The relationship between retinal nerve fibre layer thickness profiles and CorvisST tonometry measured biomechanical properties in young healthy subjects

Background/aimsTo assess the impact of papillary leakage and active inflammation on optical coherence tomography (OCT)-based retinal nerve fibre layer thickness (RNFLT) and Bruch’s membrane opening minimum rim width (BMO-MRW) measurements in uveitic eyes with and without secondary glaucoma.MethodsProspective, single-centre analysis of patients with uveitis. All patients included received a fluorescein angiography examination and an OCT scan measuring the BMO-MRW and the RNFLT in three concentric peripapillary ring scans.ResultsOverall, 95 eyes of 56 patients were enrolled. Papillary leakage and active inflammation were present in 39 (41%) and 57 (60%) eyes, respectively. Twenty-one eyes were classified as glaucomatous; 10 of those glaucomatous eyes showed papillary leakage. Both BMO-MRW and RNFLT measurements were significantly increased in eyes with papillary leakage (BMO-MRW: p=0.0001; RNFLT: first to third ring (p<0.0001)). Active inflammation led to a significantly thickened RNFLT (first ring: p=0.0026; second ring: p=0.0009; third ring: p=0.0002) while only a trend towards increased values could be observed in the BMO-MRW measurements (p=0.3063). Glaucomatous eyes with papillary leakage demonstrated significantly higher values on both BMO-MRW and RNFLT measurements than glaucomatous eyes without leakage (BMO-MRW: p=0.0159; RNFLT: first ring: p=0.0062; second ring: p=0.0037; third ring: p=0.0197). No significant difference could be observed between glaucomatous eyes with leakage and non-glaucomatous eyes without leakage (BMO-MRW: p=0.4132; RNFLT: first ring: p=0.5412; second ring: p=0.3208; third ring: p=0.1164).ConclusionsThe OCT scanning parameters BMO-MRW and RNFLT were significantly influenced by papillary leakage in uveitic eyes with and without glaucoma. RNFLT values were also significantly increased while active inflammation was present. In patients with uveitis, these OCT-based imaging tools should be interpreted with caution, especially in those with papillary leakage or active inflammation.

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Evaluation of retinal nerve fibre layer thickness as a possible measure of diabetic retinal neurodegeneration in the EPIC-Norfolk Eye Study

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2021-319853 ◽

2021 ◽

pp. bjophthalmol-2021-319853

Author(s):

Sidra Zafar ◽

Kristen A Staggers ◽

Jie Gao ◽

Yao Liu ◽

Praveen J Patel ◽

...

Keyword(s):

Nerve Fibre ◽

Structural Changes ◽

Retinal Nerve Fibre Layer ◽

Diabetes Diagnosis ◽

Fibre Layer ◽

Diabetes Status ◽

Retinal Neurodegeneration ◽

Nerve Fibre Layer ◽

Diabetic Retinal Neurodegeneration ◽

The Relationship

Background/aimsMarkers to clinically evaluate structural changes from diabetic retinal neurodegeneration (DRN) have not yet been established. To study the potential role of peripapillary retinal nerve fibre layer (pRNFL) thickness as a marker for DRN, we evaluated the relationship between diabetes, as well as glycaemic control irrespective of diabetes status and pRNFL thickness.MethodsLeveraging data from a population-based cohort, we used general linear mixed models (GLMMs) with a random intercept for patient and eye to assess the association between pRNFL thickness (measured using GDx) and demographic, systemic and ocular parameters after adjusting for typical scan score. GLMMs were also used to determine: (1) the relationship between: (A) glycated haemoglobin (HbA1c) irrespective of diabetes diagnosis and pRNFL thickness, (B) diabetes and pRNFL thickness and (2) which quadrants of pRNFL may be affected in participants with diabetes and in relation to HbA1c.Results7076 participants were included. After controlling for covariates, inferior pRNFL thickness was 0.94 µm lower (95% CI −1.28 µm to −0.60 µm), superior pRNFL thickness was 0.83 µm lower (95% CI −1.17 µm to −0.49 µm) and temporal pRNFL thickness was 1.33 µm higher (95% CI 0.99 µm to 1.67 µm) per unit increase in HbA1c. Nasal pRNFL thickness was not significantly associated with HbA1c (p=0.23). Similar trends were noted when diabetes was used as the predictor.ConclusionSuperior and inferior pRNFL was significantly thinner among those with higher HbA1c levels and/or diabetes, representing areas of the pRNFL that may be most affected by diabetes.

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