Retinal Layers Changes in Human Preclinical and Early Clinical Diabetic Retinopathy Support Early Retinal Neuronal and Müller Cells Alterations

Purpose. To evaluate the changes in thickness of individual inner and outer macular and peripapillary retinal layers in diabetes.Methods. 124 subjects (124 eyes) were enrolled: 74 diabetics and 50 controls. Macular edema, proliferative diabetic retinopathy (DR), any intraocular treatment and refractive error>6diopters were the main exclusion criteria. Full ophthalmic examination, stereoscopic fundus photography, and spectral domain-OCT were performed. After automatic retinal segmentation (layering) in 5 layers, the thickness of each layer was calculated, and values compared among groups.Results. Thirty patients had no DR, 44 patients had non proliferative DR. A significant increase of inner plexiform and nuclear layers was found in DR eyes versus controls (P<0.001). A significant decrease (P<0.01) of retinal nerve fiber layer (RNFL) and at specific sites of retinal ganglion cell layer (P=0.02) was documented in the macula. In the peripapillary area there were no differences between diabetics and controls.Conclusions. Decreased RNFL thickness and increased INL/OPL thickness in diabetics without DR or with initial DR suggest early alterations in the inner retina. On the contrary, the outer retina seems not to be affected at early stages of DM. Automatic intraretinal layering by SD-OCT may be a useful tool to diagnose and monitor early intraretinal changes in DR.

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Retinal Postphotoreceptor Layers and Macular Electroretinogram in Retinitis Pigmentosa

Ophthalmology in Russia ◽

10.18008/1816-5095-2020-1-81-87 ◽

2020 ◽

Vol 17 (1) ◽

pp. 81-87 ◽

Cited By ~ 1

Author(s):

I. V. Zolnikova ◽

S. V. Milash ◽

A. B. Chernyak ◽

D. V. Levina ◽

I. V. Egorova ◽

...

Keyword(s):

Retinitis Pigmentosa ◽

Structural Changes ◽

Automatic Segmentation ◽

Fundus Photography ◽

Bioelectrical Activity ◽

Ophthalmological Examination ◽

Fiber Layer ◽

Retinal Layers ◽

Electrophysiological Studies ◽

Sd Oct

Purpose: to assess the inner retinal layer’s changes of the central retina in comparison with bioelectrical activity of macula assessed by MERG and with thickness of photoreceptor retinal layers in patients with retinitis pigmentosa.Patients and methods: 10 patients (20 phakic eyes) with RP were examined. Mean age was 27.0 ± 18.5 years. Mean best corrected visual acuity was 0.38 ± 0.22. The fundus photography electrophysiological studies were performed besides standard ophthalmological examination. Maximal electroretinogram (ERG) or cone-rod response, ERG to 30 Hz flicker and macular ERG were registered with electroretinograph MBN (Russia). Images were acquired using the protocol of scanning Macula radial (12 lines 9 mm long, each radial image is the average out of 50 scans) with settings ultrafine with automatic segmentation of the retina and calculation thickness. Retinal segmentation with the following calculation of different retinal layers was performed on SD-OCT RS-3000 Advance (Nidek, Japan) with obtainment of the map with 6 mm in diameter in accordance with the Early Treatment Diabetic Retinopathy Study (ETDRS).Results. We revealed increased thickness of retinal nerve fiber layer (RNFL), decrease of thickness of ganglion cell layer (GCL) (p < 0,05) and normal (p > 0,05) inner nuclear layer (INL) thickness. These structural changes are associated with the decrease of bioelectric macula’s activity measured by MERG (decrease of α- and β-wave amplitude) and decrease the thickness of photoreceptor layers in all zones according to EDTRS.Conclusion. Increase of thickness RNFL, decrease of GCL’s thickness and normal INL in patients with RP is associated with decrease of thickness of photoreceptor layers in EDTRS zones and decrease of amplitude of MERG.

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Age-Related Physiologic Thinning Rate of the Retinal Nerve Fiber Layer in Different Levels of Myopia

Journal of Ophthalmology ◽

10.1155/2020/1873581 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Daun Jeong ◽

Kyung Rim Sung ◽

Youn Hye Jo ◽

Sung-cheol Yun

Keyword(s):

Nerve Fiber ◽

Retinal Nerve Fiber Layer ◽

Refractive Error ◽

Fiber Layer ◽

Nerve Fiber Layer ◽

Rnfl Thickness ◽

Significant Difference ◽

Thinning Rate ◽

Sd Oct ◽

Retinal Nerve Fiber

Purpose. To investigate the effect of refractive error on the physiologic thinning rate of the retinal nerve fiber layer (RNFL) in healthy eyes. Materials and Methods. This study analyzed 223 eyes of 141 healthy subjects followed for more than 5 years and underwent at least five serial spectral domain optical coherence tomography (SD-OCT) examinations. Longitudinal RNFL measurements were analyzed by linear mixed models incorporating follow-up duration, baseline RNFL thickness, spherical equivalent (SE), age, intraocular pressure, and visual field mean deviation. Thinning rates were classified according to SE into three groups: nonmyopic (NM; >0 D), mild-to-moderately myopic (MM; >–6 D and ≤0 D), and highly myopic (HM; ≤–6 D). Results. The overall slopes of change in RNFL thickness over time in the NM, MM, and HM groups were −0.305 ± 0.128, −0.294 ± 0.068, and −0.208 ± 0.097 μm/yr, respectively. Slopes of RNFL thickness changes in these groups were −0.514 ± 0.248, −0.520 ± 0.133, and −0.528 ± 0.188 μm/yr, in the superior quadrant; −0.084 ± 0.145, 0.107 ± 0.082, and −0.161 ± 0.112 μm/yr, in the temporal quadrant; −0.807 ± 0.242, −0.794 ± 0.130, and −0.727 ± 0.183 μm/yr, in the inferior quadrant; and 0.160 ± 0.157, 0.118 ± 0.084, and 0.429 ± 0.119 μm/yr, in the nasal quadrant. Overall and in all four quadrants, there was no significant difference in the rate of RNFL thickness change among the three groups. Conclusions. Refractive error did not affect the physiologic thinning rate of RNFL when assessed by SD OCT.

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Retinal Nerve Fiber Layer Imaging with Spectral-domain Optical Coherence Tomography (OCT)—A Review of the Cirrus HD-OCT

US Ophthalmic Review ◽

10.17925/usor.2011.04.01.12 ◽

2011 ◽

Vol 04 (01) ◽

pp. 12 ◽

Cited By ~ 1

Author(s):

Elaine To ◽

Dennis Lam ◽

Christopher Kai-shun Leung ◽

◽

...

Keyword(s):

Optical Coherence Tomography ◽

Nerve Fiber ◽

Retinal Nerve Fiber Layer ◽

Spectral Domain ◽

Optical Coherence ◽

Fiber Layer ◽

Nerve Fiber Layer ◽

Spectral Domain Oct ◽

Rnfl Thickness ◽

Retinal Nerve Fiber

High-speed, high-resolution imaging of the retinal nerve fiber layer (RNFL) with spectral-domain optical coherence tomography (OCT) has become an essential tool for evaluation of glaucoma. The Cirrus HD-OCT (Carl Zeiss Meditec, Inc. Dublin, CA) is a spectral-domain OCT that provides visualization of the distribution pattern and measurement of RNFL abnormalities in a 6x6mm2optic disc region. Analysis of the RNFL thickness deviation map—a color-coded map displaying areas of RNFL abnormalities—detects glaucoma with high sensitivity and specificity. Trend analysis of average and sectorial RNFL thicknesses, and event analysis of the RNFL thickness maps and the RNFL thickness profiles can be used to detect and follow diffuse and focal RNFL progression. RNFL measurement with spectral-domain OCT could provide important information for use in formulating treatment plans and evaluating disease prognosis in the management of glaucoma.

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Association between risk factors and retinal nerve fiber layer loss in early stages of diabetic retinopathy

International Journal of Ophthalmology ◽

10.18240/ijo.2021.02.12 ◽

2021 ◽

Vol 14 (2) ◽

pp. 255-262

Author(s):

Zhong-Qi Wan ◽

◽

Min Cui ◽

Yong-Jie Zhang ◽

◽

...

Keyword(s):

Risk Factors ◽

Diabetic Retinopathy ◽

Nerve Fiber ◽

Systolic Pressure ◽

Control Group ◽

Diabetic Patients ◽

Fiber Layer ◽

Rnfl Thickness ◽

Normal Individuals ◽

The Right

AIM: To investigate the changes of retinal nerve fiber layer (RNFL) among normal individuals, diabetic patients without diabetic retinopathy (NDR) and non-proliferative diabetic retinopathy (NPDR), and explore the possible risk factors of early diabetic retinopathy (DR). METHODS: In this cross-sectional study, 107 participants were divided in three groups. Totally 31 normal individuals (control group), 40 diabetic patients without DR (NDR group) and 36 patients with NPDR (NPDR group) were included. Optical coherence tomography (OCT) was used to detect RNFL thickness and other optic disc parameters among different groups. The potential association between RNFL loss and systemic risk factors were assessed for DR, including diabetes duration, body mass index (BMI), hemoglobin A1c (HbA1c), serum lipids, and blood pressure. RESULTS: The average and each quadrant RNFL thickness were thinner in NPDR group compared to control group of the right (P=0.00, P=0.01, P=0.01, P=0.02, P=0.04) and left eyes (P=0.00, P=0.00, P=0.00, P=0.03, P=0.04). The average, superior and inferior RNFL thickness were thinner in NDR group compared to the NPDR group of the right (P=0.00, P=0.02, P=0.03) and left eyes (P=0.00, P=0.00, P=0.01). Diabetic duration was negatively correlated with the superior, inferior, and average RNFL thickness of the right (r=-0.385, P=0.001; r=-0.366, P=0.001; r=-0.503, P=0.000) and left eyes (r=-0.271, P=0.018; r=0.278, P=0.015; r=-0.260, P=0.023). HbA1c was negatively correlated with the superior, inferior, and average RNFL thickness of the right (r=-0.316 P=0.005; r=-0.414, P=0.000; r=-0.418, P=0.000) and left eyes (r= -0.367, P=0.001; r=-0.250, P=0.030; r=-0.393, P=0.000). Systolic pressure was negatively correlated with the inferior and average RNFL thickness of the right eye (r=-0.402, P=0.000; r=-0.371, P=0.001) and was negatively correlated with the superior and average RNFL thickness of the left eye (r=-0.264, P=0.021; r=-0.233, P=0.043). CONCLUSION: RNFL loss, especially in the superior and inferior quadrants, may be the earliest structural change of the retina in diabetic patients, and is also associated with diabetic duration, HbA1c, and systolic pressure.

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High-Resolution SD-OCT and EDI-OCT in the Evaluation and Management of Multifocal Serpiginoed Choroditis

Journal of Ophthalmic Science ◽

10.14302/issn.2470-0436.jos-19-2480 ◽

2019 ◽

Vol 2 (2) ◽

pp. 1-10

Author(s):

Eman Abo Taleb ◽

Manish P. Nagpal ◽

Navneet S. Mehrotra

Keyword(s):

High Resolution ◽

Outer Segment ◽

Retinal Pigment ◽

Response To Therapy ◽

Fundus Photography ◽

Depth Image ◽

Ultrastructural Changes ◽

Vitreoretinal Interface ◽

Retinal Layers ◽

Sd Oct

Purpose To describe spectral domain optical coherence tomography (SD-OCT) and enhanced depth image OCT (EDI-OCT) findings of multifocal serpiginoid choroditis (MSC) , including affected layer of retinal involvement, changes at the vitreoretinal interface, and response to therapy. Methods A retrospective review of 20 eyes (14 patients) with MSC. Each patient underwent a complete ophthalmologic examination, fundus photography, fundus autoflorecence (FAF) and OCT imaging of the affected retina at the initial visit and on each follow-up. Results In acute stage, SD-OCT showed hyperreflective areas involving the outer retinal layers which include retinal pigment epithelium (RPE), photoreceptor outer segment tips (POST), inner segment–outer segment (IS/OS) junction, external limiting membrane (ELM), and outer nuclear layer (ONL) with choroidal and intraretinal layer cells infiltrate. EDI-OCT showed increase choroidal thickness. As the lesions began to heal, irregular, knobby elevations of outer retinal layers appeared (RPE, POST, IS/OS junction, and ELM could not be distinguished) with significant decrease in choroidal and intraretinal cells. On complete healing, loss of RPE, POST, IS/OS junction, and ELM in SD-OCT scan and absent of the choroidal and intraretinal cells and continous hyperreflactivity of the choroid (increased penetrance). Conclusion SD-OCT and EDI-OCT provides high-resolution detail regarding ultrastructural changes in vitreoretinal interface, outer retina and choroid during the course of the lesion. Serial SD-OCT and EDI-OCT also provides further insight into response to therapy by observing choroidal and intraretinal cells.

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Relationship Between HbA1c Level with Retinal Nerve Fiber Layer Thickness in Diabetic Retinopathy

Sriwijaya Journal of Ophthalmology ◽

10.37275/sjo.v2i2.34 ◽

2019 ◽

Vol 2 (2) ◽

pp. 11-21

Author(s):

Febrina Art ◽

AK Ansyori ◽

Ramzi Amin

Keyword(s):

Diabetic Retinopathy ◽

Nerve Fiber ◽

Layer Thickness ◽

Retinal Nerve Fiber Layer ◽

Significant Relationship ◽

Hba1c Level ◽

Fiber Layer ◽

Nerve Fiber Layer ◽

Nerve Fiber Layer Thickness ◽

Rnfl Thickness

Abstract Background: Diabetes mellitus (DM) have a direct effect to retinal neural tissue. Diabetic retinopathy slowly proggress with reserved visual acuity and no symptoms in early stage. Retinal nerve fiber layer thickness significantly decrease in type 2 diabetes mellitus patients related to glycemic blood level. Purpose: To analyze the relationship between HbA1c level and retinal nerve fiber layer thickness in diabetic retinopathy patients. Methods: A cross sectional analytical study was conducted in RSUP dr. Mohammad Hoesin Palembang from October 2017 until March 2018. Sixty eight type 2 diabetes mellitus patients consist of various grade of diabetic retinopathy. Measurement of HbA1c level was performed on these samples and retinal nerve fiber layer thickness was measured by Optical Coherence Tomography (OCT). Results: There is a significant relationship between duration of DM with RNFL thickness (p = 0,002). There is a significant relationship between hypertension with RNFL thickness (p = 0,007). There is a significant relationship between HbA1c level with RNFL thickness in all quadrants (superior, nasal, inferior quadrants p = 0,000, temporal quadrant p = 0,011). The most important factor of RNFL thinning in superior, nasal and inferior quadrants is HbA1c level (superior and nasal adjusted p value 0,002, inferior adjusted p value 0,002) while in temporal quadrant is hypertension (adjusted p value 0,042). Conclusion: There is a significant relationship between HbA1c level with RNFL thickness in all quadrants in which the patients with HbA1c > 7% have a higher risk of thinner RNFL compared to patients with HbA1c ≤ 7%.

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A Study of Retinal Nerve Fiber Layer Thickness by using Spectral Domain Optical Coherence Tomography in Older Adults with Diabetes Mellitus

10.35262/jiag.v15i1.17-21 ◽

2019 ◽

Vol 15 (1) ◽

pp. 17-21

Author(s):

Devendra Sharma ◽

Arvind Chauhan ◽

Avisha Mathur

Keyword(s):

Optical Coherence Tomography ◽

Diabetic Retinopathy ◽

Nerve Fiber ◽

Retinal Nerve Fiber Layer ◽

Macular Thickness ◽

Spectral Domain ◽

Diabetic Patients ◽

Optical Coherence ◽

Fiber Layer ◽

Rnfl Thickness

Introduction: Peripapillary retinal nerve fiber layer (RNFL) thinning occurs in the diabetic patients earlier than the detectable diabetic retinopathy. We conducted this study to evaluate the RNFL thickness and macular thickness in elderly diabetic patients using optical coherence tomography in comparison to healthy controls. Material and methods: One fifty study participants were divided in 3 groups (50 each): normal subjects, patients with diabetes with no detectable diabetic retinopathy (NDR) and patients with diabetic retinopathy (DR) of differing severity. The RNFL thickness and macular thickness was measured using spectral-domain optical coherence tomography (SD OCT). Results: The RNFL thickness around the optic disc differed significantly among all the 3 groups and tended to become thinner as the patient develops DR in elderly subjects. The mean, superior-temporal and upper nasal peripapillary RNFL thickness differed among all the 3 groups. We observed that, mean superior, temporal, inferior and nasal RNFL tended to be thinner as the patient develops DR. Conclusion: The RNFL thickness, macular thickness and ganglion cell complex thinning differed significantly between the healthy group and diabetic group without clinical DR. The RNFL thinning (measured by Spectral-domain OCT) is an early neurodegenerative ocular change in diabetic patients even before onset of diabetic retinopathy.

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COMPARATIVE STUDY OF RNFL THICKNESS USING SPECTRAL DOMAIN OCT AND VISUAL FIELD ANALYSIS USING HUMPHREY FIELD ANALYSER IN CASES OF POAG

10.36106/ijar/2704711 ◽

2021 ◽

pp. 62-64

Author(s):

Samra Wahaj Fatima ◽

M M M Baig ◽

Superna Mahender ◽

M. Geetanjali ◽

Mohammed Ather

Keyword(s):

Comparative Study ◽

Field Analysis ◽

Spectral Domain ◽

Automated Perimetry ◽

Care Hospital ◽

Slit Lamp ◽

Spectral Domain Oct ◽

Rnfl Thickness ◽

Field Analyser ◽

Sd Oct

Purpose: To compare RNLF structural changes by Spectral Domain- OCT and functional visual eld defects by automated perimetry in Primary Open Angle Glaucoma cases Materials And Methods: A prospective and comparative study was conducted to quantitatively measure the peripapillary retinal nerve ber layer thickness using SD-OCT and compared it with eld changes plotted by Humphrey Field analyser 24-2. The study was conducted at the department of Glaucoma of a tertiary eye care hospital for a period of one year. 60 eyes of 30 patients who diagnosed to have POAG between the age group of 40-65 were included in the study. Patients having substantial media opacity, Retinal pathology and who underwent intra ocular surgeries were excluded from the study. Informed consent obtained from patients who were included in the study. All were examined using Slit lamp, Snellen's chart, Applanation tonometer, Gonioscope, 90 D slit lamp biomicroscope to study Fundus oculi. Fields were plotted using Humphrey eld analyser 24-2 , RNFL thickness measured using SD-OCT. Results: 60 eyes of 30 patients 19 were males 11 were females. 14(23.33%) eyes showed normal visual elds but there was thinning of RNFL was noted in SD-OCT. 41 eyes (68.3%) had visual eld defects which corresponded to thinning of RNFL in that quadrant. 5 eyes (8.3%) showed advanced eld changes and had corresponding thinning of RNFL in that quadrant. Discussion: Results of this study shows a signicant difference in RNFL thickness among all three grades of glaucoma. It was observed that the average RNFL thickness value in moderate glaucoma (66.34 microns) and all quadrant thickness values were similar to Sihota et al study (RNFL-66.07 microns). The mean RNFL thickness +/- Sd (58 +/-5.52) in advanced glaucoma of present study were closely similar with the ndings of Sihota et al study (53.65 +/-14.2). Conclusion: It is concluded that RNFL thickness changes corresponds to Field changes plotted on Humphrey eld analyser in moderate glaucoma. Even in mild cases changes RNFL thickness is noted even though the elds plotted on Humphrey eld analyser doesn't show any changes. So RNFL thickness can be taken as Pre perimetric changes as diagnostic criteria for the diagnosis of POAG.

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Ability of Swept-Source Optical Coherence Tomography to Detect Retinal and Choroidal Changes in Patients with Multiple Sclerosis

Journal of Ophthalmology ◽

10.1155/2018/7361212 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Elena Garcia-Martin ◽

Laura Jarauta ◽

Elisa Vilades ◽

Jose Ramon Ara ◽

Jesus Martin ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Choroidal Thickness ◽

Optical Coherence ◽

Retinal Ganglion ◽

Fiber Layer ◽

Swept Source ◽

Rnfl Thickness ◽

Depth Analysis ◽

Retinal Thinning

Purpose. To evaluate the ability of new swept-source (SS) optical coherence tomography (OCT) technology to detect changes in retinal and choroidal thickness in patients with multiple sclerosis (MS). Methods. A total of 101 healthy and 97 MS eyes underwent retinal and choroidal assessment using SS Triton OCT (Topcon). Macular thickness and peripapillary data (retinal, ganglion cell layer (GCL+, GCL++) and retinal nerve fiber layer (RNFL) thickness) were analyzed, including choroidal thickness evaluation. Results. Significant macular thinning was observed in all ETDRS areas (p<0.001) in MS patients. Peripapillary retinal, RNFL, and GCL ++ thickness showed a significant reduction in patients in all sectors (p<0.001) except in the nasal quadrant/sector (p>0.05). GCL+ measurements were found to be reduced in the nasal (p=0.003), inferonasal (p=0.045), and temporal (p=0.001) sectors and total thickness (p<0.001). Choroidal thickness was reduced in the outer macular ring in MS patients compared with controls (p=0.038). Conclusion. New swept-source technology for OCT devices detects retinal thinning in MS patients, providing increased depth analysis of the choroid in these patients. MS patients present reduced retinal and choroidal thickness in the macular area and reduced peripapillary retinal, RNFL, and GCL thickness.

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Utility of Bruch membrane opening-based optic nerve head parameters in myopic subjects

European Journal of Ophthalmology ◽

10.5301/ejo.5001022 ◽

2017 ◽

Vol 28 (1) ◽

pp. 42-46 ◽

Cited By ~ 7

Author(s):

Marina Sastre-Ibañez ◽

Jose M. Martinez-de-la-Casa ◽

Gema Rebolleda ◽

Pilar Cifuentes-Canorea ◽

Maria Nieves-Moreno ◽

...

Keyword(s):

Cross Sectional Study ◽

Refractive Errors ◽

Sectional Study ◽

Analysis Software ◽

Fiber Layer ◽

Cross Sectional ◽

Neuroretinal Rim ◽

Rnfl Thickness ◽

Ring Analysis ◽

Sd Oct

Purpose: To evaluate whether the new rim analysis software with spectral-domain optical coherence tomography (SD-OCT) shows advantages over the retinal nerve fiber layer (RNFL) thickness in patients with moderate myopia. Methods: In this prospective cross-sectional study, we studied 65 healthy subjects, 37 with spherical refractive errors in the range of -3 to -6 D (moderate, G1) and 28 with less than -3 D (low/non-myopic, G0). All patients were examined with Heidelberg Spectralis SD-OCT, including Glaucoma Premium Module Edition (GPME) software. With GPME, we analyzed the neuroretinal rim (Bruch membrane opening-minimum rim width [BMO-MRW]) and RNFL. Results: The average age of subjects was 30.2 ± 9.3 years for G0 and 29.9 ± 7.1 years for G1 (p = 0.903). Mean sphere was −0.5 ± 0.3 D (-1.25 to 0 D) G0 and -3.9 ± 0.3 D (-6.00 to -3 D) G1 (p<0.001). The RNFL thickness comparison between G0 and G1 showed a significantly lower thickness in G1 (p = 0.018). The BMO-MRW measurements were similar in both groups (p = 0.331). With the BMO-MRW examination, the number of sectors classified as pathologic per subject in G1 were significantly lower compared to RNFL analysis (p = 0.023). Conclusions: Ring analysis based on BMO-MRW measurements shows a lower rate of false-positives compared to RNFL thickness when studying healthy moderate myopic eyes and it would be advisable to take this into consideration when analyzing these patients.

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