Optical coherence tomography angiography in retinal cavernous hemangioma

Citation： Cennamo G, Amoroso F, Solari D, Alfieri MC, de Crecchio G. Optical coherence tomography angiography in retinal cavernous hernangioma, lnt J Ophthalmol 2017; 10（12）： 1945-1946

Microperimetry and spectral domain optical coherence tomography in myelinated retinal nerve fibers

Dear Sir,I write to present the correlation between microperimetric （MP） values and the density of myelinated retinal nerve fibers （MNFs） in optical coherence tomography （OCT） imaging.

Diagnostic capability of peripapillary retinal nerve fiber layer parameters in time-domain versus spectral-domain optical coherence tomography for assessing glaucoma in high myopia

AIM： To evaluate and compare the diagnostic capabilities of peripapillary retinal nerve fiber layer（p-RNFL） parameters of Spectralis optical coherence tomography（OCT） versus Stratus OCT to detect glaucoma in patients with high myopia. METHODS： This is a retrospective, cross-sectional study. Sixty highly myopic eyes of 60 patients were enrolled, with 30 eyes in the glaucoma group and 30 eyes in the control group. All eyes received peripapillary imaging of the optic disc using Stratus and Spectralis OCT. Areas under the receiver operating characteristic curve（AUROC） and the sensitivity at specificity of 〉80% and 〉95% for p-RNFL parameters obtained using the two devices to diagnose glaucoma were analysed and compared. RESULTS： In Spectralis OCT, p-RNFL thickness parameters with the largest AUROC were the temporal-inferior sector（0.974） and the inferior quadrant（0.951）, whereas in Stratus OCT, the best parameters were the 7-o＇clock sector（0.918） and the inferior quadrant（0.918）. Compared to the Stratus OCT parameters, the Spectralis OCT parameters demonstrated generally higher AUROC; however, the difference was not statistically significant. CONCLUSION： The best p-RNFL parameters for diagnosing glaucoma in patients with high myopia were the temporal-inferior sector on Spectralis OCT and the 7-o＇clock sector on Stratus OCT. There were no significant differences between the AUROCs for Spectralis OCT and Stratus OCT, which suggest that the glaucoma diagnostic capabilities of these two devices in patients with high myopia are similar.

Comparison of peripapillary retinal nerve fiber layer thickness between myopia severity groups and controls

AIM： To compare the peripapillary retinal nerve fiber layer（RNFL） thickness measured via optical coherence tomography（OCT） between different groups of myopia severity and controls. METHODS： This was a prospective cross-sectional study. All subjects underwent a full ophthalmic examination, refraction, visual field analysis and A-scan biometry. Myopic patients were classified as low myopia（LM） [spherical equivalent（SE） from greater than-0.5 D, up to-3.0 D], moderate myopia（MM; SE greater than-3.0 D, up to-6.0 D） and high myopia（HM; SE greater than-6.0 D）. The control group consisted of emmetropic（EM） patients（SE from ＋0.5 D to-0.5 D）. A Zeiss Cirrus HD-OCT machine was used to measure the peripapillary RNFL thickness of both eyes of each subject. The mean peripapillary RNFL thickness between groups was compared using both analysis of variance and analysis of covariance.RESULTS： A total of 403 eyes of 403 subjects were included in this study. The mean age was 31.48±10.23 y. There were 180（44.7%） eyes with EM, 124（30.8%） with LM, 73（18.1%） with MM and 26（6.5%） with HM. All groups of myopia severity had a thinner average RNFL than the EM group, but after controlling for gender, age, and axial eye length, only the HM group differed significantly from the EM group（P=0.017）. Likewise, the superior, inferior and nasal RNFL was thinner in all myopia groups compared to controls, but after controlling for confounders, only the inferior quadrant RNFL was significantly thinner in the HM group, when compared to the EM group（P=0.017）. CONCLUSION： The average and inferior quadrant RNFL is thinner in highly myopic eyes compared to emmetropic eyes. Refractive status must be taken into consideration when interpreting the OCT of myopic patients, as RNFL thickness varies with the degree of myopia.

Changes in retinal vessel diameters in migraine patients during attack-free period

AIM：To evaluate the retinal vessel diameters in patients with migraine by optical coherence tomography（OCT）.METHODS：In this cross-sectional study,124 eyes of 62 patients with a diagnosis of unilateral migraine during attack-free period and 42 age-and sex-matched control subjects were included. Migraine patients were divided into the ≤2 migraine attacks per month group and the ≥5 migraine attacks per month group. All subjects underwent complete ophthalmological and neurological examinations before measurements. Retinal vessel diameters and choroidal thickness were examined with the Spectralis OCT.RESULTS：The mean diameters of the arteries in the eyes on the headache side of control group,≥5 migraine attacks per month and ≤2 migraine attacks per month group at 480 μm from the optic disk（Raster 3）were 119.54±46.69,136.68±25.93 and 119.34±31.75 μm respectively with a steady decline to 105.57±32.15,118.18±31.87 and 108.05±38.77 μm at 1440 μm（Raster 7）,the last measurement point,respectively. The retinal artery diameter measurements were significantly increased in ≥5 migraine attacks per month patients at four out of five measured points compared to control group（P〈0.05）. There were no statistical differences at any of the points of vein measurements. The choroidal thickness measurements were significantly decreased in ≥5 migraine attacks per month patients at all measured points compared to control group（P〈0.05）.CONCLUSION：The retinal artery diameter is found to increase significantly and the choroidal thickness is found to decrease in the eyes on the headache side in ≥5 migraine attacks per month patients compared to control group.

Correlation between macular ganglion cell-inner plexiform layer thickness and visual acuity after resolution of the macular edema secondary to central retinal vein occlusion

AIM： To examine the thickness of the ganglion cell-inner plexiform layer（GCIPL） in eyes with resolved macular edema（ME） in non-ischemic central retinal vein occlusion（CRVO）, applying spectral-domain optical coherence tomography（SD-OCT）, and its relationship with visual acuity.METHODS： The retrospective observational case-control study included 30 eyes of non-ischemic CRVO patients with resolved ME（ME eyes） after treatment, and 30 eyes of non-ischemic CRVO patients without ME（non-ME eyes）. The macular GCIPL thickness, peripapillary retinal nerve fiber layer（p RNFL） thickness and central macular thickness（CMT） were measured on a SD-OCT scan. Linear regression analyses were performed to determine the correlation between the thickness of each and the visual acuity（VA）.RESULTS： No significant difference in average GCIPL thickness, mean pR NFL thickness and CMT were observed between ME group and non-ME group（P=0.296, 0.183, 0.846）. But, minimum GCIPL thickness was reduced in ME eyes compared with non-ME eyes（P=0.022）. Final VA significantly correlated with the minimum GCIPL thickness in ME eyes（r=-0.482, P=0.007）, whereas no correlation was found with average GCIPL thickness, average pR NFL thickness and mean CMT.CONCLUSION： Minimum GCIPL thickness is reduced in ME eyes compared with non-ME eyes, and correlated with the VA in non-ischemic CRVO. These results propose that inner retinal damage occurring in patients with ME secondary to non-ischemic CRVO may lead to permanent visual defect after treatment.

Retinal ganglion cell-inner plexiform and nerve fiber layers in neuromyelitis optica

AIM： To determine the thickness of the retinal ganglion cell-inner plexiform layer（GCIPL） and the retinal nerve fiber layer（RNFL） in patients with neuromyelitis optica（NMO）.METHODS： We conducted a cross-sectional study that included 30 NMO patients with a total of 60 eyes. Based on the presence or absence of optic neuritis（ON）, subjects were divided into either the NMO-ON group（30 eyes） or the NMO-ON contra group（10 eyes）. A detailed ophthalmologic examination was performed for each group; subsequently, the GCIPL and the RNFL were measured using highdefinition optical coherence tomography（OCT）. RESULTS： In the NMO-ON group, the mean GCIPL thickness was 69.28±21.12 μm, the minimum GCIPL thickness was 66.02±10.02 μm, and the RNFL thickness were 109.33±11.23, 110.47±3.10, 64.92±12.71 and 71.21±50.22 μm in the superior, inferior, temporal and nasal quadrants, respectively. In the NMO-ON contra group, the mean GCIPL thickness was 85.12±17.09 μm, the minimum GCIPL thickness was 25.39±25.1 μm, and the RNFL thicknesses were 148.33±23.22, 126.36±23.45, 82.21±22.30 and 83.36±31.28 μm in the superior, inferior, temporal and nasal quadrants, respectively. In the control group, the mean GCIPL thickness was 86.98±22.37 μm, the minimum GCIPL thickness was 85.28±10.75 μm, and the RNFL thicknesses were 150.22±22.73, 154.79±60.23, 82.33±7.01 and 85.62±13.81 μm in the superior, inferior, temporal and nasal quadrants, respectively. The GCIPL and RNFL were thinner in the NMO-ON contra group than in the control group（P〈0.05）; additionally, the RNFL was thinner in the inferior quadrant in the NMO-ON group than in the control group（P〈0.05）. Significant correlations were observed between the GCIPL and RNFL thickness measurements as well as between thickness measurements and the two visual field parameters of mean deviation（MD） and corrected pattern standard deviation（PSD） in the NMO-ON group（P〈0.05）. CONCLUSION： The thickness of the GCIPL and RNFL, as measured using OCT, may indicate optic nerve damage in patients with NMO.

Optical coherence tomography in measuring retinal nerve fiber layer thickness in normal subjects and patients with open-angle glaucoma

Objectives To investigate image characteristics and thickness of the retinal nerve fiber layer (RNFL) in normal and glaucomatous eyes using optical coherence tomography (OCT), and analyze the relationship between RNFL thickness and visual field index.Methods Eighty-three normal persons (150 eyes) and 83 patients with primary open angle glaucoma (POAG, 149 eyes) underwent OCT examinations with 3.4 mm diameter circle scan to calculate the RNFL thickness. Statistical analysis was used to compare differences in RNFL thickness in quadrants and means between the normal and glaucomatous groups and the different stages of POAG. Linear correlation and regression analysis were used to show the correlation between RNFL thickness and visual field index of 115 eyes in glaucomatous patients. Reproducibility, sensitivity and specificity of RNFL measurements using OCT were evaluated.Results RNFL thickness measured by OCT in normal subjects was thicker in superior and inferior, less in temporal, and thinnest in nasal quadrants. The curve showed double peaks. RNFL of glaucomatous patients showed local thinning or defect, diffuse thinning, or both. The mean RNFL thicknesses of the normal group in the temporal, superior, nasal and infeior quadrants were 90.1 ± 10.8 lμm, 140.4 ± 10.5μm, 85.2 ± 14.0 μm, and 140.4 + 9.7 μm, respectively with a mean of 114.2 ± 6.0 μm. The numbers for the glaucomatous group were respectively 56.0 ± 31.0 μm, 81.0 ± 36.3 μm, 47.1 ± 27.5 μm, and 73.4 ±38.4 μm for the four quadrants, with a mean of 64.6 ± 28.8 μm. There was a significant difference in RNFL thickness between the normal and glaucomatous groups (P ＜ 0.000), and the three stages (early,developing and late) of glaucornatous groups (P ＜ 0.000). There was a close negative relationship between RNFL thickness and visual field index ( r = - 0.796, P ＜ 0.0001 ). The sensitivity and specificity of RNFL thickness in POAG measured using OCT were 93.3％ and 92.0％, respectively.Conclusions OCT can quantitatively measure RNFL thickness differences between normal persons and glaucomatous patients. RNFL thickness gradually decreases while visual field defect increases with the development of POAG.

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.