Changes in retinal nerve fiber layer and macular retinal thickness and predictive value of outcome in children with abnormal refractive amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the changes in retinal nerve fiber layer(RNFL)and macular retinal thickness(MRT)in children with refractive abnormalities and amblyopia, and their predictive value of outcome.METHODS: A total of 168 children with myopic refractive abnormalities and monocular amblyopia admitted to our hospital from January 2020 to October 2022 were selected as the observation group, with 118 cases of mild to moderate amblyopia and 50 cases of severe amblyopia, and 168 children with normal vision were included as the control group in a 1:1 ratio during the same period. The changes of RNFL and MRT in two groups of children were statistically counted, and the correlation between the severity of refractive abnormalities and RNFL and MRT in children with amblyopia was analyzed. Additionally, the observation group was divided into effective subgroup and ineffective subgroup based on the therapeutic effect. The general information, as well as RNFL and MRT of the effective subgroup and the ineffective subgroups before and after treatment were compared. Logistic was used to analyze the factors influencing efficacy, and ROC curves was plotted to analyze the predictive value of RNFL and MRT alone or in combination for efficacy.RESULTS: RNFL and MRT of cases of severe amblyopia were higher than those of the mild to moderate amblyopia and the control groups(all P<0.05); the severity of amblyopia in children with refractive abnormalities is positively correlated with RNFL and MRT(rs=0.745 and0.724, both P<0.001); among patients of mild to moderate and severe, there were statistically significant differences between the effective and ineffective subgroups in terms of initial treatment age, fixation form, treatment compliance, as well as RNFL, MRT, and their differences before and 1mo postoperatively(all P<0.05). Logistic analysis showed that initial treatment age, fixation nature, treatment compliance, RNFL and MRT before and 1mo postoperatively were all factors influencing the therapeutic effect of amblyopia with refractive abnormalities in children(all P<0.05); after 1mo of treatment, the combined prediction of RNFL and MRT was significantly better than that of single prediction in children with mild to severe amblyopia.CONCLUSION:There are differences in RNFL and MRT in children with abnormal refractive amblyopia, and they are closely related to the different degrees and curative effects of children. The combination of RNFL and MRT after 1mo of treatment has certain value in predicting children with different degrees of abnormal refractive amblyopia.

The Analysis of Retinal Nerve Fiber Layer in Amblyopia Using Spectral Domain Optical Coherence Tomography

PURPOSE: To determine whether retinal nerve fiber layer (RNFL) thickness and optic nerve head parameters differ in the amblyopic and normal fellow eyes of hyperopic anisometropic amblyopic patients using spectral domain optical coherence tomography (SD-OCT). METHODS: This study included 30 patients with hyperopic anisometropic amblyopia; patient eyes were divided into 30 anisometropic amblyopic eyes and 30 normal fellow eyes. RNFL thickness, disc area, rim area, average cup-to-disc ratio, and cup volume were obtained using SD-OCT. Axial length was obtained using the IOL Master®, and the interocular differences between group were analyzed. RESULTS: Nasal quadrant RNFL thickness of amblyopic eyes was significantly thicker than that of normal fellow eyes in amblyopic patients (p = 0.010). Among optic nerve parameters, cup volume of amblyopic eyes was significantly smaller than that of normal fellow eyes (p = 0.021). No significant relationship between refractive error and RNFL thickness was observed, and a significant positive linear relationship was observed between neural rim area and RNFL thickness (rho = 0.426, p = 0.005). CONCLUSIONS: SD-OCT analysis of hyperopic anisometropic amblyopic eyes demonstrated a significant increase in nasal RNFL thickness compared to fellow non-amblyopic eyes. No optic nerve head parameters except cup volume showed significant change.

Retinal Nerve Fiber Layer Thickness in a Subset of Karachi (Pakistan) Population.

Aim: To provide the normal range of retinal nerve fiber layer (RNFL) thickness in a subset of Karachi population by Spectralis OCT and to evaluate the effects of age and gender on it. Methodology: 300 eyes from 150 healthy subjects aged 40 years and above with no ocular pathologies were examined using standard protocols by a single examiner. Subjects with high myopia, history of diabetic or hypertensive retinopathy, raised intraocular pressure (> 21 mmHg) and previous intraocular or laser surgery were excluded from the study. The mean retinal nerve fiber layer thickness was calculated and was correlated with age and gender difference. Results: The mean global retinal nerve fiber layer thickness was found to be 99.02±9.08 μm in our set of population. Out of four quadrants the maximum RNFL thickness was found in inferior quadrant (126.45±16.23 μm) followed by the thickness of 121.50±15.03 μm in superior quadrant, 78.99±13.99 μm in nasal quadrant and 68.90±13.10 μm in temporal quadrant. We found strong negative correlation of RNFL thickness with age (P= 0.001) and not significant relation with gender (P= 0.8). Conclusions: Keeping in mind the variations in RNFL thickness with ethnic differences, this study provides the normal values of RNFL thickness according to our set of population. It is concluded that RNFL thickness decreases significantly with increasing age but gender had no significant effect on it.

Difference of GCIPL Thickness of Diabetes and Normal Eyes in Spectral Domain OCT

PURPOSE: To analyze the difference of the ganglion cell-inner plexiform layer (GCIPL) thickness in diabetic and normal eyes of patients using spectral domain optical coherence tomography (OCT) (Carl Zeiss Meditec, Dublin, CA, USA). METHODS: The authors compared and analyzed the difference of the GCIPL thickness measured with spectral domain optical coherence tomography (OCT) in 42 diabetic and 92 normal subjects. RESULTS: The study subjects were divided into 3 groups: 92 normal subjects, 22 diabetic patients without diabetic retinopathy, and 26 diabetic patients with diabetic retinopathy. Presence of diabetes mellitus (DM) or diabetic retinopathy did not influence the retinal nerve fiber layer (RNFL) thickness. The GCIPL thickness tended to be thinner especially in the superior sector GCIPL. The GCIPL thickness of normal subjects, diabetes patients without diabetic retinopathy, and diabetic retinopathy patients was 82.24 +/- 7.21 microm, 81.86 +/- 9.53 microm, and 76.77 +/- 14.13 microm, respectively, especially in the superior sector GCIPL (p = 0.029). CONCLUSIONS: Retinal ganglion cell layer thinning was induced by diabetes and diabetic retinopathy, and originated specifically from the superior part of the retina.

Changes of Peripapillary Retinal Nerve Fiber Layer Thickness Profile According to Aging in Myopic Eyes

PURPOSE: To evaluate the effects of age on the distributional variability of peripapillary retinal nerve fiber layer (RFNL) thickness measured by optical coherence tomography (OCT) in myopia. METHODS: Only the right eye of 64 myopic patients with long axial length (> or =24.5 mm) was included in the present study. The patients were divided into 2 age groups, 20 to 39 years of age and 40 to 59 years of age. Eventually, 42 subjects were selected and matched based on the difference of axial length not exceeding 0.5 mm between subjects in each group. The RFNL thickness was measured using Stratus OCT and average thickness, angular locations of double humps, and false-positive rate were compared. RESULTS: In both groups, the distribution of RNFL thickness in a double hump pattern was observed, which had a deviation to the temporal side only in the younger myopic eye group, but not in the middle-aged group. The middle-aged group had significantly thinner RNFL in 1, 7, and 8 clock-hour sectors compared to the younger myopic eyes (p < or = 0.02). Probability of abnormal OCT parameters at the 5% level of the 2 groups with the built-in RNFL normative database was not significantly different. CONCLUSIONS: The variability of RFNL thickness distribution related to axial length was less observed in the middle-aged group than the younger-aged group. These results should be considered in glaucoma diagnosis when using OCT.

Regularity on change of retinal nerve fiber layer thickness with acute high intraocular pressure / 医用生物力学

Objective To measure the rabbit retinal nerve fiber layer(RNFL) thickness in vivo under different intraocular pressures (IOP) and at different time intervals after acute high IOP, and to obtain the regularity on change of RNFL thickness with acute high IOP. Methods Four groups of acute high IOP model were formed by perfusing the saline water into the anterior chamber of rabbit eyes, then RNFL thickness under different IOPs was measured by optical coherence tomography with radial scanning mode whose center was optical papilla and diameter was 6 mm. Results The absolute change values of RNFL thickness were(-27.16±14.24), (-33.33±6.74), (-48.75±5.24), (-67.29±3.89) μm under different IOPs of (4.50±0.35), (6.07±0.31), (7.74±0.26), (10.71±0.07) kPa, respectively. The linear relationship was found between the relative change of RNFL thickness and IOP. IOP could return to the normal level within two days after acute high IOP, while the RNFL thickness could be restored at the second week, and it was easier to restore if the IOP was lower than 6.65 kPa. Conclusions The acute high IOP could cause RNFL thickness to decrease significantly with the increased acute high IOP, but it will be restored after some time.

Comparison of the Detection Rate, Location and Amount of Retinal Nerve Fiber Layer Defect

PURPOSE: To compare the detection rate of the patients with retinal nerve fiber layer (RNFL) defect and the amount of RNFL defect according to the patients' age. METHODS: Retrospective chart reviews of 22,811 subjects, who visited the health care center from January 2009 to December 2009 were performed. The detection rate, location and average amount of RNFL defect and the proportions of the patients who were diagnosed with glaucoma through Humphrey visual field (HVF) test or determined as a glaucomatous optic disc were compared according to the patients' age. RESULTS: The proportions of the patients whose RNFL defect were detected was highest in the patients 60 years old or older (2.3%) and was statistically significant (p = 0.012). However, there was no significant difference among the other age groups (under 40 years: 1.7%, 40 thru 49 years: 1.5%, 50 thru 59 years: 2.0%). The proportions of the patients who were determined as glaucoma through the HVF test or glaucomatous optic disc were also highest in the patients 60 years old or older (1.4%), however, there was no statistically significant difference (p = 0.070) among the age groups (under 40 years: 1.1%, 40 thru 49 years: 0.9%, 50 thru 59 years: 1.2%). CONCLUSIONS: The RNFL defect is likely to be detected in subjects less than 40 years of age and the detection rate is similar to subjects in their 40's and 50's. The use of fundus photography to detect RNFL defect in a health care center is recommended in subjects under 40 years of age.

Application of retinal tomography in primary open angle glaucoma / 中国康复理论与实践

@#ObjectiveTo study the application of retinal tomography in primary open angle glaucoma diagnosis.MethodsThe differences between POAG, high myopia with suspected glaucoma and normal volunteers on the rim area, rim volume and the thickness of retinal nerve fiber layer (RNFL) thickness in quadrants under Heideberg retinal tomography-Ⅱ(HRT-Ⅱ) were analyzed.ResultsIn the cases of POAG and high myopia with suspected glaucoma, the values of rim area, rim volume and RNFL thickness were significantly lower than that in normal group.ConclusionRetinal tomography can be used in the diagnosis of POAG.

Medical Treatment of Glaucoma

No abstract available.

Correlation Between Frequency Doubling Technology Perimetry and Scanning Laser Polarimetry in Glaucoma Suspects and Glaucomatous Eyes

The aim of this study was to determine the relationship between the frequency doubling technology (FDT) screening algorithm and parapapillary retinal nerve fiber layer (RNFL) thickness in the eyes of glaucoma suspects and patients with open angle glaucoma. FDT C20-1 screening program and a scanning laser polarimetry (SLP) system (GDx-NFA) was used to assess 53 glaucomatous eyes, 53 glaucoma suspects and 36 normal control eyes. In glaucomatous eyes, there were correlations between the FDT the screening algorithm and RNFL retardation values in several polarimetric indices, most significantly "inferior thickness" (r = -0.321, P = 0.029). In the eyes of glaucoma suspects, however, we observed no correlation between the FDT results and RNFL retardation values (r = 0.080, P > 0.05, "inferior thickness"). In glaucomatous eyes, the abnormal scores obtained with FDT screening program correlated negatively with RNFL retardation values, as measured by SLP. Despite poor correlation between the FDT abnormal score and RNFL retardation value in glaucoma suspects, detection of abnormality using the FDT screening protocol may aid in the assessment of early glaucomatous structural damage.