scholarly journals Factors Associated with Changes in Peripapillary Retinal Nerve Fibre Layer Thickness in Healthy Myopic Eyes

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jianli Du ◽  
Yang Du ◽  
Yanyan Xue ◽  
He Wang ◽  
Yaping Li

Myopic people face an elevated risk of primary open angle glaucoma. Changes in the fundus in people with high myopia often lead to misdiagnosis of glaucoma, as this condition has many clinical signs in common with myopia, making the diagnosis of glaucoma more challenging. Compared to reduction of the visual field, a decrease in retinal nerve fibre layer (RNFL) thickness occurs earlier in glaucoma, which is widely considered useful for distinguishing between these conditions. With the development of optical coherence tomography (OCT), RNFL thickness can be measured with good reproducibility. According to previous studies, this variable is not only affected by axial length but also related to the patient’s age, gender, ethnicity, optic disc area, and retinal blood flow in myopia. Herein, we intend to summarize the factors relevant to the RNFL in myopia to reduce the false-positive rate of glaucoma diagnosis and facilitate early prevention of myopia.

2020 ◽  
pp. bjophthalmol-2020-316169
Author(s):  
Chung Young Kim ◽  
Eun Ji Lee ◽  
Ji-Ah Kim ◽  
Hyunjoong Kim ◽  
Tae-Woo Kim

Background/AimsTo investigate whether parapapillary choroidal microvasculature dropout (MvD) is associated with progressive retinal nerve fibre layer (RNFL) thinning in eyes with primary open-angle glaucoma (POAG) and disc haemorrhage (DH).MethodsParapapillary microvasculature was evaluated by swept-source optical coherence tomography (OCT) angiography (OCTA) in 50 eyes with POAG and DH, 1 year before, at the time of and 1 year after the detection of DH. MvD was defined as an area in the parapapillary deep layer of focal sectoral dropout with no visible microvascular network. Progressive changes in OCT RNFL thickness were compared in groups of eyes with and without MvD.ResultsCumulative prevalence of MvD was 76.0% (38 eyes) at 1 year after detection of DH. All MvDs were detected in the same sectoral locations as DH. In eyes with MvD, global RNFL thickness and sectoral RNFL thickness at the location of DH were significantly reduced, both from 1 year before to the time of DH detection (both p<0.001) and from DH detection to 1 year later (both p<0.001). In eyes without MvD, however, the reductions in global (p=0.011) and sectoral (p=0.007) RNFL thickness were significant only from DH detection to 1 year later.ConclusionIn eyes with POAG, RNFL thinning was spatially consistent and progressive at the location of MvD accompanied by subsequent DH and continued to progress after the occurrence of DH. When DH was not accompanied by MvD, progressive RNFL thinning was more likely to occur after the detection of DH.


2019 ◽  
Vol 104 (7) ◽  
pp. 974-979 ◽  
Author(s):  
Bingyao Tan ◽  
Jacqueline Chua ◽  
Thiyagrajan Harish ◽  
Amanda Lau ◽  
Alfred Tau Liang Gan ◽  
...  

Background/aimsTo assess the agreement in measuring retinal nerve fibre layer (RNFL) thickness between spectral-domain (SD; Cirrus HD, Carl Zeiss Meditec, USA) optical coherence tomography (OCT) and swept-source (SS; Plex Elite 9000, Carl Zeiss Meditec) OCT using an OCT angiography (OCTA) scanning protocol.Methods57 participants (12 glaucomatous, 8 ocular hypertensive and 74 normal eyes) were scanned with two OCT instruments by a single experienced operator on the same day. Circumpapillary RNFL thicknesses were automatically segmented for SD-OCT and manually segmented for SS-OCTA scans. Agreement of global RNFL thickness, as well as average thickness in four quadrants was assessed using intraclass correlation coefficients (ICCs).ResultsThere was excellent agreement in the inferior and superior quadrants and the global (all ICC >0.90), followed by good agreement in the temporal (ICC=0.79) and nasal (ICC=0.73) quadrants. The ICC values were similar in the subgroups except within the ocular hypertension group, where the nasal quadrant was less agreeable (ICC=0.31). SS-OCTA-derived RNFL thickness was on average 3 µm thicker than SD-OCT, particularly in the nasal (69.7±11.5 µm vs 66.3±9.3 µm; p<0.001) and temporal (75.6±13.7 µm vs 67.9±12.3 µm; p<0.001) quadrants.ConclusionsRNFL measurements taken with SS-OCTA have good-to-excellent agreement with SD-OCT, which suggests that the RNFL thickness can be sufficiently extracted from wide-field OCTA scans.


2020 ◽  
Vol 104 (10) ◽  
pp. 1448-1452 ◽  
Author(s):  
Sungsoon Hwang ◽  
Mingui Kong ◽  
Hyeonyoung Ko ◽  
Don-Il Ham ◽  
Yun-Mi Song

Background/aimCharacterising genetic effect on macular retinal nerve fibre layer (RNFL) is needed to obtain better understanding of various retinopathies and optic neuropathies. The purpose of this study was to evaluate genetic influence on macular RNFL thickness.MethodsThis is a cross-sectional, twin and family study. Three hundred and sixty-two Korean adults with healthy eyes were included in the study from 79 households with two or more family members. Macular RNFL thickness was measured with optical coherence tomography at nine macular subfields defined by the ETDRS. Intraclass correlation coefficients (ICCs) were estimated to assess intrafamilial resemblance of RNFL thickness by different types of family relationship. Heritability of RNFL thickness was evaluated using variance decomposition model.ResultsRNFL thickness increased from central subfield to outer subfields. Temporal quadrant RNFL was thinner compared with other quadrants. Monozygotic twin pairs showed the highest ICCs of RNFL thickness, although the ICC level varied across different subfields. Heritability of RNFL thickness was the highest at central subfield (0.81). RNFL thicknesses of outer subfields were moderately to highly heritable: 0.53, 0.71, 0.47 and 0.66 for superior, inferior, temporal and nasal fields, respectively. RNFL thicknesses at inner subfields showed the lowest heritability: 0.21, 0.24, 0.27 and 0.27 for superior, inferior, temporal and nasal subfields, respectively.ConclusionMacular RNFL thickness is significantly influenced by genetic factors. It varies largely by subfields with the highest heritability at the central subfield and a relatively lower heritability at inner subfields.


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
Alshaimaa M Lotfy ◽  
A H Saad ◽  
T H Mohamed ◽  
Y A Elzankalony

Abstract Background Diabetes mellitus is a metabolic disorder characterized by chronic hyperglyaemia. Diabetes cause many complication. diabetic retinopathy is common complication which affects up to 80 percent of all patients who have diabetes for more than10 years or more. Retinal functional abnormalities as reduced contrast sensitivity and ERG abnormalities could be detected in diabetic patients before microvascular lesions can be detected in ophalmological examination. Purpose to determine correlation between retinal nerve fibre layer thickness measured by Optical coherence tomography and glycosylated haemoglobin in type 2 non proliferative diabetic retinopathy. Patients and Methods In our study was conducted on patient recruited from National institute of Diabetes and endocrinology in the ophthalmic clinic. Patients were evaluated for peri-papillary retinal nerve fibre layer ( RNFL) thickness by optical coherence tomography (RS 3000 advance). Blood were taken for HbA1c. The study was included 164 eyes from 87 patients. The patients were non proliferative diabetic retinopathy(NPDR) classified into three groups according to Early Treatment Diabetic Retinopathy Study into; Mild group was 69 eyes from 35 patients, moderate group58 eyes from 31 patient, Severe group 37 eyes from 21 patients. Results The severe group show statistically significant difference with the others (P &lt; 0.001) except with mild group in nasal and inferior quadrant, therefore the thickness was high in the severe groups because the edema in RNFL. In our study we observed decrease in total thickness of RNFL in peripapillary area. However, among each quadrant we observed that the superior quadrant was thinner compared to other quadrants (p &lt; 0.001). There was insignificant correlation between RNFL thickness with the Glycosylated haemoglobin ( HbA1c )in all NPDR groups. Conclusion Early NPDR patients appear to have thinner RNFL thickness and severe NPDR patients show increasing RNFL thickness. There are not correlation between RNFL thickness and glycosylated haemoglobin.


2012 ◽  
Vol 06 (05) ◽  
pp. 280
Author(s):  
Ahmad A Aref ◽  
Donald L Budenz ◽  
◽  

Clinical discrimination between myopic tilted optic discs and glaucomatous optic neuropathy is often challenging, especially when considering that myopia is a risk factor for the development of glaucoma. Myopic tilted discs are usually larger than average, with associated relative cupping and thinner neuroretinal rim tissue. Histopathological study has revealed thinner parapapillary retinal tissue in these eyes. Optical coherence tomography (OCT)-measured average retinal nerve fibre layer (RNFL) thickness has been found to decrease with longer axial length and higher myopic refractive error. Parapapillary RNFL quadrant and clock-hour analyses result in a higher false-positive rate in myopic eyes. Careful slit-lamp examination, quality baseline stereoscopic disc photographs and frequent serial visual field testing are essential to the follow-up of myopic individuals with suspected glaucoma. A novel diagnostic parameter, OCT-derived ganglion cell analysis, may prove to be useful in the diagnosis and follow-up of these individuals.


2021 ◽  
Author(s):  
Παναγιώτης Γιαννακούρας

Σκοπός: H Κυστική Ίνωση αποτελεί την πιο κοινή γενετική διαταραχή στην Καυκάσια φυλή που κληρονομείται με υπολειπόμενο χαρακτήρα και μπορεί να οδηγήσει τελικά στο θάνατο. Προσβάλλει κυρίως τους πνεύμονες. Ο σκοπός της εργασίας αυτής ήταν να μελετηθεί η προσβολή του οφθαλμού σε ασθενείς με Κυστική Ίνωση στον ελληνικό πληθυσμό.Μέθοδος: Πενήντα ενήλικοι ασθενείς με Κυστική Ίνωση και 60 υγιείς εθελοντές αντίστοιχης ηλικίας και φύλου, συμπεριλήφθηκαν στη μελέτη και υποβλήθηκαν σε πλήρη οφθαλμολογικό έλεγχο που περιελάμβανε την αξιολόγηση του χρόνου διάσπασης της δακρυϊκής στιβάδας, τη μέτρηση του πάχους της ωχράς κηλίδας και της στιβάδας των νευρικών ινών του αμφιβληστροειδούς (Macular Thickness and Retinal Nerve Fibre Layer-RNFL-thickness) με τη χρήση Spectral Domain-OCT.Αποτελέσματα: Οι ασθενείς με Κυστική Ίνωση παρουσίασαν στατιστικά μικρότερο πάχος των νευρικών ινών του αμφιβληστροειδούς γύρω από την περιθηλαία περιοχή (median 82 IQR 67-102 vs 92.5 IQR 82-107, p=0.005) και μικρότερο ποσοστό φυσιολογικού χρόνου διάσπασης χρωστικής της δακρυϊκής στιβάδας (56.0% vs 96.7%,p=0.001) σε σχέση με την ομάδα εθελοντών. Όλοι οι ασθενείς με Κυστική Ίνωση με χρόνο διάσπασης χρωστικής μικρότερο από 10 δευτερόλεπτα διεγνώσθησαν με βλεφαρίτιδα κατά τη διάρκεια της οφθαλμολογικής εξέτασης. Η ομάδα των ασθενών που ήταν ομόζυγοι για την πιο γνωστή μετάλλαξη της Κυστικής Ίνωσης, F508del, παρουσίασαν χαμηλότερο πάχος της στιβάδας των νευρικών ινών του αμφιβληστροειδούς γύρω από την περιθηλαία περιοχή, pRNFL thickness (p=0.014) και χαμηλότερο ποσοστό φυσιολογικού χρόνου διάσπασης της χρωστικής στη δακρυϊκή στιβάδα, normal tear Break-Up Time (p=0.001). Επιπλέον ευρήματα, παρόντα μόνο στην ομάδα των ασθενών της Κυστικής Ίνωσης ήταν στικτές αμφιβληστροειδικές αιμορραγίες (4 ασθενείς), ελίκωση των αγγείων (4 ασθενείς), αμφιβήστροειδικές αλλοιώσεις δίκην κοχλίου ή θυσάνου (2 ασθενείς χωρίς διαθλαστικές διαταραχές). Δεν εντοπίστηκαν σημαντικές διαφορές στην αξιολόγηση της οπτικής οξύτητας, στις διαθλαστικές μετρήσεις, στα γωνιοσκοπικά ευρήματα ή στη μέτρηση της ενδοφθάλμιας πίεσης μεταξύ των 2 ομάδων.Συμπεράσματα: Η εργασία αυτή, απ’όσο είμαστε σε θέση να γνωρίζουμε, αποτελεί τη μεγαλύτερη οφθαλμολογική μελέτη ασθενών με Κυστική Ίνωση. Βρέθηκε ότι οι ασθενείς με ΚΙ εμφάνισαν στατιστικά σημαντικά μικρότερο πάχος της στιβάδας των νευρικών ινών του αμφιβληστροειδούς γύρω από την περιθηλαία περιοχή και μικρότερο ποσοστό φυσιολογικών τιμών χρόνου διάσπασης χρωστικής της δακρυϊκής στιβάδας σε σχέση με την ομάδα που αποτέλεσε τους εθελοντές. Υπογραμμίζουμε τη σημασία της προσεκτικής τακτικής οφθαλμολογικής εξέτασης και παρακολούθησης αυτών των ασθενών.


2020 ◽  
pp. bjophthalmol-2020-315985 ◽  
Author(s):  
Damon Wong ◽  
Jacqueline Chua ◽  
Mani Baskaran ◽  
Bingyao Tan ◽  
Xinwen Yao ◽  
...  

Background/aimsTo identify factors that influence the diagnostic performance of circumpapillary retinal nerve fibre layer (RNFL) thickness measurements in the detection of primary open-angle glaucoma (POAG).Methods1592 eyes from 1076 healthy controls and 758 eyes from 502 patients with POAG underwent optical coherence tomography (OCT) imaging to assess RNFL parameters. Visual field (VF) mean deviation (MD) from standard automated perimetry was used to indicate severity in subjects with glaucoma.ResultsRNFL thickness significantly decreased with age (ρ=−0.10 to −0.16, p<0.001) and increased with spherical equivalent (SE) refractive error (ρ=0.23–0.29, p<0.001) in healthy and glaucoma groups but showed a significant reduction with SE (ρ=−0.20, p<0.001) in the temporal RNFL of healthy subjects. RNFL measurements significantly decreased with VF MD (ρ=0.08–0.53, p<0.05) in subjects with POAG. When healthy subjects and subjects with glaucoma were matched to subgroups within a factor, significant differences in area under the curve (AUC) between subgroups were only found with SE AUCs increased significantly with disease severity, particularly in the global, inferior and superior measurements (p<0.001). Overall, the diagnostic performance of the inferior and global RNFL measurements were found to be more resilient to different factors.ConclusionDiagnostic accuracy in glaucoma was influenced by SE but could be mitigated by using controls with similar refractive characteristics. Increasing disease severity led to significantly better diagnostic accuracy. These factors should be considered when using OCT for glaucoma diagnosis in practice.


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