1
|
Eadie BD, Dyachok OM, Quach JH, Maxner CE, Rafuse PE, Shuba LM, Vianna JR, Chauhan BC, Nicolela MT. Non-arteritic anterior ischemic and glaucomatous optic neuropathy: Implications for neuroretinal rim remodeling with disease severity. PLoS One 2023; 18:e0286007. [PMID: 37200340 DOI: 10.1371/journal.pone.0286007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 05/06/2023] [Indexed: 05/20/2023] Open
Abstract
PURPOSE Post-acute non-arteritic ischemic optic neuropathy (NAION) and glaucomatous optic neuropathy (GON) can be difficult to differentiate clinically. Our objective was to identify optical coherence tomography (OCT) parameters to help differentiate these optic neuropathies. METHODS We compared 12 eyes of 8 patients with NAION and 12 eyes of 12 patients with GON, matched for age and visual field mean deviation (MD). All patients underwent clinical assessment, automated perimetry (Humphrey Field Analyzer II; Carl Zeiss Meditec, Dublin, CA, USA), and OCT imaging (Spectralis OCT2; Heidelberg Engineering, Heidelberg, Germany) of the optic nerve head and macula. We derived the neuroretinal minimum rim width (MRW), peripapillary retinal nerve fibre layer (RNFL) thickness, central anterior lamina cribrosa depth, and macular retinal thickness. RESULTS MRW was markedly thicker, both globally and in all sectors, in the NAION group compared to the GON group. There was no significant group difference in RFNL thickness, globally or in any sector, with the exception of the temporal sector that was thinner in the NAION group. The group difference in MRW increased with increasing visual field loss. Other differences observed included lamina cribrosa depth significantly greater in the GON group and significantly thinner central macular retinal layers in the NAION group. The ganglion cell layer was not significantly different between the groups. CONCLUSIONS The neuroretinal rim is altered in a dissimilar manner in NAION and GON and MRW is a clinically useful index for differentiating these two neuropathies. The fact that the difference in MRW between the two groups increased with disease severity suggests distinct remodelling patterns in response to differing insults with NAION and GON.
Collapse
Affiliation(s)
- Brennan D Eadie
- Department of Ophthalmology and Visual Sciences, Dalhousie University, and Nova Scotia Health Authority, Halifax, Canada
| | - Oksana M Dyachok
- Department of Ophthalmology and Visual Sciences, Dalhousie University, and Nova Scotia Health Authority, Halifax, Canada
| | - Jack H Quach
- Department of Ophthalmology and Visual Sciences, Dalhousie University, and Nova Scotia Health Authority, Halifax, Canada
| | - Charles E Maxner
- Department of Ophthalmology and Visual Sciences, Dalhousie University, and Nova Scotia Health Authority, Halifax, Canada
| | - Paul E Rafuse
- Department of Ophthalmology and Visual Sciences, Dalhousie University, and Nova Scotia Health Authority, Halifax, Canada
| | - Lesya M Shuba
- Department of Ophthalmology and Visual Sciences, Dalhousie University, and Nova Scotia Health Authority, Halifax, Canada
| | - Jayme R Vianna
- Department of Ophthalmology and Visual Sciences, Dalhousie University, and Nova Scotia Health Authority, Halifax, Canada
| | - Balwantray C Chauhan
- Department of Ophthalmology and Visual Sciences, Dalhousie University, and Nova Scotia Health Authority, Halifax, Canada
| | - Marcelo T Nicolela
- Department of Ophthalmology and Visual Sciences, Dalhousie University, and Nova Scotia Health Authority, Halifax, Canada
| |
Collapse
|
2
|
Gambini G, Carlà MM, Caporossi T, Baldascino A, Crincoli E, De Vico U, Savastano A, Caporossi A, Rizzo S. Early evaluation of optic nerve head morphology and choroidal thickness after PreserFlo MicroShunt implantation. Int Ophthalmol 2022; 43:1207-1214. [PMID: 36129605 PMCID: PMC10113179 DOI: 10.1007/s10792-022-02519-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/11/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this study is to investigate changes in choroidal and optic nerve morphological parameters following MicroShunt PreserFlo implantation. The secondary aim is to investigate how the structural changes relate to the decrease in intraocular pressure (IOP). METHODS Prospective observational study on 15 eyes with glaucoma requiring MicroShunt implantation. Optical coherence tomography was used to measure macular choroidal thickness (MCT), peripapillary choroidal thickness (PCT), lamina cribrosa depth (LCD), cup depth and prelaminar tissue thickness (PLT), before and one day after surgery. Results were expressed in median and interquartile range (IQR) and correlated with IOP results. RESULTS The IOP decreased from a median of 25 (IQR = 11) mmHg to 8 (IQR = 2) mmHg the day after surgery. Median MCT increased after MicroShunt implantation from 252.1 (IQR = 156.4) µm to a postoperative value of 318.1 (IQR = 166.6) µm (p < 0.001), with a median increase of + 87.7 µm (+ 26.4%). PCT increased from 157.2 (IQR = 109.1) µm before surgery to 206.0 (IQR = 136.1) µm after surgery (p < 0.001). Moreover, we found a significant post-operative decrease in cup depth (median reduction of - 29.3 µm, p < 0.001) and an increase in PLT (median increase of 27.3 µm, p = 0.028). On the other side, LCD reduction 24 h after surgery didn't reach any statistical significance. CONCLUSION PreserFlo implantation determines retinal structural changes which appear similar to those caused by traditional filtering surgery, confirming the effectiveness of this device, meantime carrying a much smaller complications rate when compared to trabeculectomy.
Collapse
Affiliation(s)
- Gloria Gambini
- Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
| | - Matteo Mario Carlà
- Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli 8, 00168, Rome, Italy.
- Catholic University "Sacro Cuore", Rome, Italy.
| | - Tomaso Caporossi
- Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
| | - Antonio Baldascino
- Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
| | - Emanuele Crincoli
- Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
| | - Umberto De Vico
- Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
| | - Alfonso Savastano
- Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
| | - Aldo Caporossi
- Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
| | - Stanislao Rizzo
- Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS", Largo A. Gemelli 8, 00168, Rome, Italy
- Catholic University "Sacro Cuore", Rome, Italy
| |
Collapse
|
3
|
Guo X, Chen D, Luo S, Huang J, Li Y. EDI-OCT choroidal thickness in Posner-Schlossman syndrome. Int Ophthalmol 2020; 40:877-889. [PMID: 31894459 DOI: 10.1007/s10792-019-01251-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 12/16/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To compare the choroidal thickness (CT) of the affected eyes with the contralateral eyes in the active period and in the remission period in Posner-Schlossman syndrome (PSS) using EDI-OCT. PATIENTS AND METHODS This prospective longitudinal study included 15 patients with PSS and 15 age- and sex-matched healthy subjects. All subjects underwent complete ophthalmologic examinations, and EDI-OCT was conducted to measure macular CT (mCT) at the subfoveal locations and at 0.5, 1.0 and 2.0 mm superior, inferior, nasal and temporal to the fovea. The mean measurements at each location were used for analysis. Linear regression analysis was performed to analyse the correlation between the choroidal thickness and IOP, and the correlation between the choroidal thickness and episode time. RESULTS The mean mCT was significantly thinner in affected eyes than in contralateral eyes in the acute phase (p = 0.010) but were not different in the remission phase (p = 0.404). The mean mCT was significantly increased in the remission phase compared to that in the acute phase in the affected eyes (p = 0.000). The mCT of healthy subjects was significantly thicker than in the affected eyes (p = 0.020) and similar to the fellow eyes of PSS patients (p = 0.357) in the acute phase. Linear regression analyses show negative correlations between the mCT changes and IOP changes in the affected eyes compared to those in the fellow eyes in the acute period (R2 = 0.396, p = 0.033) and between the mCT changes and IOP changes from the acute period to the remission period in the affected eyes (R2 = 0.372, p = 0.027). Linear regression analyses show positive correlations (age- and sex-matched) between the CT changes and episode time from the affected eyes to the fellow eyes in the acute period (R2 = 0.492, p = 0.012). CONCLUSIONS The mCT values of the PSS-affected eyes were significantly thinner than those of the fellow eyes in the acute phase and in the remission phase, and this change was correlated with IOP reduction and episode time.
Collapse
Affiliation(s)
- Xiujuan Guo
- Department of Ophthalmology, The Second People's Hospital of Foshan, Foshan, 528000, People's Republic of China
| | - Di Chen
- Department of Ophthalmology, The Second People's Hospital of Foshan, Foshan, 528000, People's Republic of China
| | - Shuke Luo
- Department of Ophthalmology, The Second People's Hospital of Foshan, Foshan, 528000, People's Republic of China.
| | - Jinfei Huang
- Department of Ophthalmology, The Second People's Hospital of Foshan, Foshan, 528000, People's Republic of China
| | - Yanhao Li
- Department of Ophthalmology, The Second People's Hospital of Foshan, Foshan, 528000, People's Republic of China
| |
Collapse
|
4
|
Kim JA, Kim TW, Lee EJ, Kim JM, Girard MJA, Mari JM. Intereye Comparison of Lamina Cribrosa Curvature in Normal Tension Glaucoma Patients With Unilateral Damage. Invest Ophthalmol Vis Sci 2019; 60:2423-2430. [PMID: 31158274 DOI: 10.1167/iovs.19-26828] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate intereye differences in lamina cribrosa (LC) morphology in normal tension glaucoma (NTG) patients with unilateral damage. Methods A total of 152 eyes of 76 treatment-naive NTG patients with unilateral damage from the ongoing Investigating Glaucoma Progression Study were included. Optic nerve heads were scanned using enhanced-depth spectral-domain optical coherence tomography. The magnitude of the LC curve and LC position were assessed by measuring the LC curve index (LCCI) and LC depth (LCD), respectively, at seven locations spaced equidistantly across the vertical optic disc diameter. LCCI and LCD were compared between glaucomatous and fellow healthy eyes. Results Eyes with NTG had larger average LCCI and LCD than contralateral healthy eyes (for both P < 0.002). The LCCI was greater in the glaucomatous eyes at all seven locations (P < 0.001). Univariate conditional logistic regression analysis showed that higher baseline intraocular pressure (P = 0.010), deeper LCD (P = 0.007), and larger LCCI (P < 0.001) were significantly associated with the presence of glaucoma. In multivariate analysis, only larger LCCI was significantly associated with the presence of glaucoma (P < 0.001). Conclusions Glaucomatous eyes have more steeply curved LC than fellow healthy eyes. This finding suggests that LC undergoes significant remodeling in NTG eyes.
Collapse
Affiliation(s)
- Jeong-Ah Kim
- Department of Ophthalmology, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Tae-Woo Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eun Ji Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Michaël J A Girard
- Department of Biomedical Engineering, National University of Singapore, Singapore.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | | |
Collapse
|
5
|
Feola AJ, Nelson ES, Myers J, Ethier CR, Samuels BC. The Impact of Choroidal Swelling on Optic Nerve Head Deformation. ACTA ACUST UNITED AC 2018; 59:4172-4181. [DOI: 10.1167/iovs.18-24463] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Andrew J. Feola
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, United States
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Atlanta, Georgia, United States
| | | | - Jerry Myers
- NASA Glenn Research Center, Cleveland, Ohio, United States
| | - C. Ross Ethier
- Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, Georgia, United States
| | - Brian C. Samuels
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama, United States
| |
Collapse
|