Structural impairment patterns in peripapillary retinal fiber layer and retinal ganglion cell layer in mitochondrial optic neuropathies

AIM：To evaluate the structural injure patterns in peripapillary retinal fiber layer （pRNFL）, retinal ganglion cell layer （RGCL） and their correlations to visual function in various mitochondrial optic neuropathies （MON） to offer help to their differential diagnosis.METHODS：Totally 32 MON patients （60 eyes） were recruited within 6mo after clinical onsets, including 20 Leber hereditary optic neuropathy （LHON） patients （37eyes）, 12 ethambutol-induced optic neuropathy （EON）patients （23 eyes）, and 41 age-gender matched healthy controls （HC, 82 eyes）. All subjects had pRNFL and RGCL examinations with optic coherence tomography （OCT） and visual function tests.RESULTS：In the early stages of MON, the temporal pRNFL thickness decreased （66.09±22.57μm）, but increased in other quadrants, compared to HC （76.95±14.81μm）. The other quadrants remaining stable for LHON and EON patients besides the second hour sector of pRNFL thickness reduced and the temporal pRNFL decreased （56.78±15.87μm） for EON. Total macular thickness in MON reduced remarkably（279.25±18.90μm; P=0.015）, which mainly occurring in the inner circle （3 mm diameter of circle） and the nasal temporal sectors in the outer circle （5.5 mm diameter of circle）, in contrast to those in HC. RGCL thickness reduced in each sector of the macula （61.90±8.73μm; P≤0.001）. It strongly showed the correlationship of best corrected visual acuity （R=0.50, P=0.0003） and visual field injury （R=0.54,P=0.0002） in MON patients.CONCLUSION：OCT is a potential tool for detecting structural alterations in the optic nerves of various MON. Different types of MON may have different damage patterns.

Primary Sjgren's syndrome related optic neuritis

AIM:To determine the clinical features,diagnosis and treatment of the primary Sjogren syndrome(SS)related optic neuritis.METHODS:The clinical data of 8 patients(12 eyes)with primary SS related optic neuritis were analyzed retrospectively.RESULTS:Eight of 128 consecutive patients with optic neuritis resulted from varied causes fulfilled the diagnostic criteria for the primary SS.They presented initially with the signs and symptoms of non-specific optic neuritis,and 5 patients presenting without dryness showed a chronic inflammation of submandibular gland or parotid gland,and lymphocyte infiltration was demonstrated by labial gland biopsy in 2 patients.There were serum positive titers for anti-Sjogren syndrome A(SSA)in 7 patients and anti-Sjogren syndrome B(SSB)in 8 patients.Anti-aquaporin-4(AQP4)antibody was negative in all the 8 patients.Both glucocorticoids and immunosuppressive agent were administered,and visual acuity elevated in 8 eyes(66.7%),3 patients(37.5%)recurred in the follow-up.CONCLUSION:Primary SS related optic neuritis is less common and easily misdiagnosed.The conventional therapies for optic neuritis could not control the recurrence.

Structural-visual functional relationships detected by optical coherence tomography in varying age-cohorts' patients with optic neuritis

AIM: To assess the relationships of final best-corrected visual acuity(BCVA) and the optic nerve structural loss in varying age-cohorts of optic neuritis(ON) patients.METHODS: This is a retrospective, cross-sectional study.Totally 130 ON subjects(200 eyes) without ON onset within 6mo were included, who underwent BCVA assessment,peripapillary retinal nerve fibre layer(pRNFL) and macular segmented layers evaluation by optical coherence tomography(OCT).RESULTS: For the 0-18y cohort, the final BCVA(logMAR)was significantly better and less frequent recurrences than adult cohorts(P=0.000). The final BCVA(logMAR) in all age-cohorts of the ON patients had negative and linear correlations to the pRNFL thicknesses and macular retinal ganglion cell layer(mRGCL) volumes, when the pRNFL thicknesses were reduced to the thresholds of 57.2-67.5 μm or 0.691-0.737 mm;in mRGCL volumes, respectively, with the strongest interdependence in the 19-40y cohort. The ON patients from varying age cohorts would be threatened by blindness when their pRNFL thicknesses dropped 36.7-48.3 μm or the mRGCL volumes dropped to 0.495-0.613 mm;.CONCLUSION: The paediatric ON has best prognosis and young adult ON exhibits perfectly linear correlations of final vision and structural loss. The pRNFL and the mRGCL could be potential structural markers to predict the vision prognosis for varying-age ON patients.

Macular thickness as a predictor of loss of visual sensitivity in ethambutol-induced optic neuropathy

Ethambutol is a common cause of drug-related optic neuropathy.Prediction of the onset of ethambutol-induced optic neuropathy and consequent drug withdrawal may be an effective method to stop visual loss.Previous studies have shown that structural injury to the optic nerve occurred earlier than the damage to visual function.Therefore,we decided to detect structural biomarkers marking visual field loss in early stage ethambutol-induced optic neuropathy.The thickness of peripapillary retinal nerve fiber layer,macular thickness and visual sensitivity loss would be observed in 11 ethambutol-induced optic neuropathy patients（22 eyes） using optical coherence tomography.Twenty-four healthy age-and sex-matched participants（48 eyes） were used as controls.Results demonstrated that the temporal peripapillary retinal nerve fiber layer thickness and average macular thickness were thinner in patients with ethambutol-induced optic neuropathy compared with healthy controls.The average macular thickness was strongly positively correlated with central visual sensitivity loss（r2=0.878,P=0.000）.These findings suggest that optical coherence tomography can be used to efficiently screen patients.Macular thickness loss could be a potential factor for predicting the onset of ethambutol-induced optic neuropathy.

Robustness self-testing of states and measurements in the prepare-and-measure scenario with 3 → 1 random access code

Recently, Tavakoli et al.proposed a self-testing scheme in the prepare-and-measure scenario, showing that self-testing is not necessarily based on entanglement and violation of a Bell inequality [Phys.Rev.A 98 062307(2018)].They realized the self-testing of preparations and measurements in an N → 1(N ≥ 2) random access code(RAC), and provided robustness bounds in a 2 → 1 RAC.Since all N → 1 RACs with shared randomness are combinations of 2 → 1 and 3 → 1 RACs, the3 → 1 RAC is just as important as the 2 → 1 RAC.In this paper, we find a set of preparations and measurements in the3 → 1 RAC, and use them to complete the robustness self-testing analysis in the prepare-and-measure scenario.The method is robust to small but inevitable experimental errors.

Acute Bilateral Optic Neuritis in Active Ankylosing Spondylitis

Ankylosing spondylitis （AS）, which primarily affects the sacroiliac joints, spine, and enthuses, is a chronic inflammatory rheumatic disorder. Acute anterior uveitis is the most common ophthalmologic involvement, whereas optic neuritis （ON） rarely coexists with AS.r^j ON is an immune-mediated inflammation of the optic nerve, which could be the initiated symptom of multiple sclerosis （MS） or neuromyelitis optica （NMO）. Bilateral simultaneous ON with long enhanced optic nerve lesions in magnetic resonance imaging （MRI） was considered as features of NMO spectrum disorders （NMOSDs）. However, comprehensive review of the current literature showed little evidence of AS as an accompanied autoimmune condition in NMO,121 and the specific biomarker aquaporin-4 antibody （AQP4-Ab） was negative in our patient. In the current report, we present the first case of ON with active AS in a Chinese male patient. The association between the two diseases remains to be evaluated.