A cross-sectional study analyzing the correlation between the mean retinal nerve fiber layer and ganglion cell layer thickness with axial length and refractive errors among children aged 5–15 years

Purpose: To analyze the correlation between the mean retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness with axial length and refractive errors among children aged 5–15 years. Methods: This cross?sectional, observational study was done on 130 eyes of 65 consecutive subjects with refractive errors. The patients were evaluated for RNFL thickness and macular GCL thickness using spectral domain? optical coherence tomography. Results: One hundred and thirty eyes of 65 subjects aged between 5 and 15 years were divided into three groups based on their spherical equivalent in diopters (D). The children with a spherical equivalent of ??0.50 D were considered myopic, ??0.5 to ?+0.5 D were considered emmetropic, and ?+0.50 D were considered hypermetropic. RNFL thickness and GCL thickness were correlated with age, gender, spherical equivalent, and axial length. The mean global RNFL thickness was 104.58 ?m ± 7.567. Conclusion: There exists a negative correlation between RNFL thickness and macular GCL thickness with increasing severity of myopia and increase in axial length, and the possible reason could be stretching of the sclera, which further leads to stretching of the retina, resulting in thinner RNFL and macular GCL thickness

Alterations of macular ganglion cell layer thickness and optic disc parameters in patients with early diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the changes of optic disc parameters, peripapillary retinal nerve fibers layer(pRNFL)thickness and macular ganglion cell layer(mGCL)thickness among patients with early diabetes retinopathy and healthy controls by Cirrus HD-optical coherence tomography(OCT).METHODS: In this cross-sectional comparative study, 45 non-diabetic retinopathy(NDR), 52 mild nonproliferative diabetic retinopathy(NPDR), 55 moderate NPDR with type 2 diabetes mellitus(T2DM)and 64 age-matched healthy controls were included. The fasting blood glucose(FBG), duration of diabetes, glycosylated hemoglobin(HbA1c)and past history of the patients were collected in detail. Optic disc parameters(i.e., binocular RNFL thickness symmetry percentage, rim area, optic disc area, cup-to-disc ratio, cup volume), pRNFL thickness and mGCL thickness were measured by Cirrus HD-OCT. The comparison of different groups was performed by one-way analysis of variance.RESULTS: Compared with the control group, the binocular RNFL thickness symmetry percentage and rim area were significantly decreased, while the average C/D and vertical C/D were significantly increased in the NDR group, mild NPDR group and moderate NPDR group(all P<0.05). Compared with the control group, the peripapillary RNFL thicknesses(superior, temporal, inferior, nasal)and macular GCL thickness(average, minimum, superior, supero-temporal, infero-temporal, inferior, supero-nasal, and infero-nasal)became thinner in the NDR group, mild NPDR group, and moderate NPDR group(all P<0.05).CONCLUSION: Patients with early DR have significantly decreased binocular RNFL thickness asymmetry, rim area, pRNFL and mGCL thickness, while they have significantly increased cup-to-disc ratio when compared to healthy controls. The results support the statement that DM causes inner retinal neurodegenerative changes even in T2DM patients without overt microangiopathy.

Assessment of retinal manifestations of Parkinson’s disease using spectral domain optical coherence tomography: A study in Indian eyes

Purpose: To assess the retinal manifestations of Parkinson’s disease using optical coherence tomography. Methods: A prospective case?control study comparing 30 eyes from 15 patients with Parkinson’s disease and 22 eyes from 11 healthy age?matched controls. Total macular subfield thickness and the thickness of the ganglion cell layer, nerve fiber layer, and peripapillary retinal nerve fiber layer were measured with spectral?domain optical coherence tomography (SD?OCT). Results: The mean age of PD patients was 68.4 years ± 10.64 (range: 46–82) and in the control group was 66.36 ± 5.22 (range: 64–68). The average disease duration in patients with PD was 6.7 ± 2.8 years (range: 2–10 years). The mean best?corrected visual acuity in PD was 20/26 and 20/20 in controls, with P = 0.0059, which was significant. Significant difference was also found in the contrast sensitivity between both groups. Structural differences in the central macular thickness (P = 0.0001), subfield thicknesses in the superior (P = 0.003), inferior (P = 0.001), nasal (P = 0.004), and temporal subfields (P = 0.017) was seen. Severe thinning of the ganglion cell layer was seen in PD patients (P = 0.000) as well as of the nerve fiber layer (P = 0.004). Peripapillary retinal nerve fiber thickness measured showed significant thinning in superotemporal (P = 0.000), superonasal (P = 0.04), inferonasal (P = 0.000), inferotemporal (P = 0.000), nasal (P = 0.000), and temporal quadrants (P = 0.000). Conclusion: Visual dysfunction was observed in patients with PD along with structural alterations on OCT, which included macular volumes, ganglion cell layer, and peripapillary retinal nerve fiber layer.

Evaluation of retinal nerve fiber layer, ganglion cell layer, and optic nerve head morphological parameters in patients with obstructive sleep apnea and comparison with normal population

Purpose: To compare the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and optic nerve head (ONH) morphological parameters between obstructive sleep apnea (OSA) patients and age?matched controls using spectral domain optical coherence tomography (SD?OCT). Methods: This case control study was conducted in a multi?specialty tertiary care hospital from 2014 to 2016. Patients diagnosed to have OSA by overnight polysomnography were included in the study. Fifty eyes of 25 OSA patients with clinically normal optic disc were compared with 50 eyes of age?matched controls. The study population underwent detailed ophthalmological evaluation including SD?OCT. Results: There was significant thinning of the superior, inferior, and average RNFL in the OSA group when compared to controls. GCL analysis also showed a significant thinning of the six sectors as well as average and minimum ganglion cell layer + inner plexiform layer in OSA patients. The optic nerve head rim area was significantly decreased in OSA patients when compared to controls. Conclusion: OSA patients even with clinically normal optic disc showed significant decrease in the RNFL thickness, GCL thickness, and rim area when compared to age?matched controls. Hence, these patients constitute a high?risk population who need to be regularly screened and followed up for ocular co?morbidities

Assessment of intraocular pressure, macular thickness, retinal nerve fiber layer, and ganglion cell layer thicknesses: ocular parameters and optical coherence tomography findings in attention-deficit/hyperactivity disorder

Objective: To compare intraocular pressure (IOP) and macular, retinal nerve fiber layer (RNFL), and ganglion cell layer (GCL) thicknesses in treatment-naive children with attention-deficit/hyperactivity disorder (ADHD), children with ADHD on regular methylphenidate (MPH) treatment for at least 3 months, and healthy controls. Methods: A total of 58 treatment-naive children with ADHD, 45 children with ADHD on regular MPH treatment, and 44 healthy controls were enrolled in this study. All participants underwent a comprehensive eye examination. Optical coherence tomography (OCT) was used to assess global RNFL thickness, central macular thickness, and GCL thickness in both eyes. Results: Separate univariate analysis of covariance (ANCOVA) on the outcome variables revealed a significant difference among the research groups with respect to IOP in the left eye. Post-hoc univariate analyses indicated that left IOP was significantly higher in children with ADHD under MPH treatment than among healthy controls. However, global RNFL thickness, central macular thickness, and GCL thickness of both eyes, as well as IOP in the right eye, were not significantly different across groups. Conclusion: Further longitudinal follow-up studies are needed to determine whether MPH treatment has any effect on IOP or OCT findings.

A study of retinal neurodegeneration using optical coherence tomography in type 2 diabetes mellitus patients without retinopathy: A cross-sectional study

Background: Neurodegeneration of retina (retinal diabetic neuropathy) is the earlier sign of diabetes mellitus before the appearance of any vascular sign of diabetic retinopathy. Hence, through neurodegenerative changes, we can diagnose and monitor the early neuronal damage of the retina. Objectives: The objective of the study were to establish whether the retinal neurodegeneration is earlier than vasculopathic changes in patients with diabetes and their relationship with the duration of diabetes. Materials and Methods: A total of 180 diabetic patients and 164 healthy controls were collected from a rural-based tertiary care hospital in West Bengal for this cross-sectional study. All have gone through proper history taking, comprehensive ocular examinations and spectral-domain optical coherence tomography imaging to detect the thickness of retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL). Results: Our study showed that the RNFL thickness of the right and left eyes for the cases was 37.62 μm and 37.68 μm, respectively, and that for controls were 39.68 μm and 39.70 μm, respectively. The GCL thickness of the right and left eyes was 32.63 μm and 32.43 μm, respectively, in cases and that for controls were 33.73 μm and 33.87 μm, respectively. In respect of the duration of diabetes, mean RNFL thickness of the right and left eyes for <1 year, 1–2 years, and >2 years was 40.20 μm and 40.03 μm; 38.17 μm and 38.31 μm; and 35.48 μm and 35.69 μm, respectively. Mean GCL thickness of the right and left eyes for <1 year, 1–2 years, and >2 years was 34.25 μm and 33.72 μm; 31.98 μm and 31.44 μm; and 30.82 μm and 31.35 μm, respectively. The data were analyzed by appropriate statistical methods. Conclusion: This study showed that thinning of RNFL and GCL occurred in diabetes before the appearance of microaneurysm.

Parameters of optic disc and macular in primary open-angle glaucoma measured by spectral domain optical coherence tomography and its influencing factors / 第二军医大学学报

Objective: To measure the parameters of optic disc and macula by spectral domain-optical coherence tomography (SD-OCT) in healthy controls and patients with mild or moderate primary open-angle glaucoma (POAG), and to analyze the related influencing factors. Methods: Forty patients (40 eyes) with mild or moderate POAG who were admitted to our department from Sep. 2015 to Aug. 2018 were enrolled, including 20 patients aged 20-39 years old and 20 patients aged 60-79 years old. Contemporaneous 40 healthy controls (40 eyes) were also included (20 aged 20-39 years old and 20 aged 60-79 years old). All subjects received comprehensive ophthalmic examination. SD-OCT was used to measure the thickness of peripapillary retinal nerve fiber layer (pRNFL), the thickness of macular average ganglion cell layer combined with the inner plexiform layer (GCL-IPL), the macular minimum GCL-IPL thickness, and the average thickness of the macular cube. Results: The average and minimum GCL-IPL thickness decreased significantly with age in both healthy control and POAG groups (P0.05). The mean, superior, inferior and temporal thicknesses of pRNFL in the POAG group (both 20-39 years old and 60-79 years old subgroups) were significantly thinner than those in the healthy control group (P0.05). And no significant difference was found in the nasal thickness of pRNFL between POAG group and healthy control group of the same age (P>0.05). Conclusion: The pRNFL thickness measured by SD-OCT is related to POAG, and it can be used as a detection index for early diagnosis of POAG.

Retinal Ganglion Cell Layer Thicknesses and Visual Functions in Patients with Bilateral Temporal Optic Atrophy

PURPOSE: To investigate correlations between macular retinal ganglion cell (RGC) layer thickness and best-corrected visual acuity (BCVA) and visual field parameters in patients with bilateral temporal optic atrophy.METHODS: Thirty eyes of 15 patients with bilateral temporal optic atrophy and 30 eyes of 15 normal subjects that were age- and sex-matched were included in the study. We measured the thicknesses of the RGC layers of posterior poles using optical coherence tomography volume scanning. The RGC layer was divided into nine zones based on the Early Treatment of Diabetic Retinopathy Study baseline. Possible correlations of the RGC layer with the BCVA and visual field parameters were determined.RESULTS: The RGC layer thickness was significantly thinner in all patients compared to those in the control group (p = 0.001). The RGC layer thicknesses in the inner superior, inner temporal, inner inferior, and inner nasal areas were significantly correlated with the BCVA (r = −0.650, r = −0.626, r = −0.616, and r = −0.636, respectively; p = 0.000). The RGC layer thicknesses in the outer superior, outer temporal, outer inferior, and outer nasal areas were significantly correlated with the mean deviation of the visual field test (r = 0.470, r = 0.349, r = 0.496, and r = 0.469, respectively; p < 0.05).CONCLUSIONS: In patients with bilateral temporal optic atrophy, the RGC layer thickness in the medial region was correlated with the BCVA, and the RGC layer thickness in the lateral region was correlated with the mean deviation of the visual field test.

Structural evaluation of preperimetric and perimetric glaucoma

Purpose: To evaluate diagnostic ability of macular ganglion cell layer–inner plexiform layer (GCL-IPL) for detection of preperimetric glaucoma (PPG) and perimetric glaucoma and comparison with peripapillary RNFL. Methods: Three hundred and thirty seven eyes of 190 patients were enrolled (127 normals, 70 PPG, 140 perimetric glaucoma). Each patient underwent detailed ocular evaluation, standard automated perimetry, and spectral domain optical coherence tomography. Diagnostic abilities of GCL-IPL and RNFL parameters were determined. Data were compared using one-way analysis of variance, Pearson's Chi-square test, and area under the curve (AUC). Results: After adjusting for age, gender, and signal strength, all GCL-IPL and RNFL parameters except mean thickness and disc area differed significantly. Among GCL-IPL thicknesses, inferotemporal had the highest AUC (0.865) for classifying perimetric glaucoma from normals, inferior (0.746) for PPG from normals, and inferotemporal (0.750) for perimetric glaucoma from PPG. When using RNFL, inferior thickness had the highest AUC (0.922) in discriminating POAG from normal, while the same parameter had lower AUC (0.813) in discriminating PPG from normal. The average thickness had maximum AUC (0.775) for discriminating POAG from PPG. For discriminating perimetric glaucoma and normals, inferotemporal GCL-IPL had the highest strength (sensitivity 81.43% and specificity 77.96%), slightly lower than inferior RNFL thickness (sensitivity 87.85% and specificity 84.26%). The same parameters were sensitive in discriminating perimetric glaucoma from PPG (87.14% and 92.85%, respectively). However, their specificities were poor (56.43% both). Conclusion: RNFL had better diagnostic ability, when compared with GCL-IPL for detecting PPG and perimetric glaucoma. However, difference was small and may not be clinically relevant.

Structural evaluation of perimetrically normal and affected hemifields in open angle glaucoma

Purpose: To study macular ganglion cell layer--inner plexiform layer complex (GCL + IPL) in relation to peripapillary retinal nerve fiber layer (RNFL) in glaucomatous eyes with superior or inferior hemifield defects (HD) and to study structural configuration in normal hemifield. Methods: This was an observational cross-sectional study. Data from consecutive 45 superior HD (SHD) and 50 inferior HD (IHD) eyes were analyzed. Each patient underwent detailed ocular examination, standard automated perimetry, and spectral domain optical coherence tomography (SD-OCT). After adjusting for age, gender, and signal strength, area under receiver operating characteristic curve (AUC) was calculated to determine diagnostic ability of GCL + IPL and peripapillary RNFL. Apparently normal hemifield was compared with true normal hemifield. Data were analyzed with SPSS, analysis of variance, t-test, Chi-square test, and receiver operating curve. Results: In the SHD glaucoma group, best parameters for discriminating normal eyes from glaucomatous eyes were inferotemporal GCL + IPL thickness (0.935) and inferior quadrant RNFL thickness (0.971). For IHD glaucoma, average GCL + IPL thickness (0.877) and average RNFL thickness (0.950) had best AUC values. When evaluating apparently normal hemifield in both groups, statistically significant difference was found in inferior GCL + IPL sector (0.865) and inferior quadrant RNFL (0.883) in IHD and superonasal GCL + IPL (0.725) and superior quadrant RNFL (0.842) in SHD groups. Conclusion: SD-OCT may be a useful ancillary diagnostic tool for evaluation of early macular and circumpapillary structural changes in glaucomatous eyes with localized visual field defects. Apparently normal hemifields show structural damage and should be considered in management of glaucoma.

Optical coherence tomography findings in bipolar disorder: a preliminary receiver operating characteristic analysis on ganglion cell layer volume for diagnosis

Abstract Background Optical coherence tomography (OCT) has been recently used to investigate neuropsychiatric disorders. Objective The aim of this study was to compare the retinal nerve fiber layer thickness (RNFLT) and the ganglion cell layer (GCL) volume in patients with type 1 bipolar disorder (BPD1, diagnosed according to DSM 5) to the values in healthy controls. Methods Eighty consecutive outpatients with a diagnosis of euthymic BPD1 and 80 healthy controls were enrolled in the study. Following assessment with the Sociodemographic Data Form, Structured Clinical Interview for DSM-IV (SCID-I), Hamilton Depression Scale and Young Mania Evaluation Scale, both groups underwent Optical coherence tomography (OCT). Results The mean RNFL thickness and mean GCL volume were significantly lower in the BPD1 group than in the controls (p < 0.05). The GCL global value had a significant and independent effect in distinguishing the BPD1 patients from the controls. A cut-off value of 101 mm3 for global GCL volume was proposed to distinguish BPD1 patients from controls with a sensitivity of 87.5%. Discussion Lower values of GCL volume and RNFLT in patients suffering from BPD1 suggest that neurodegeneration may occur during the course of BPD and that this degeneration can be characterized in particular by a thinning of the GCL volume.

Optical coherence tomography findings in conversion disorder: are there any differences in the etiopathogenesis of subtypes?

Abstract Background: Optical coherence tomography is a contactless and fast neuroimaging method. Previous Studies have observed thinning of the ganglion cell layer and inner plexiform layer in many neurodegenerative diseases. Objective: The aim of this study was to compare the layers of ganglion cell complex in conversion disorder. Methods: This study involved 50 conversion disorder patients and 50 healthy volunteers as the control. The parameters were measured and recorded automatically by a spectral optical coherence tomography device. Results: There was no difference in the retinal nerve fiber layers between the conversion disorder group and the control group (p > 0.05). The left and right choroid layer thickness acquired from three regions of the choroid layer was higher in patients compared with controls (p < 0.05). The ganglion cell layer and inner plexiform layer volumes were also significantly lower in the patient group (p < 0.05). Discussion: These ganglion cell layer and inner plexiform layer findings suggest that neurodegeneration occurs during the course of conversion disorder especially in subtype involved motor component. The choroid seems to be more related to the sensory component and it may be used to determine the active stage of the disease and to monitor inflammatory process like other inflammation markers used in systemic inflammatory diseases.

Baseline morphological characteristics as predictors of final visual acuity in patients with branch retinal vein occlusions: MARVEL report no. 3

Purpose: To determine the predictive values of baseline optical coherence tomography (OCT) abnormalities on 12-month visual acuity changes in eyes with macular edema (ME) caused by branch retinal vein occlusions (BRVO). Methods: We performed a post hoc analysis of data from 75 participants in the 12-month MARVEL trial. OCT abnormalities at baseline, including ganglion cell layer cystoid spaces (GCL), intraretinal hyper-reflective dots, and central subfield thickness (CST), were correlated with improvements in visual acuity and the number of anti-vascular endothelial growth factor injections required using a multivariate regression model. Results: Eyes with baseline CST > 500 ?m had greater visual gains compared to those with CST <500 ?m (+21.09 vs +16.08 letters, P = 0.04). Eyes with hyper-reflective dots (+13.97 vs +19.93 letters, P = 0.02), and GCL cysts (+9.8 vs +18.9, P = 0.003) had inferior gains in visual acuity. Neurosensory macular detachments at the baseline did not affect gains in visual acuity. Ninety percent of the gain in visual acuity was recorded after two injections and was maintained until month 12. Conclusion: Baseline OCT of <500 ?m, hyper-reflective dots, and GCL cystoid spaces are associated with poorer gains in visual acuity. Most of the visual gain occurs after two injections.

Retinal nerve fiber layer and ganglion cell layer changes on optical coherence tomography in early multiple sclerosis and optic neuritis cases

Purpose: To study the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) changes on optical coherence tomography in early multiple sclerosis (MS) patients. Methods: A prospective cohort study was conducted at a tertiary care center. Patients of early MS (expanded disability status scale <3) with or without optic neuritis (ON) and idiopathic ON were included. Twenty age-matched individuals were taken as controls. Changes in RNFL and GCL thickness were evaluated along with the correlation with visual function parameters such as visual acuity, contrast sensitivity, and visual evoked response at first visit and again at six months. Results: Forty-four patients of MS with or without ON (24 and 20 patients respectively), 29 patients with idiopathic ON, and 20 healthy controls constituted the cohorts. Mean LogMAR best-corrected visual acuity was found to be significantly reduced in all groups except fellow eyes (FE) of ON group. Mean values of average RNFL thickness and values in superior, temporal, and inferior quadrant were significantly reduced. Similarly, overall mean values of average GCL-inner plexiform layer (IPL) thickness and values in superior, superonasal, superotemporal, inferonasal, and inferotemporal quadrant were significantly reduced in all groups except FE of ON group (P < 0.05). All the visual parameters significantly correlated with GCL + IPL thickness. Conclusion: GCL + IPL thickness is a more sensitive clinical structural marker than RNFL in early MS with/without ON and ON patients and correlates with all the visual parameters better than RNFL thickness.

Correlation between serum homocysteine level and retinal ganglion cell layer thickness in diabetic patients / 眼科新进展

Objective To explore the correlation between the level of serum homocysteine (Hcy) and the thickness of retinal ganglion cell layer (GCL) on optical coherence tomography (OCT) in patients with type 2 diabetes.Methods Totally 60 diabetic patients were collected from October 2016 to October 2017 in the Shengjing Hospital of China Medical University,and they were divided into two groups:diabetic patients without retinopathy (NDR group,n =30) and non-proliferative diabetic retinopathy group (NPDR group,n =30) according to the ETDRS classification,and meanwhile additional 30 healthy subjects were enrolled as control group.The level of serum Hcy was detected,and the retinal GCL thickness was measure using OCT in all patients for the analysis of the correlation of serum Hcy level with the thickness of GCL.Results The serum Hcy level was (11.87 ± 2.19) nmol · L-1 in the control group,(14.87 ± 0.42)nmol · L-1 in the NDR group and (20.77 ± 2.40) nmol · L-1 in the NPDR group,which was significantly increased gradually,and the difference was statistically significant (P =0.000),but the thickness of GCL was (88.33 ± 6.36) μm,(81.73 ± 1.41) μm and (64.00 ± 12.73) μm in the three groups,accordingly,which was decreased significantly gradually,with statistically significant difference (P =0.000).Along with the progress of fundus lesions,the level of serum Hcy increased,but the thickness of GCL decreased,and there was a significant negative correlation of the serum Hcy level with the thickness of GCL in the retina by Pearson (r =-0.908,P =0.000).Conclusion The increase of serum Hcy level in diabetic patients is associated with the decrease of retinal GCL thickness,and Hcy is involved in neurodegenerative changes in patients with diabetic retinopathy.

Analysis of subfoveal choroidal thickness and macular ganglion cell layer thickness in hyperopia anisometropic amblyopic eyes / 上海交通大学学报（医学版）

Objective· To analyze and compare the subfoveal choroidal thickness and macular ganglion cell layer (MGCL) thickness in hyperopia anisometropic amblyopic children between the amblyopic eyes and the fellow eyes.Methods · The subfoveal choroidal thickness and the MGCL thickness were measured by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) in 63 hyperopic anisometropic amblyopic children.The value of subfoveal choroidal thickness and the MGCL thickness were compared between the amblyopic eyes and the fellow eyes.The average thickness of the eyes between the different types was compared using the paired t test.Results· Mean subfoveal choroidal thickness was (321.83±12.74) μm and (316.78±18.76) μm respectively in amblyopic and fellow eyes (P 0.182).Mean MGCL thickness was (83.78±4.81) μm in amblyopic eyes and (83.26±4.17) μm in the fellow eyes (P=0.223).Conclusion· Mean subfoveal choroidal thickness and MGCL thickness were not statistically significant between hyperopic anisometropic amblyopic eyes and normal fellow eyes.

Analysis of subfoveal choroidal thickness and macular ganglion cell layer thickness in hyperopia anisometropic amblyopic eyes / 上海交通大学学报（医学版）

Objective: To analyze and compare the subfoveal choroidal thickness and macular ganglion cell layer (MGCL) thickness in hyperopia anisometropic amblyopic children between the amblyopic eyes and the fellow eyes. Methods: The subfoveal choroidal thickness and the MGCL thickness were measured by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) in 63 hyperopic anisometropic amblyopic children. The value of subfoveal choroidal thickness and the MGCL thickness were compared between the amblyopic eyes and the fellow eyes. The average thickness of the eyes between the different types was compared using the paired t test. Results: Mean subfoveal choroidal thickness was (321.83±12.74) μm and (316.78±18.76) μm respectively in amblyopic and fellow eyes (P=0.182). Mean MGCL thickness was (83.78±4.81) μm in amblyopic eyes and (83.26±4.17) μm in the fellow eyes (P=0.223). Conclusion: Mean subfoveal choroidal thickness and MGCL thickness were not statistically significant between hyperopic anisometropic amblyopic eyes and normal fellow eyes.

A Case Report of Occipital Lobe Epilepsy and Related Optical Coherence Tomography Findings

PURPOSE: In the present case report, visual pathway damage confirmed by retinal ganglion cell layer (GCL) damage on optical coherence tomography (OCT) in occipital lobe epilepsy was described. CASE SUMMARY: A 25-year-old female with idiopathic generalized epilepsy developed visual blurring followed by a generalized seizure. On brain magnetic resonance imaging (MRI), very subtle changes of the cortex in the left parietooccipital lobe were observed. Two days after the attack, even after the disappearance of epileptiform wave on electroencephalogram (EEG), visual acuity in both eyes was 0.5 and a perimetry revealed nearly complete visual defect in both eyes. OCT showed severe thinning of GCL and mild thinning of retinal nerve fiber layer (RNFL). No additional seizure attack occurred thereafter. One month after the attack, her visual acuity was recovered to 1.0 in both eyes and her left visual hemifield defect was recovered. However, even 6 months after the attack, her right visual hemifield defect and GCL damage persisted in both eyes. CONCLUSIONS: We reported a case in which the visual pathway damage caused by occipital lobe epilepsy was identified using OCT, despite very subtle changes in brain imaging. This case indicated GCL thinning is an objective and prognostic index for the irreversible visual field defect in occipital lobe epilepsy.

Changes of the Individual Retinal Layer Thickness in Non-proliferative Diabetic Retinopathy in Type 2 Diabetes

PURPOSE: To compare retinal layer thickness in non-proliferative diabetic retinopathy in type 2 diabetic patients as measured by optical coherence tomography. METHODS: A total of 108 eyes from 71 patients, between January 2015 and July 2016, were included in this study. Of these, 39 eyes were included in the control group, 38 eyes in the diabetic group without non-proliferative diabetic retinopathy, and 31 eyes in the non-proliferative diabetic retinopathy group (NPDR). We measured the thickness of each retinal layer by optical coherence tomography (OCT). A total of ten layers were evaluated including the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE), inner retinal layer (IRL), outer retinal layer (ORL), and the total retinal layer (TRL). We compared the superior, inferior, nasal, and temporal regions at 1–3mm from the central fovea. RESULTS: RNFL was thinner in the superior region of the NPDR, as compared with that of the control group, showing statistical significance (p = 0.016). The thickness of all regions in the GCL, IPL, and IRL were decreased in NPDR, as compared to the control group with statistical significance. In addition, the thickness of the superior region in the GCL, IPL, and IRL showed statistically significant differences between controls and the no diabetic retinopathy (DR) group (p = 0.026, 0.003, 0.003). The thickness of the INL, OPL plus ONL, RPE, and ORL in all three groups showed no significant difference. The differences in the decreased thickness in the IRL were similar to that of TRL. CONCLUSIONS: Retinal neurodegeneration was observed in the IRL, which included changes to the RNFL, GCL, and IPL in early type 2 diabetes before microvascular injury was apparent. Thorough control of blood glucose is required in early diabetes, and further studies to delay retinal neurodegeneration are required. OCT might have an important role in early diagnosis and follow up of diabetic retinopathy.

Comparison of Inner Retinal Thickness between the Fellow Eyes of Unilateral Branch Retinal Vein Occlusion and Normal Control

PURPOSE: The purpose of this study was to compare inner retinal thickness and retinal nerve fiber layer (RNFL) thickness between fellow eyes with unilateral branch retinal vein occlusion (BRVO) and normal control eyes. METHODS: Retrospective cross-sectional study including 59 patients diagnosed with unilateral BRVO and 51 control subjects. Using spectral domain optical coherence tomography, we investigated the average, 4 quadrant, and 12 clock-hour RNFL thicknesses and the average, minimum, superior, superonasal, superotemporal, inferior, inferonasal, and inferotemporal thicknesses of the ganglion cell-inner plexiform layer (GCIPL) layer. RESULTS: Patients with unilateral BRVO had a higher incidence of hypertension. In the fellow eyes of the unilateral BRVO patients, 7 and 11 o'clock RNFL thicknesses were significantly thinner than for the control eyes. There was no significant difference in the GCIPL thickness between the two groups CONCLUSIONS: The RNFL thickness of the fellow eyes of the unilateral BRVO patients showed significant decreases in the 7 and 11 o'clock sectors (p=0.005, 0.017, respectively), whereas there was no significant difference in the GCIPL thickness between the two groups. In the RNFL thickness analysis, the 7 and 11 o'clock sectors were found to be dominant locations of decreased RNFL thickness for the open angle glaucoma. Further, glaucomatous change should be carefully monitored in the fellow eyes of unilateral BRVO patients.