Thinning In Eyes Research Articles

Measurement of retinal nerve fiber layer and macular ganglion cell-inner plexiform layer with spectral-domain optical coherence tomography in patients with optic nerve head drusen.

To evaluate the effect of optic nerve head drusen (ONHD) on the retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) using Cirrus optical coherence tomography (OCT). Fifty-seven eyes of thirty patients with ONHD and thirty-eight eyes of twenty age-matched and sex-matched control subjects underwent circumpapillary and macular scanning using Cirrus OCT. The percentages of eyes with abnormal GCIPL and RNFL values according to the Cirrus normative data were analysed and compared. Overall, eyes with ONHD showed abnormally reduced values for average and minimum GCIPL thicknesses in 35 % and 45 % of cases compared to 2 % for both values in control eyes (P < 0.001). Average RNFL thickness comparison between eyes with ONHD and normal eyes revealed abnormal thinning in 33 % vs. 0 %, respectively (p = 0.002). The percentage of abnormal thinning increased with higher grades of ONHD for all the parameters evaluated, so that in grade III drusen, values were abnormally reduced in 80 % of eyes in all three analyses. Regarding buried ONHD, 30 % and 4 % of eyes had an abnormally reduced minimum GCIPL and average RNFL thickness, respectively. Furthermore, 26 % of these eyes had abnormal GCIPL exams with a normal or increased RNFL thickness. Both RNFL and GCIPL analysis reveal significant thinning in eyes with ONHD directly correlated with drusen severity. In buried ONHD, the abnormality rate was significantly higher with GCIPL compared to RNFL evaluation, suggesting that GCIPL analysis might be an early structural indicator of neuronal loss in the setting of thickened RNFL.

Quantitative Analysis of Diabetic Macular Ischemia Using Optical Coherence Tomography

We described the optical coherence tomography (OCT) features of diabetic macular ischemia (DMI), and correlate these findings with visual acuity (VA). Clinical and imaging data were collected from 100 patients with type 2 diabetes. Qualitative grading of DMI severity was determined according to criteria defined by the Early Treatment Diabetic Retinopathy Study. Quantitative analysis of foveal avascular zone (FAZ), and OCT images were performed using custom software. In all eyes, the outer retina was thicker in eyes with DMI (167.4 ± 18.5 vs. 150.4 ± 31.4 μm, P = 0.04). However, subanalysis of eyes "without macular edema" revealed the converse; outer retinal thinning in eyes with DMI (223.1 ± 31.2 vs. 244.9 ± 37.2 μm, P = 0.007). A thinner retinal nerve fiber layer also was observed to correlate with increasing FAZ size (r = -0.231, P = 0.03), which strengthened in eyes "without macular edema" (r = -0.62, P = 0.001). In the choroid, quantification of its sublayers revealed a thicker Haller's large vessel layer in the presence of DMI (144.3 ± 51.0 vs. 103.5 ± 39.4 μm, P = 0.01). In eyes with DMI, a thicker retina was correlated with worsening VA (r = 0.52, P = 0.001). However, when eyes with macular edema were excluded, a thinner retina was associated with poor VA (r = -0.37, P = 0.004). In eyes with DMI, we observed thinning of the retinal nerve fiber layer, outer retina, and thickening of Haller's large vessel layer of the choroid. These parameters showed good correlation with VA and may serve as a useful tool for monitoring DMI in clinical practice or future clinical trials.

Retinal layers measurements in healthy eyes and in eyes receiving silicone oil‐based endotamponade

PurposeTo characterize the concordance/symmetry of each retinal layers in individuals without macular pathology and to further characterize the localization of inner retinal thinning in eyes receiving silicone oil-based endotamponade.MethodsRetinal layers of one hundred eyes of 50 individuals without macular pathology were imaged using spectral domain optical coherence tomography (SD-OCT) and manually segmented using ImageJ software (developed by Wayne Rasband, NIH, Bethesda, MD, USA). In the second part of the study, retrospective analysis of 3028 cases of pars plana vitrectomy in University Eye Hospital Cologne, Germany, was conducted, retrieving nine patients with silicone oil-based endotamponade with no macular condition interfering retinal layers measurements. These patients had retinal detachment not involving the macula due to various conditions. In these patients, retinal layer segmentation was performed and compared with the fellow eye.ResultsThere is a moderate-to-high concordance for all retinal layers between the right and the left eye of the same individual. In eyes receiving silicone oil-based endotamponade, the inner retinal layers become subsequently thinner. Ganglion cell and inner plexiform layers contribute most to this thinning, that is, 0.537 ± 0.096 mm3 compared with 0.742 ± 0.117 mm3; p = 0.006. Outer retinal layers were not affected by silicone oil-based endotamponade (p = 0.439 for the differences of calculated outer retinal layers).ConclusionGanglion cell and inner retinal layers become subsequently thinner after the use of silicone oil-based endotamponade. This study advocates the use of spectral domain optical coherence tomography for patient management with silicone oil endotamponade to early detect subsequent retinal thinning.

Can color vision and retinal nerve fiber layer thickness serve as suitable biomarkers in childhood demyelinating disease?

With OCT a better understanding of neurodegeneration in demyelinating disease can be achieved by capturing thinning of the retinal nerve fibre layer (RNFL). On the other hand it is well known that color vision is often affected in these patients. The purpose of this study is to investigate whether there is any association between RNFL thinning and color vision deficiency in children and young adults with demyelinating disease with or without a history of optic neuritis (ON). Thirty young patients (13-28 years) participated in this study. They all had clinically and neuroradiologically confirmed demyelinating disease (which was diagnosed before the age of 16 years) with or without a history of ON. After a thorough clinical examination, they underwent OCT imaging using high-resolution spectral-domain OCT (SD-OCT; Spectralis, Heidelberg Engineering, Germany), measuring RNFL thickness. In addition all patients had a monocular psychophysical color vision evaluation using Ishihara test and Farnsworth-Munnsell hue 100 (FM 100) test. The FM 100 test error score (E.S.) was compared to SD-OCT parameters in eyes with and without ON. All eyes of patients with demyelinating disease showed RNFL thinning compared to normative data. Although thinning in eyes without a history of ON was much smaller, compared to RNFL thinning in eyes after one or more episodes of ON, where significant RNFL thinning was found (P < 0.01). Average E.S. of the whole group of patients was more than 90, ranging from 28 to 584 and was much higher in ON eyes (range, 68-584) compared to eyes without ON (28-56). A strong correlation was found between color vision FM 100 error score and RNFL thickness (P < 0.001). Also other potentially useful biomarkers (such as ERG) need to be analyzed in patients with demielinating disease. Color vision loss and RNFL thinning measured with SD-OCT are in strong correlation in patients with demyelinating disease and can therefore serve as suitable biomarkers of the disease.

Retinal Axonal Loss Begins Early in the Course of Multiple Sclerosis and Is Similar between Progressive Phenotypes

BackgroundTo determine whether retinal axonal loss is detectable in patients with a clinically isolated syndrome (CIS), a first clinical demyelinating attack suggestive of multiple sclerosis (MS), and examine patterns of retinal axonal loss across MS disease subtypes.Methodology/Principal FindingsSpectral-domain Optical Coherence Tomography was performed in 541 patients with MS, including 45 with high-risk CIS, 403 with relapsing-remitting (RR)MS, 60 with secondary-progressive (SP)MS and 33 with primary-progressive (PP)MS, and 53 unaffected controls. Differences in retinal nerve fiber layer (RNFL) thickness and macular volume were analyzed using multiple linear regression and associations with age and disease duration were examined in a cross-sectional analysis. In eyes without a clinical history of optic neuritis (designated as “eyes without optic neuritis”), the total and temporal peripapillary RNFL was thinner in CIS patients compared to controls (temporal RNFL by −5.4 µm [95% CI −0.9 to −9.9 µm, p = 0.02] adjusting for age and sex). The total (p = 0.01) and temporal (p = 0.03) RNFL was also thinner in CIS patients with clinical disease for less than 1 year compared to controls. In eyes without optic neuritis, total and temporal RNFL thickness was nearly identical between primary and secondary progressive MS, but total macular volume was slightly lower in the primary progressive group (p<0.05).Conclusions/SignificanceRetinal axonal loss is increasingly prominent in more advanced stages of disease – progressive MS>RRMS>CIS – with proportionally greater thinning in eyes previously affected by clinically evident optic neuritis. Retinal axonal loss begins early in the course of MS. In the absence of clinically evident optic neuritis, RNFL thinning is nearly identical between progressive MS subtypes.

Diagnosis and follow‐up in patients with optic neuritis by means of optical coherence tomography (OCT) and scanning laser polarimetry (GDx)

Abstract Purpose: To evaluate the accuracy of ocular imaging technologies, such as Optical coherence tomography (OCT) and Scanning laser ophthalmoscopy (GDx) in the diagnosis and follow‐up of optic neuritis. Methods: A total of 13 patients with optic neuritis and 13 age‐ and sex‐matched healthy controls were included in this prospective, clinical study and followed up for six months. All of them underwent neurologic assessment and a complete ophthalmic examination that included visual acuity, colour vision (Ishihara pseudoisochromatic plates), visual field, OCT and GDx. Results: In acute episode, there were significant differences in visual acuity, Ishihara colour test, visual field mean deviation (MD), either in anterior or posterior optic neuritis, compared with healthy eyes. Eyes with acute papillitis showed increased RNFL thickness measured by OCT in every retinal quadrant compared with healthy eyes, but differences were not statistically significant. Six months after the acute episode, visual acuity, colour test and visual field had improved but we observed RNFL thinning in eyes with optic neuritis compared with control eyes. Both the OCT and the GDx detected significant differences between the groups six months after the acute episode Conclusions: Structural analysis of the RNFL by means of OCT and GDx is useful in optic neuritis diagnosis and follow‐up. Optic neuritis, either anterior or posterior, causes a decrease in the RNFL thickness, which can be detected by OCT and GDx

Effect of optic nerve head drusen on nerve fiber layer thickness

Objective The purpose of the study was to evaluate the effect of optic nerve head drusen (ONHD) on nerve fiber layer (NFL) thickness by visual field testing, red-free photography of NFL, and optical coherence tomography (OCT). Design The study design was a prospective clinical study. Participants Twenty-three eyes of 15 consecutive patients with ONHD and 27 eyes of 27 age-matched control subjects participated. Intervention Ophthalmologic examination, color and red-free photography, automated Humphrey visual field testing, and OCT were performed. Each of the drusen study eyes were graded on a scale of 0 to III based on the amount of visible ONHD. Grade 0 represented the absence of clinically visible ONHD, and grade III represented an optic nerve head with abundant drusen. Main outcome measures Findings from clinical evaluation and color optic nerve head photographs and NFL evaluation by red-free photography, visual fields, and OCT were measured. Results The number of study eyes with visual field defects increased with the higher grade drusen discs, corresponding both with progressively thinner NFL measurements by OCT and NFL loss shown by NFL photography. The NFL evaluation showed NFL thinning by red-free photography in 12 (71%) of 17 eyes with visible drusen (grades I–III discs) and visual field defects in 9 (53%) of 17 eyes in this group. By OCT measurements, the superior and inferior NFLs were significantly thinner in the eyes with visible ONHD compared with those of control eyes in the superior quadrant ( P < 0.001) and inferior quadrant ( P = 0.004). Compared with grade 0 discs, grades I through III discs showed statistically significant thinning of the NFL superiorly ( P < 0.001). No statistical significant thinning of the NFL was seen in grade 0 discs compared with those of control subjects. Conclusions Optical coherence tomography is able to detect NFL thinning in eyes with ONHD and appears to be a sensitive and early indicator of NFL thinning. Increased numbers of clinically visible ONHD correlated with NFL thinning shown by OCT measurements and both visual field defects and NFL loss seen by red-free photography.