. 42 subjects with OAG (n = 14), M (n = 14) and OAG-M (n = 14) were included in a prospective pilot study. Mean peripapillary retinal nerve fiber layer (RNFL) thickness, RNFL in superior, temporal, inferior, nasal quadrants, macular ganglion cell complex (GCC) and its' layers, vessel density (VD) of optic nerve head (ONH) and macula were evaluated. The OAG-M group showed significantly lowest thickness of mean peripapillary RNFL 89 (49-103) μm (p = 0.021), temporal quadrant 64.5 (51-109) μm (p = 0.001) and inferior quadrant 107 (64-124) μm (p = 0.025). The macular RNFL was thinnest in the OAG-M group (p <0.001). Macular VD in inferior quadrant was lowest in OAG-M group at superficial capillary plexus 45.92 (40.39-51.72) % (p = 0.014) and choriocapillaris 51.62 (49.87-56.63) % (p = 0.035). The lowest ONH VD of temporal quadrant was found in the OAG-M group 52.15 (35.73-59.53) % (p = 0.001) in the superficial capillary plexus. Similarly, the lowest VD of inferior quadrant was found in OAG-M group in the choriocapillaris 54.42 (46.31-64.64) % (p<0.001). The M group showed the least thinning in the peripapillary RNFL thickness in the temporal quadrant and macular RNFL compared to other two groups. The highest macular VD in the inferior quadrant was in the M group in the superficial capillary plexus, deep capillary plexus and choriocapillaris. The M group showed highest VD in the temporal quadrant and in total VD of ONH at the superficial capillary plexus and in total VD of ONH at the deep capillary plexus. The observed decrease in peripapillary RNFL thickness of the temporal quadrant, macular RNFL thickness, the decrease of macular VD at the inferior quadrant and decrease in VD of the ONH temporal quadrant in deep capillary plexus could be beneficial for diagnosing glaucoma in high myopia.

Foveal and Macular Thickness Measurements in Myopes as Determined by Optical Coherence Tomography

BACKGROUND&#x0D; Myopia is becoming one of the major public health problems globally. Various structural changes are seen in the fundus of myopic patients. Hence there is a need to understand the normal macular thickness in myopes. With the advent of Optical Coherence Tomography (OCT), foveal and macular thickness can be measured with micrometer resolution. However, there have been hardly any studies that have compared the central foveal and macular thickness among low, moderate and high myopes. We wanted to assess foveal and macular thickness in low, moderate and high myopic patients and study the association between foveal and macular thickness with axial length and spherical equivalent.&#x0D; METHODS&#x0D; A total of 150 eyes of 150 subjects with varying degrees of myopia who presented to the Department of Ophthalmology, Christian Medical College and Hospital, Ludhiana formed the study group. Comprehensive ophthalmic examination was performed which included visual acuity, refraction by autorefractometer, axial length by NIDEK AL-SCAN, foveal and macular thickness measurements by Optical Coherence Tomography.&#x0D; RESULTS&#x0D; A total of 150 patients of different grades of myopia were analyzed. The central foveal thickness increased from mild to high myopia. The average macular thickness, and the thickness of the various quadrants in inner and outer macula ring decreased with progression of myopia.&#x0D; CONCLUSIONS&#x0D; It was observed from our study that with increasing grades of myopia, there is increase in central foveal thickness and decrease in the average macular thickness which should be considered mainly in high myopes in retinal disorders.

Quantitative study of peripapillary retinal nerve fiber layer thickness and peripapillary vessel density in patients with different stages of Parkinson's disease.

To observe the changes in the thickness of peripapillary retinal nerve fiber layer (pRNFL) and peripapillary vessel density (pVD) in patients with different stages of Parkinson's disease (PD). Totally 47 patients (47 eyes) with primary PD were divided into the mild group and the moderate-to-severe group according to Hoehn & Yahr (H&Y) stage. Among them, there were 27 cases (27 eyes) in mild group and 20 cases (20 eyes) in moderate-to-severe group. And 20 cases (20 eyes) who were included in the control group were healthy people who came to our hospital for health screening at the same time. All participants underwent optical coherence tomography angiography (OCTA) examinations. The pRNFL thickness, total vessel density (tVD) and capillary vessel density (cVD) of the optic disc in average, superior half, inferior half, superior nasal (SN), nasal superior (NS), nasal inferior (NI), inferior nasal (IN), inferior temporal (IT), temporal inferior (TI), temporal superior (TS), and superior temporal (ST) were measured. One-way ANOVA was used to compare the differences of optic disc parameters among the three groups, and Pearson and Spearman correlations were used to analyze the correlation between pRNFL, pVD and the disease duration, H&Y stage and UPDRS-III score in patients with PD, respectively. There were significant differences in pRNFL thickness in average, superior half, inferior half, SN, NS, IN, IT and ST quadrants among the three groups (P<0.05). In PD group, the pRNFL thickness in average, superior half, inferior half, NS and IT quadrants were negatively correlated with H&Y stage and UPDRS-III score, respectively (P<0.05). There were statistically significant differences in the cVD of whole image, inferior half, NI and TS quadrants, the tVD of the whole image, inferior half, and peripapillary among the three groups (P<0.05). In PD group, the tVD of whole image and the cVD of NI and TS quadrants were negatively correlated with the H&Y stage, respectively (P<0.05); the cVD of TS quadrant was negatively correlated with UPDRS-III score (P<0.05). The thickness of pRNFL in PD patients is significantly decreased, and it is negatively correlated with H&Y stage and UPDRS-III score. With the increase of the severity of the disease, the pVD parameters in PD patients increase at first in the mild group, and then decrease in the moderate-to-severe group, and negatively correlate with H&Y stage and UPDRS-III score.

Short-term effect of macular edema on the peripapillary retinal nerve fiber layer in patients with wet age-related macular degeneration and diabetic macular edema: A comparative study

BackgroundThe combined presence of glaucoma and age-related macular degeneration (ARMD), or glaucoma and diabetes mellitus (DM), occur fairly frequently, especially in elderly patients. This study was intended to compare the effect of resolving macular edema due to DM and wet ARMD on peripapillary retinal nerve fiber layer (RNFL) thickness. MethodsThis cross-sectional study included 76 patients with macular edema secondary to DM (n = 40, 52.6%) or wet ARMD (n = 36, 47.4%). The control group was comprised of 34 age and sex-matched healthy subjects. All study participants underwent evaluation of central macular thickness (CMT) and the peripapillary RNFL using spectral domain-optical coherence tomography (SD-OCT). Data from eyes that received an anti-VEGF injection were obtained one month after the procedure and were compared with pre-injection data. ResultsThe average initial thickness of the global peripapillary RNFL was 98.9 ± 16.7 (61–163) µm in the macular edema group and 92.0 ± 16.0 (84–115) µm in the control group (p = 0.045). The post-injection global peripapillary RNFL thickness was 97.3 ± 19.0 (61–163) µm in the macular edema group and 92.2 ± 18.0 (81–126) µm in the control group (p = 0.187). In the DM group, the changes in global RNFL thickness, as well as central and temporal quadrant thicknesses, were found to correlate significantly with the change in CMT (r = 0.356, p = 0.024; r = 0.545, p < 0.001, respectively). ConclusionsMacular edema in wet ARMD appeared not to affect RNFL thickness. Differences in the etiology of macular edema can have varied effects on peripapillary RNFL. It is recommended that peripapillary RNFL thickness be evaluated cautiously in DM patients receiving intravitreal anti-VEGF therapy.

Refractive status and retinal morphology in children with a history of intravitreal ranibizumab for retinopathy of prematurity.

This study investigated the characteristics of refractive status, visual acuity, and retinal morphology in children with a history of receiving intravitreal ranibizumab for retinopathy of prematurity (ROP). Children 4-6years of age were enrolled and divided into the following four groups: group 1, children with a history of ROP who had been treated with intravitreal ranibizumab; group 2, children with a history of ROP who had not received any treatment; group 3, premature children without ROP; and group 4, full-term children. Refractive status, peripapillary retinal nerve fiber layer (RNFL), and macular thickness were measured. A total of 204 children were enrolled. In group 1, myopic shift was not noted, but poorer best corrected visual acuity (BCVA) and shorter axial length were observed. Significantly lower peripapillary RNFL thickness in the average total and superior quadrant, higher central subfield thickness, lower parafoveal retinal thickness in average total, superior, and nasal and temporal quadrants were observed in group 1 than in the other groups. The poor BCVA in patients with ROP was correlated with the lower RNFL thickness in the superior quadrant. Conclusion: Children with a history of type 1 ROP treated with ranibizumab did not show a myopic shift but did show abnormal retinal morphology and the poorest BCVA among all groups. We suggest that pediatric ophthalmologists should always pay attention to visual development in patients with ROP with a history of intravitreal ranibizumab. What is Known: • Anti-VEGF is efficiently and widely used in the treatment of type 1 retinopathy of prematurity (ROP), and different anti-VEGF agents are associated with different prevalence of myopia. • Patients with ROP who receive treatment such as laser therapy or cryotherapy have abnormal macular development and retinal nerve fiber layer (RNFL) thickness. What is New: • Children with a history of ROP treated with intravitreal ranibizumab did not show a myopic shift but did show poor BCVA at 4-6years of age. • Abnormal macular morphology and lower peripapillary RNFL thickness were found in these children.