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The correlation between visual acuity outcomes and optical coherence tomography parameters following surgery for diabetic epiretinal membrane and taut posterior hyaloid
摘要： Purpose: To evaluate the relationship between visual outcomes and the determinants detected by spectral domain optical coherence tomography (OCT) in eyes with epiretinal membrane (ERM) and/or taut posterior hyaloid (TPH) that underwent pars plana vitrectomy (PPV). Materials and methods: A total of 30 participants with diabetic ERM and TPH were included in the study. All study participants underwent PPV. Preoperative and postoperative best corrected visual acuity (BCVA), peripapillary retinal nerve fiber layer (RNFL), macular RNFL, ganglion cell layer, inner plexiform layer, and ganglion cell complex thicknesses were measured in each participant. Linear regression analyses were performed to determine the association between the OCT parameters and the visual acuity measured at the time of the OCT measurement. Results: The postoperative BCVA logarithm of the minimum angle of resolution (logMAR) values were statistically higher than the preoperative values in the ERM group and TPH group (P=0.001 and P<0.001, respectively). The postoperative BCVA logMAR value was negatively correlated with average RNFL, inferior RNFL thicknesses, and image quality (P=0.002, P=0.004, and P=0.006, respectively). The preoperative and postoperative BCVA logMAR value difference was not correlated with age and all of the OCT parameters measured (P>0.05). Conclusion: This study shows that achievement of better peripapillary RNFL thickness results in better visual outcome after PPV and ERM/TPH removal.
关键词： retinal nerve fiber layer,ganglion cell complex,optical coherence tomography,taut posterior hyaloid,diabetic epiretinal membrane
更新于2025-09-23 15:22:29
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Relationship between Peripapillary Retinal Nerve Fiber Layer Thickness Measured by Optical Coherence Tomography and Visual Field Severity Indices
摘要： Purpose: Though there are many reports regarding the structure-function relationship in glaucoma, they are too complicated to apply to the routine clinical setting. The aim of this study was to investigate the direct relationship between peripapillary retinal nerve fiber layer (RNFL) thickness measured by optical coherence tomography (OCT) and visual field (VF) severity indices computed by standard automated perimetry. Methods: This cross-sectional comparative study included 104 glaucomatous patients and 59 healthy subjects. Peripapillary RNFL thickness was measured by spectral domain (SD) and time domain (TD) OCTs. Four glaucoma VF severity indices, including mean deviation (MD), pattern standard deviation (PSD), Collaborative Initial Glaucoma Treatment Study (CIGTS) VF score, and Advanced Glaucoma Intervention Study (AGIS) VF score, were calculated using standard automated perimetry. The Pearson’s correlation coefficients (r) between the average and quadrants of peripapillary RNFL thicknesses and the four VF severity indices were calculated. Results: In glaucomatous eyes, the r value between the average RNFL thickness measured by SD OCT and each VF severity index were 0.562, -0.514, -0.577, and -0.567 for the MD, PSD, CIGTS VF score, and AGIS VF score, respectively (all p < 0.001). Among each quadrant, the inferior RNFL thickness showed the largest r value; 0.587, -0.552, -0.613, and -0.598 for the MD, PSD, CIGTS VF score, and AGIS VF score, respectively (all p < 0.001). Measurements by TD OCT showed similar strengths of association with SD OCT. Conclusions: Moderate correlation was identified between peripapillary RNFL thicknesses measured by SD/TD OCT and glaucoma VF severity indices. Among each quadrant, the inferior RNFL thickness showed the greatest association with glaucoma VF severity indices. There was no significant difference according to the type of VF severity index or the type of OCTs.
关键词： Glaucoma,Retinal nerve fiber layer thickness,Optical coherence tomography,Visual fields
更新于2025-09-23 15:22:29
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Comparison of Kang's and Littmann's Methods of Correction for Ocular Magnification in Circumpapillary Retinal Nerve Fiber Layer Measurement
摘要： PURPOSE. To assess and compare the accuracy of Kang’s method for ocular magnification correction in circumpapillary retinal nerve fiber layer (cpRNFL) thickness measurement with that of the currently used Littmann’s method. METHODS. A total of 148 eyes of 148 healthy participants underwent cpRNFL measurement without correction and with correction by Littmann’s method using spectral-domain optical coherence tomography. Correction of ocular magnification by Kang’s method is based on the observed uncorrected cpRNFL thickness. The accuracy of Kang’s method was compared with that of Littmann’s method for magnification correction by using the Pearson product-moment correlation coefficient (r) and Bland–Altman analysis. RESULTS. A total of 132 eyes were assessed. The two methods used to correct the global cpRNFL thickness were strongly correlated (r = 0.940, P < 0.01), and the mean difference between the two methods was -0.4 μm, with 95% limits of agreement (LoA) of –6 μm without systemic bias (P > 0.05). Although the cpRNFL thicknesses corrected with the two methods at quadrant and 12-o’clock sectors showed a strong correlation (r > 0.731, P < 0.01), high LoAs ranging from –13.3 to –27.9 and systemic biases were observed at nasal and inferior sectors. CONCLUSION. No difference was found between Kang’s and Littmann’s methods for correction of ocular magnification in global cpRNFL thickness measurement. However, with regard to magnification correction for sectoral cpRNFL thickness, further scrutiny of Kang’s method is warranted, even in healthy participants, because of the high variability between Littmann’s and Kang’s methods.
关键词： Littmann’s method,optical coherence tomography,magnification correction,circumpapillary retinal nerve fiber layer,Kang’s method
更新于2025-09-23 15:22:29
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Usefulness of peripapillary nerve fiber layer thickness assessed by optical coherence tomography as a biomarker for Alzheimer’s disease
摘要： The use of optical coherence tomography (OCT) has been suggested as a potential biomarker for Alzheimer’s Disease based on previously reported thinning of the retinal nerve fiber layer (RNFL) in Alzheimer’s disease’s (AD) and Mild Cognitive Impairment (MCI). However, other studies have not shown such results. 930 individuals (414 cognitively healthy individuals, 192 probable amnestic MCI and 324 probable AD) attending a memory clinic were consecutively included and underwent spectral domain OCT (Maestro, Topcon) examinations to assess differences in peripapillary RNFL thickness, using a design of high ecological validity. Adjustment by age, education, sex and OCT image quality was performed. We found a non-significant decrease in mean RNFL thickness as follows: control group: 100,20 ± 14,60 μm, MCI group: 98,54 ± 14,43 μm and AD group: 96,61 ± 15,27 μm. The multivariate adjusted analysis revealed no significant differences in mean overall (p = 0.352), temporal (p = 0,119), nasal (p = 0,151), superior (p = 0,435) or inferior (p = 0,825) quadrants between AD, MCI and control groups. These results do not support the usefulness of peripapillary RNFL analysis as a marker of cognitive impairment or in discriminating between cognitive groups. The analysis of other OCT measurements in other retinal areas and layers as biomarkers for AD should be tested further.
关键词： retinal nerve fiber layer,optical coherence tomography,Alzheimer’s Disease,cognitive impairment,biomarker
更新于2025-09-23 15:21:21
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Multivariate Model of the Intersubject Variability of the Retinal Nerve Fiber Layer Thickness in Healthy Subjects
摘要： We present and validate a multivariate model that partially compensates for retinal nerve fiber layer (RNFL) intersubject variability. A total of 202 healthy volunteers randomly attributed to a training (TS) and a validation (VS) sample underwent complete ophthalmic examination, including Fourier-domain optical coherence tomography (FD-OCT). We acquired FD-OCT data centered at the optic disc (OD) and the macula. Two-dimensional (2D) projection images were computed and registered, to determine the distance between fovea and OD centers (FD) and their respective angle (FA). Retinal vessels were automatically segmented in the projection images and used to calculate the circumpapillary retinal vessel density (RVD) profile. Using the TS, a multivariate model was calculated for each of 256 sectors of the RNFL, including OD ratio, orientation and area, RVD, FD, FA, age, and refractive error. Model selection was based on Akaike Information Criteria. The compensation effect was determined for 12 clock hour sectors, comparing the coefficients of variation (CoV) of measured and model-compensated RNFL thicknesses. The model then was applied to the VS, and CoV was calculated. The R value for the multivariate model was, on average 0.57 (max = 0.68). Compensation reduced the CoV on average by 18%, both for the TS and VS (up to 23% and 29%), respectively. We have developed and validated a comprehensive multivariate model that may be used to create a narrower range of normative RNFL data, which could improve diagnostic separation between early glaucoma and healthy subjects. This, however, remains to be demonstrated in future studies.
关键词： physiological biomarkers,multivariate model,retinal nerve fiber layer
更新于2025-09-23 15:21:01
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Peripapillary Retinal Nerve Fiber Layer Thickness Measured by Optical Coherence Tomography in Different Clinical Subtypes of Multiple Sclerosis
摘要： Background Multiple sclerosis (MS) is a chronic inflammatory demyelinating autoimmune disease of the central nervous system (CNS) with axonal degeneration as major determinant of neurological disability. Assessment of unmyelinated retinal nerve fibers using optical coherence tomography (OCT) may be useful for diagnosing the onset and rate of progression of neurodegeneration. Objective: To assess the incidence and severity of damage of the peripapillary retinal nerve fiber layer (RNFL) in two different MS subtypes: non-progressive [Prog(-)MS] and progressive [Prog(+)MS]. Methods 48 patients (96 eyes) with MS were included: 13 males, 35 females; aged 22-62 years (mean 38.8; SD ±10.02) in two subgroups: 26 Prog(-)MS and 22 Prog(+)MS. 3 subtypes of Prog(+)MS were identified by neurologist, according to Lublin criteria: 3 patients had PPMS (14%), 7 had SPMS(32%), 12 had PRMS(54%). RRMS subtype was considered a non-progressive phenotype, designated as Prog(-)MS. All 22 patients with progressive MS phenotypes were included in one group, designated as Prog(+)MS. Progressive disease can be defined over 1 year. The expanded EDSS score was determined by the treating MS specialist and confirmed by the study investigators through the records review. Definition included a 3-strata progression magnitude in the absence of a relapse, confirmed after 3 months within the leading Functional System and required an Expanded Disability Status Scale step ≥ 4 and pyramidal score ≥ 2. 11 Prog(-)MS (16 eyes) and 10 Prog(+)MS (13 eyes) patients had a history of optic neuritis (ON). EDSS score was 1.5-6.5 (mean 3.83±1.62) in the Prog(+)MS group and 1.0-3.5 (mean 1.40±0.57) in the Prog(-)MS. Control group: 31 healthy volunteers (3 males, 28 females), aged 20-62 years (mean 37.4 ±10.88). Peripapillary RNFL thickness was measured around the optic nerve head (ONH) using spectral-domain OCT (Topcon OCT 1000 MarkII, FastMap v. 3.40, Topcon, Japan). Scans were obtained according to OSCAR-IB consensus criteria. The generalized estimating equation model (GEE) was used in the statistical analysis to assess differences in RNFL thickness between Prog(-)MS and Prog(+)MS patients, taking into consideration history of ON, EDSS score, immunomodulatory therapy, MS progression, MS duration, age and gender. The protocol was approved by the Ethical Committee of the Medical Centre of Postgraduate Education, Warsaw, Poland and informed consent was obtained from all subjects. Results There was a significant difference between Prog(-)MS and Prog(+)MS groups for mean, nasal and superior quadrant of RNFL thickness. For individuals with a history of ON, significant differences were found between the two MS phenotypes regardless of RNFL thickness measurements. Conclusions A significant correlation was established between RNFL thickness and progression of neurodegeneration in MS patients with no regard to history of ON. RNFL thickness may be considered a MS biomarker and potential diagnostic tool for assessment of disease progression.
关键词： multiple sclerosis,spectral-domain optical coherence tomography,peripapillary retinal nerve fiber layer
更新于2025-09-23 15:21:01
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Response of the Retinal Nerve Fiber Layer Reflectance and Thickness to Optic Nerve Crush
摘要： PURPOSE. To study the effects of acute optic nerve damage on the re?ectance of the retinal nerve ?ber layer (RNFL) and to compare the time courses of changes of RNFL re?ectance and thickness. METHODS. A rat model of optic nerve crush (ONC) was compared with previously studied normal retinas. The re?ectance and thickness of the RNFL were studied at 1 to 5 weeks after ONC. Re?ectance spectra from 400 to 830 nm were measured for eyes with ONC, their contralateral untreated eyes, and eyes with sham surgery. Directional re?ectance was studied by varying the angle of incidence. RNFL thickness was measured by confocal microscopy. RESULTS. After ONC, the RNFL re?ectance remained directional. At 1 week, RNFL re?ectance decreased signi?cantly at all wavelengths (P < 0.001), whereas there was no signi?cant change in RNFL thickness (P ? 0.739). At 2 weeks, both RNFL re?ectance and thickness decreased signi?cantly, and by 5 weeks they declined to approximately 40% and 30%, respectively, of the normal values. Although RNFL re?ectance decreased at all wavelengths, there was a greater reduction at short wavelengths. Spectral shape at long wavelengths was similar to the normal. Some of these changes were also found in the contralateral untreated eyes, but none of these changes were found in eyes with sham surgery. CONCLUSIONS. Decrease of RNFL re?ectance after ONC occurs prior to thinning of the RNFL and the decrease is more prominent at short wavelengths. Direct measurement of RNFL re?ectance, especially at short wavelengths, may provide early detection of axonal damage.
关键词： optic nerve crush,optical properties,thinning of the RNFL,directional reflectance,retinal nerve fiber layer
更新于2025-09-19 17:15:36
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Comparison of optic coherence tomography results in patients with diagnosed epilepsy: Findings in favor of neurodegeneration
摘要： Background: Epilepsy is a chronic neurological disease characterized with recurrent seizures. Progressive neuronal degeneration is a common consequence of long-term and/or recurrent seizure activity in epilepsy. Optical coherence tomography (OCT) is a new medical imaging technique that displays biological tissue layers as high-resolution tomographic sections. The aim of our study was to evaluate OCT findings in patients with epilepsy and to compare OCT findings in terms of disease duration, presence of status, seizure frequency, and drug use. Methods: Forty-three patients who had epilepsy according to the Commission on Classification and Terminology of the International League Against Epilepsy (ILAE) in 2010 and 40 healthy controls were recruited for the study. Disease duration, seizure frequency, status history, and multiple drug use were noted. Retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner-plexiform layer (IPL), and choroid thinning were analyzed by using spectral OCT. Results: The mean RNFL values are 101.48 ± 11.33 in the patient group and 108.76 ± 8.37 in the control group (p = 0.001). The mean GCL thickness values in the patient and control groups are 1.14 ± 0.12 and 1.22 ± 0.05, (p < 0.001). The mean IPL thickness is 0.93 ± 0.09 in the patient group and 0.97 ± 0.05 in the control group (p = 0.02). Choroid thickness is significantly increased in the patient group (p < 0.001). Conclusions: Demonstration of RNFL, IPL, and GCL thinning might indicate neurodegeneration, and choroid thickening indicates neuroinflammation. We found no association between disease duration, seizure frequency, status history, and multiple drug use and OCT parameters. Further studies with larger patient groups should clarify the matter.
关键词： Retinal nerve fiber layer,Optic coherence tomography,Choroidal thickness,Ganglion cell layer,Epilepsy
更新于2025-09-19 17:15:36
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Automatic Computer-Aided Diagnosis of Retinal Nerve Fiber Layer Defects Using Fundus Photographs in Optic Neuropathy
摘要： PURPOSE. To evaluate the validity of an automatic computer-aided diagnosis (CAD) system for detection of retinal nerve fiber layer (RNFL) defects on fundus photographs of glaucomatous and nonglaucomatous optic neuropathy. METHODS. We have proposed an automatic detection method for RNFL defects on fundus photographs in various cases of glaucomatous and nonglaucomatous optic neuropathy. In order to detect the vertical dark bands as candidate RNFL defects, the nonuniform illumination of the fundus image was corrected, the blood vessels were removed, and the images were converted to polar coordinates with the center of the optic disc. False positives (FPs) were reduced by using knowledge-based rules. The sensitivity and FP rates for all images were calculated. RESULTS. We tested 98 fundus photographs with 140 RNFL defects and 100 fundus photographs of healthy normal subjects. The proposed method achieved a sensitivity of 90% and a 0.67 FP rate per image and worked well with RNFL defects with variable depths and widths, with uniformly high detection rates regardless of the angular widths of the RNFL defects. The average detection accuracy was approximately 0.94. The overall diagnostic accuracy of the proposed algorithm for detecting RNFL defects among 98 patients and 100 healthy individuals was 86% sensitivity and 75% specificity. CONCLUSIONS. The proposed CAD system successfully detected RNFL defects in optic neuropathies. Thus, the proposed algorithm is useful for the detection of RNFL defects.
关键词： computer-aided diagnosis,glaucoma,optic neuropathy,fundus photographs,retinal nerve fiber layer
更新于2025-09-19 17:15:36
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Diffuse Retinal Nerve Fiber Layer Defects Identification and Quantification in Thickness Maps
摘要： PURPOSE. To report retinal nerve fiber layer (RNFL) defect identification and quantification in RNFL thickness maps according to the structural RNFL loss, and to evaluate diffuse RNFL defects. METHODS. A total of 170 patients with glaucoma and 186 normal subjects were consecutively enrolled. We defined RNFL defects in an RNFL thickness map by the degree of RNFL loss. The reference level for RNFL defect determination was set as a 20% to 70% degree of RNFL loss with a 1% interval. To identify RNFL defects, each individual RNFL thickness map was compared to the normative database map by using MATLAB software, and the region below the reference level was detected. The area, volume, location, and angular width of each RNFL defect were measured. Diffuse RNFL defects were defined as having an angular width > 30°. RESULTS. The optimal reference level for glaucomatous RNFL defects identification was 42% loss of RNFL. Retinal nerve fiber layer defects were identified in all (100%) of the 170 glaucoma patients and false-positive RNFL defects were detected in 16 (8.16%) cases among the 186 normal subjects. In all, 64.1% of glaucoma patients had diffuse RNFL defects, and 47.7% of diffuse RNFL defects were associated with mild glaucoma patients. The volume of diffuse RNFL defects was significantly associated with the severity of glaucomatous damage (P = 0.009). Diffuse RNFL defects were located closer to the center of the optic disc than localized RNFL defects (P < 0.001). CONCLUSIONS. Retinal nerve fiber layer thickness map analysis is an effective method for analyzing RNFL defects. Quantitative measurements (area, volume, location, and width) were useful to understanding diffuse RNFL defects.
关键词： OCT,diffuse RNFL defect,RNFL thickness map,retinal nerve fiber layer
更新于2025-09-19 17:15:36