Retinal Peripapillary Nerve Fiber Layer Thickness in Neuromyelitis Optica

Optical coherence tomography (OCT) analyzes the neurodegeneration in neuromyelitis optica (NMO) and multiple sclerosis (MS) and quantifies optical atrophy. The retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness are decreased, and this structural change is correlated with visual function of patients, including contrast vision and visual field deviation. The main objective of this study was to evaluate the Bruch membrane opening minimum rim width (BMO) of the patients with NMO. We studied the thickness of the BMO by OCT, in patients with NMO (n = 25; 34 eyes), MS (n = 50; 70 eyes), and a control group (n = 51; 100 eyes). The study evaluated the structure-function relationship with the correlation between OCT and visual function: Visual acuity, Pelli-Robson score, Sloan 2.5 and 1.25, color vision, standard automated perimetry (SAP), and frequency-doubling technology perimetry (FDT). The average thickness of BMO was significantly reduced in NMO and MS with or without a history of optic neuritis (ON). Significant thinning of the average, nasal, and inferonasal BMO in the absence of ON in NMO was found compared with controls (P = 0.022, 0.006, and 0.026, respectively). BMO was strongly correlated with Pelli-Robson score (P < 0.001), Sloan 2.5 (P < 0.001), and mean deviation of SAP and FDT (P = 0.004). The sectorial study found a high correlation between the BMO and the corresponding sector of the visual field. The BMO thickness is decreased after ON in NMO and MS. This study showed an improved ability of BMO over RNFL and GCL to detect infraclinical impairment in patients with NMO without a history of optic neuropathy. Like the RNFL and GCL, BMO is well correlated with visual function, including contrast vision and visual field deviation.

Optical coherence tomography as a tool for monitoring pediatric pseudotumor cerebri

Structural and Functional Assessment in HIV-Infected Patients Using Optical Coherence Tomography and Frequency-Doubling Technology Perimetry

Background As assessment of the peripapillary retinal nerve fiber layer (RNFL) has been an important approach for detecting structural damage in patients with glaucoma and myopia is a vital risk factor of primary open glaucoma,it is urgent to establish the correlation between RNFL thickness and myopia,not only for understanding the characteristics of RNFL with the change of the degree of myopia,but also for identifying those myopic patients with the early stage of glaucoma.Objective This study was to assess the influence of myopia for the thickness of RNFL measured by 3D optical coherence tomography (3D-OCT).Methods Two hundred and fifty-eight eyes of 258 myopic subjects from General Hospital of Ningxia Medical University were recruited.The myopic eyes were divided into low myopia group (42 eyes,-0.5 D ≤ SE ≤-3.0 D),middle myopia group (120 eyes,-3.0 D＜SE≤-6.0 D),high myopia group (58 eyes,-6.0 D＜SE≤-8.0 D) and extreme high myopia group (38 eyes,SE ＞-8.0 D).The peripapillary RNFL thickness profile including temporal,superior,nasal and inferior quadrants and each of the 12 clocks was measured by 3D-OCT.The measured values were compared among different degrees of myopia,and the correlations between spherical equivalent (SE) and axial length with RNFL thickness were analyzed using linear regression equation.Results The RNFL thickness was gradually declined with the increase of SE and elongation of axis,showing significant differences among the 4 groups in the superior,nasal and inferior quadrants and mean RNFL thickness (F=10.48,15.60,3.31,8.98,all at P＜0.05),but temporal RNFL thickness was increased with the SE rise,with markedly difference among the 4 groups (F =2.92,P =0.03) ; and RNFL thicknesses in the superior,nasal,inferior quadrants and mean RNFL thickness were evidently declined in the high and extreme high myopia group in comparison with low myopia group (all at P＜0.05).The overall RNFL parameters at 1:00,2:00,3:00,4:00,5:00,6:00,8:00,12:00 o'clock sectors were thinning as the increase of SE (all at P＜0.05) and unchanged at the 7:00,9:00,10:00,11:00 sectors in different SE groups (all at P＞ 0.05).Negative correlations were found between axial length or SE with the RNFL thicknesses at superior,nasal and inferior quadrants,average thickness as well as 1:00,2:00,3:00,4:00,5:00,6:00,11:00,12:00 o 'clock,and positive correlation was seen between the axial length or SE with the RNFL thicknesses at temporal quadrant.Conclusions The thickness of RNFL varys with the different degree of myopia and axial length. Key words: Optical coherence tomography; Myopia; Retinal nerve fiber

BackgroundThe aim of this study was to determine the interocular differences in the peripapillary retinal nerve fibre layer (RNFL), peripapillary choroidal thickness (PCT) and subfoveal choroidal thickness (SFCT) in healthy adults with isometropia, using enhanced depth imaging optical coherence tomography (EDI SD-OCT).MethodsOne hundred healthy Chinese adults with spherical equivalents of ≤ ±3 dioptres and interocular differences of <0.5 dioptres were prospectively enrolled in this study. They underwent RNFL and PCT measurements via EDI SD-OCT, with a 3.4 mm scan circle centred on the optic nerve head. Subfoveal choroidal thickness (SFCT) measurements were also taken with a horizontal line scan centred on the macula. Right and left eyes were compared by a paired t-test, and the interocular differences were calculated. The agreement and correlations of the RNFLs, PCTs and SFCTs between the right and left eyes were analysed.ResultsEighty-six subjects (172 eyes) were included in the final analysis, consisting of 44 (51.6 %) males and 42 (48.8 %) females; 55 (63.9 %) had emmetropia and 33 (36.1 %) had ametropia. The RNFL was statistically significantly thicker in the right eyes when compared to the left eyes in the temporal quadrant, and thinner on average in the nasal superior quadrant (p < 0.05). However, the differences in the choroidal thicknesses in all of the quadrants between the right and left eyes were not statistically significant. The tolerance limits of the average RNFL were −21.1 μm and 7.1 μm, and the mean and standard deviation of the interocular difference in the average PCT was −2.2 ± 24.2 μm. The RNFLs and PCTs in all of the locations in the right eyes were significantly correlated with those in the left eyes. However, no significant associations between the age, sex, interocular asymmetry of spherical the equivalent or interocular differences in the RNFL and PCT were detected.ConclusionThe PCT did not differ significantly between the right and left eyes, although interocular asymmetry of the RNFL existed in this Chinese population with isometropia.

Objective To investigate the peripapillary retinal nerve fiber layer (RNFL) thickness,changes in full-field flash electroretinogram (ERG) and their relationship in patients of without obvious diabetic retinopathy (non-diabetic retinopathy,the NDR),light and moderate non-proliferative diabetic retinopathy (NPDR).Methods In our hospital census type 2 diabetes and 128 cases (256eyes),according to the inspection results in accordance with the diabetic retinopathy international staging divided into the NDR group and light,moderate NPDR groups,select age-matched normal subjects 38 cases (76 eyes) as a control group,all subjects mydriasis large line of full-field ERG to determine retinal function using optical coherence tomography (OCT) peripapillary RNFL thickness scanning.Results Compared with the control group,in dark adaptation 3.0,DM groups oscillator potential reaction,b-wave amplitude of light and moderate NPDR group,a-wave amplitude of moderate NPDR group and the b-wave amplitude of moderate NPDR group in light adaptation decreased (P ＜0.05),The incubation period of light,dark adaptation 3.0 b-wave in each group and dark adaptation 3.0 a-wave in light and moderate NPDR group were delay (P ＜0.05); The RNFL thickness in the DM patients than in the normal control group were thinner,compared with the normal control group,the difference of superior in the NDR group,superior and inferior in light NPDR group,every quadrant and the mean RNFL thickncss around the optic disc in moderate NPDR group was statistically significant (P ＜0.05).Conclusions With the increase in the degree of retinopathy in patients with DM,impaired retinal function gradually worsen,the RNFL thickness around the optic disc gradually reduce,ERG and OCT combination of both,quantitative detection of changes in RNFL thickness and prognosis to determine retinal function to provide a reliable means of detection. Key words: Diabetes; Retinal nerve fiber layer thickness; Optical coherence tomography; Full-field flash ERG Figure

In various neurodegenerative diseases ocular manifestations are very common which can be examined and monitored in vivo by a novel imaging technique Optical Coherence Tomography (OCT). So this study was conducted to compare retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) between multiple sclerosis (MS) patients and healthy individual by optical coherence tomography (OCT). For this study 40 eyes of twenty consecutive MS patients and 40 eyes of 20 age matched healthy controls were taken. Comprehensive standardized ophthalmic examinations included visual acuity, cycloplegic refraction, color vision and intraocular pressure. Optical coherence tomography was performed using 3D Topcon OCT; RNFL thickness and ganglion cell complex (GCC) was detected with the inbuild software. Mean values for the thickness of the peripapillary RNFL and ganglion cell complex (GCC) were calculated and compared between both groups. It was observed that the RNFL thickness in each quadrant and ganglion cell complex (GCC) in MS patients were all significantly decreased in comparison to healthy controls. So it can be concluded that OCT is a valuable research instrument for evaluation and monitoring MS progression by measurement of the retinal nerve fiber layer (RNFL) as purely axonal structure (indicative for axonal loss) and the macular ganglion cell complex (evidence of neuronalloss).

PurposeThe majority of patients with autosomal dominant optic atrophy (DOA) harbour pathogenic OPA1 mutations. Although DOA is characterised by the preferential loss of retinal ganglion cells (RGC), about 20% of patients with OPA1 mutations will develop a more severe disease variant (DOA+), with additional neuromuscular features. In this prospective, observational case series, optical coherence tomography (OCT) was used to define the pattern of retinal nerve fibre layer (RNFL) loss in patients with both the pure and syndromal forms of DOA.MethodsForty patients with a molecular diagnosis of DOA due to OPA1 mutations were prospectively recruited from our neuro-ophthalmology clinic: 26 patients with isolated optic atrophy, and 14 patients manifesting DOA+ features. Peripapillary RNFL thickness was measured with the Fast RNFL (3.4) acquisition protocol on a Stratus OCT™.ResultsThere was a statistically significant reduction in average RNFL thickness in the OPA1 group compared with normal controls (P < 0.0001). The percentage decrease was greatest in the temporal quadrant (59.0%), followed by the inferior (49.6%), superior (41.8%), and nasal (25.9%) quadrants. Patients with DOA+ features had worse visual outcomes compared with patients with pure DOA, and except in the temporal quadrant, RNFL measurements were significantly thinner for the DOA+ group. There was an inverse correlation between average RNFL thickness and LogMAR visual acuity (P < 0.0001).ConclusionsRGC loss in DOA is characterised by severe involvement of the temporal papillomacular bundle, with relative sparing of the nasal fibres. RNFL thinning is more pronounced in patients with DOA+ phenotypes.

To evaluate macular thickness and peripapillary retinal nerve fibre (pRNFL) layer thickness in primary open angle glaucoma (POAG) patients using optical coherence tomography (OCT) in semi-urban population of eastern U.P. : Cross-sectional observational study carried out on 72eyes of 42 POAG patients and 72 eyes of 36 normal individuals above 40 years from January 2023 – August 2023 in eye OPD of Hind Institute of Medical Sciences, Barabanki. Best corrected visual acuity, anterior segment examination, Gonioscopy, tonometry, Central corneal thickness, perimetry, fundoscopy, peripapillary RNFL and macular thickness using OCT was done in all patients. POAG patients had significantly lower mean pRNFL quadrant measurements in superior, inferior and temporal quadrants when compared with controls. 83.68 ± 13.55 vs.140.01 ± 4.53; p=0.001 for superior quadrant; 76.33 ± 12.96 vs. 141.99 ± 4.51; p=0.001 for inferior quadrant; 52.31 ± 8.67 vs. 74.36 ± 3.56; p=0.001 for temporal quadrant. Mean pRNFL thickness in the nasal quadrant was not found significant in our study (55.53±7.08 vs. 80.85±5.24; p=0.295). Significant differences in thickness in foveal, inferior outer, temporal inner and nasal inner sector between POAG and control patients (p&amp;#60;0.05) were found. Superior, inferior and temporal pRNFL quadrants thickness and foveal, inferior outer, temporal inner and nasal inner macular thickness were found to be the best parameters to diagnose POAG at early stage.

Background: Glaucoma is a disease that belongs to a group of neurodegenerative diseases, such as impaired visual field and optic neuropathy with progressive damage to the optic nerve and retinal nerve fiber layer (RNFL) which is caused by the loss of ganglion cells and axon of the optic. Changes in the optic nerve and RNFL may occur prior to the abnormalities of the visual field nerves. Currently, the visual field examination should be performed to diagnose glaucoma but with patient-subjective result. Before it is detectable, visual field abnormalities are likely going to lose its ganglion cells by 40%. The purpose of this study was to assess and compare the peripapillary retinal nerve fiber layer (RNFL) between the normal and glaucoma eyes with vertical cup disc ratio (CDR) 0.4 to 0.7 in eye clinic Cipto Mangunkusumo Hospital (RSCM) Kirana. Methods: A total of 40 eyes of normal group and 34 eyes of glaucoma following Humphrey field analyzer examination and Optical Coherence Tomography (OCT) were evaluated. Peripapillary RNFL thickness between normal and glaucoma eyes were analyzed and compared each other. Eyes of glaucoma group then were grouped into early-stage glaucoma, according to the criteria in the initial stages of the examination results of Humphrey field analyzer. Result of peripapillary RNFL thickness was analyzed to get a cut off value. Results: Peripapillary RNFL thickness in the normal group with vertical CDR 0.4 to 0.7 was 111.3±9.8 μm to 118.0±3.0 μm, and glaucoma groups with vertical CDR 0.4 to 0.7 was 105.6±12.6 μm to 113.7±6.1 μm. Retinal nerve fiber layer thickness in normal group compared to glaucoma group in the superior quadrant, inferior, nasal, temporal and average on CDR 0.4 to 0.7 was not statistically significant (p&gt;0.05), except on vertical CDR 0.6 average peripapillary RNFL (p&lt;0.05). Cut off value of peripapillary RNFL in superior quadrant was 164 μm, inferior 169.5 μm, nasal 82.5 μm, temporal 73.5 μm and average 111.8 μm. Conclusion: There was no difference in changes of peripapillary RNFL along with the progression of vertical CDR but clinically, peripapillary RFNL thickness in glaucoma group is thinner than that of normal group with the same vertical CDR except in temporal quadrant. Keywords: Retinal nerve fiber layer (RNFL), cup disc ratio (CDR), optical coherence tomography (OCT)

Neuromyelitis optica spectrum disorders (NMOSD) are most often characterized by severe involvement of the optic nerves and/or spinal cord in a mono- or multiphasic manner and associated with anti-aquaporin 4 (AQP4) antibody (Ab) positivity. Optical coherence tomography (OCT) showed moderate to severe retinal axonal loss in neuromyelitis optica spectrum disorders (NMOSD) after optic neuritis (ON) episode. Peripapillary retinal nerve fiber layer (RNFL) and macular thinning seem more marked in NMOSD than in multiple sclerosis (MS) and sometimes (8.7–25.6 %) accompanied by a nonspecific macular change: microcystic macular edema (MME). NMOSD patients without ON might present subclinical retinal axonal loss, but it remains a matter of debate and seems clearly to occur in a lower intensity than in MS. The mechanism of this subclinical involvement remains unclear but could be due to anti-AQP4 antibodies and AQP4 expression on astrocytes inside the optic nerve and RNFL and on retinal Muller cells. OCT may help to differentiate NMOSD from MS by rigorous analysis of eyes with multiple sclerosis associated ON (MSON) and without MSON. In NMOSD, correlations between visual disability and OCT parameters are strong, whereas correlations between clinical disability and OCT parameters remain to be discussed. A few brain magnetic resonance imaging (MRI) studies coupled to OCT investigated optic ways imaging and found interesting correlation between retinal axonal loss and brain white and gray matter parameters. OCT is a wonderful tool enabling us to quantify retinal axonal loss in NMOSD. The main limitations of OCT studies in NMOSD are the small size of NMOSD cohort and sometimes a severe residual visual acuity enabling not to perform OCT.

Aims/Background Pediatric acquired demyelinating disorders (ADS) include various monophasic and recurrent inflammatory conditions of the central nervous system (CNS). Optic neuritis (ON) is a demyelinating disease primarily affecting the optic nerve axons due to autoimmune inflammation. To investigate the clinical characteristics, ophthalmic manifestations, laboratory test results, and prognostic indicators of Chinese children and adolescents with ADS. Methods The clinical data of 57 patients with ADS treated in the Beijing Children's Hospital from March 2021 to December 2023, were retrospectively collected and analyzed. The primary outcomes include best-corrected visual acuity (BCVA) at onset, peripapillary retinal nerve fiber layers (RNFL) thickness, serum myelin oligodendrocyte glycoprotein (MOG) antibody level, aquaporin-4 (AQP4) antibody level, and final BCVA after hormone therapy. Results The analyses included 57 children and adolescents in the study, including 38 optic neuritis (ON), 12 neuromyelitis optica spectrum disorder (NMOSD), 5 acute disseminated encephalomyelitis (ADEM), and 2 multiple sclerosis (MS) patients. The median age of patients facing the initial attack of ON was 9 years (3-15 years), with 23 children and adolescents (40.4%) aged eight years or younger, and 37 patients (64.9%) were bilaterally affected. Half of the children and adolescents (15/30) were MOG-Ab seropositive, and 19.4% (6/31) were AQP4-Ab seropositive. Children and adolescents with NMOSD were more likely to have severe visual impairment at acute onset (p < 0.05), with 84.2% of them having low vision acuity (BCVA worse than 0.1), as compared with 64.9% in the ON group. The RNFL thickness of affected eye was thinner than unaffected eyes (median 72.0 μm vs. median 102.0 μm, p < 0.05). Patients with NMOSD exhibited lower RNFL thickness across all measured sectors compared to those with ON. Significant differences were noted in the average RNFL and in each specific region of the retina, including the temporal RNFL, nasal RNFL, nasal superior RNFL, nasal inferior RNFL, temporal superior RNFL, and temporal inferior RNFL (all p < 0.05). After the treatment with intravenous methylprednisolone, both patients with ON (52 eyes; 86.7%) or NMOSD (20 eyes; 90.9%) group had functional visual recovery (BCVA better or equal 0.4). Conclusion This study shows that Chinese children and adolescents with ADS present distinctive clinical features, including earlier onset and more bilateral involvement. Furthermore, NMOSD patients experience more severe visual acuity impairment and thinner peripapillary RNFL. All children and adolescents of ON or NMOSD respond well to methylprednisolone treatment.

Background Both functional and morphological changes in amblyopic development are known to occur at various levels in the central visual pathway.However,whether the retina is involved or not during amblyopic progression remains controversial.Objective This study was designed to compare the thicknesses of the fovea and retinal nerve fiber layer (RNFL) of the normal fellow eye of amblyopic eye using optical coherence tomography (OCT) in children with myopic anisometropia.Methods Twenty-two patients with unilateral myopic anisometropic amblyopia were included as the anisometropia amblyopia group.Ten unilateral myopic anisometropic amblyopia subjects received treatment and recovered were used as the amblyopic cure group,and 11 individuals with simple myopic anisometropia without amblyopia were enrolled as the control group.OCT was performed on both eyes of all the subjects with informed consent.Fovea retinal thickness and RNFL thickness from the superior,inferior,nasal and temporal quadrants in the peripapillary region were evaluated.The measurement parameters were bilaterally compared in all the individuals by paired t test.The multiple regression model was used to analyze the correlation of retinal thickness with amblyopia patients.This study was approved by the Ethic Committee of this hospital.Written informed consent was obtain from each subject prior to the eye examination.Results Fovea retinal thickness increased in the amblyopic eyes compared with the fellow eyes,showing a statistically significant difference between them (P =0.001).However,no significant differences were found in the fovea retinal thickness between both eyes in the amblyopic cure group and simple myopic anisometropia without amblyopia group (P =0.778,0.943).Among the anisometropia amblyopia group,amblyopia cure group and simple myopic anisometropia without amblyopia group,the RNFL thicknesses of the temporal quadrant was significantly thicker in the higher myopic lateral eyes than those of the fellow eyes (P＜0.001,P =0.003,P =0.046).However,the differences in the superior,inferior,nasal and the average RNFL thickness were not statistically significant between the two eyes (P＞0.05).A negative correlation was found between the inferior retinal thickness with age (r=-0.559,P=0.016).Conclusions The fovea may be affected in unilateral myopic anisometropic amblyopia.There is no significant difference in the RNFL thickness between simple myopic eye and unilateral myopic anisometropia amblyopic eye.Improvement in amblyopia is coming along with the reduction of the thickness of the fovea. Key words: Refractive error/myopia; Anisometropia; Amblyopia; Optical coherence tomography; Foveal thickness; Retinal nerve fiber layer thickness

Objective To measure RNFL thickness by Frequency-domain optical coherence tomography (OCT) in patients with different stages of primary glaucoma (CACG and POAG),to evaluate the correlation between RNFL thickness and visual field mean defect (MD),to detect RNFL thickness change of early stage primary glaucoma,and to discuss the clinical significance in the early diagnosis of primary glaucoma objectively. Methods Ninety-two subjects of 40 normal and 52 with different stages of primary glaucoma were enrolled in this study.RNFL thickness was measured by Zeiss Cirru HD-OCT,and visual field was tested by Zeiss Humphrey-750.The association between visual field MD and RNFL thickness was evaluated with Pearson correlation coefficients. Results In the normal group,mean RNFL thickness was 112.91±9.36μm; the early period glaucoma group 94.43±7.67μm; the middle period glaucoma group 80.82±10.36μm; the later period glaucoma group 67.86±8.01μm.Visual field MD in each group was-0.88±1.53dB,-4.26±1.83dB,-7.43±2.64dB and -17.06±5.85dB.The differences in mean RNFL thickness and visual field MD between normal and each stage glaucoma group were significant (P ＜0.05) by independent sample t-test.In each stages of glaucoma group,mean RNFL thickness and visual field MD (early period:r =-0.537,middle period:r =-0.615,later period:r=-0.804) correlated significantly (P ＜0.05).In the early period glaucoma group,superior RNFL thickness was 116.32±11.65μm,inferior RNFL thickness 105.58±9.73μm,nasal RNFL thickness 75.40±10.91μm,and temporal RNFL thickness 70.28±13.08μm.In group B,superior RNFL thickness was 140.15±8.79μm,inferior RNFL thickness 137.29±10.07μm,nasal RNFL thickness 90.20±14.19μm,and temporal RNFL thickness 88.43±10.85μm.The difference of superior and inferior RNFL thickness between group A1 and group B had statistical significance tested by independent sample t-test,P ＜0.05; nasal and temporal RNFL thickness between group A1 and group B was tested by independent sample t-test,P ＞0.05,there was no statistical significance difference. Conclusions Frequency-domain OCT detected that the average of RNFL thickness become thinning with the progression of disease in the primary glaucoma patients,have negative correlation with vision MD,it is able to objectively reflect the degree of glaucomatous optic nerve damage.Frequency-domain OCT can show significantly decreased superior and inferior RNFL thickness of the early period primary glaucoma,which shows good ability in distinguishing normal from early period primary glaucomatous eyes. Key words: Optical coherence tomography (OCT); Retinal nerve fiber layer (RNFL); Mean defect (MD); Early diagnosis primary glaucoma

Purpose: To evaluate optic nerve head (ONH) parameters, peripapillary retinal nerve fiber layer (RNFL) thickness, and macular thickness by using Cirrus HD spectral-domain optical coherence tomography (OCT) in young patients with retinitis pigmentosa (RP).Methods: ONH parameters, RNFL thickness, and macular thickness were measured and compared between 36 eyes from 36 young RP patients (RP group; mean age, 23.08 years) and 70 eyes from 70 healthy young subjects (control group; mean age, 22.66 years) using Cirrus HD-OCT. The effects of the presence of optic disc pallor and the severity of visual field (VF) defects on OCT parameters were also evaluated.Results: The RP group had a greater rim area, smaller cup-to-disc ratio, smaller cup volume, thicker RNFL, and thinner macula than the control group (p ≤ 0.024). ONH parameters were not affected by the presence of optic disc pallor (p ≥ 0.239). Eyes with more severe VF defects (mean deviation ≤ −13.88 dB) had thinner average macular areas than eyes with less severe VF defects (mean deviation ≥ −13.88 dB; p = 0.002). Meanwhile, the ONH parameters and average peripapillary RNFL thickness were not significantly different between the two groups (p ≥ 0.275).Conclusions: Young eyes with RP exhibited different OCT parameters compared to healthy eyes. Among the various OCT parameters, only macular thickness was associated with disease severity. These findings should be considered when evaluating young RP patients.