Quantitative analysis of the optic nerve head parameters in patients with age-related macular degeneration

Purpose. To determine the characteristics of anatomical retinal changes and of the choroidal blood flow in patients with combined pathology: age-related macular degeneration (AMD) and primary open-angle glaucoma (POAG). Materials and methods. We investigated two study groups (SG): SG1 - AMD in association with POAG, 113 patients; SG2 - AMD without glaucomatous nerve damage , 92 patients; mean age - 71.9 ± 9.3 years. Measurements of the neuro-sensory retina (NSR) thickness and of the ganglion cells complex (GCC) thickness by optical coherence tomography (OCT) in manual regimen (42 eyes in SG1, 38 eyes in SG2) and the estimation of choroidal blood flow (HBF) by ultrasonography (18 eyes in SG1, 38 eyes in SG2) were performed in two areas: area I - 4 mm laterally to the optic nerve head; area II - 4 mm medially to the optic nerve head. Results. The GCC thickness in patients with combined pathology (SG1) was significantly lower than in patients with AMD (IG2) in the areas I and II; the thickness index of the GCC was significantly reduced in SG1 in areas I and II, whereas in SG2 this index was increased. Significant differences of HBF in areas I and II in SG1 were found, as well as reduced peak systolic flow velocity, the time-averaged maximum velocity of blood flow, maximum end-diastolic flow velocity, as compared with SG2. The index of peripheral resistance was reduced in SG1 in area I and increased in area II, whereas in SG2 it was increased in area I and reduced in area II. Conclusion. In patients with combined pathology - AMD and POAG - NSR thickness was reduced due to the thinning of the ganglion cell layer and the formation of an ischemic pattern of choroidal blood flow in the macula and medially to the optic nerve head.

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Parapapillary atrophy in optic neuropathies: Histology and clinical relevance

European Journal of Ophthalmology ◽

10.1177/11206721211060655 ◽

2021 ◽

pp. 112067212110606

Author(s):

Ana Banc ◽

Stefania Bianchi Marzoli

Keyword(s):

Optic Nerve ◽

Optic Neuropathy ◽

Optic Nerve Head ◽

Clinical Findings ◽

Age Related Macular Degeneration ◽

Glaucomatous Optic Neuropathy ◽

Age Related ◽

High Resolution Images ◽

Parapapillary Atrophy ◽

Optic Nerve Disorders

Parapapillary atrophy is one of the parameters of the optic nerve head area which are assessed during the ophthalmoscopic examination particularly useful to characterize glaucomatous optic neuropathy. Optical coherence tomography evaluation provides high-resolution images of the optic nerve head and surrounding area, and can be used to study parapapillary atrophy. Different parapapillary atrophy zones were described depending on their histological features and research has been conducted to investigate the possible association between the presence and/ or size of parapapillary atrophy zones and several optic nerve disorders. In this review we discuss the histology and the clinical findings related to parapapillary atrophy in patients with glaucomatous optic neuropathy, non-glaucomatous optic neuropathies (e.g. arteritic and non-arteritic anterior ischemic optic neuropathies; suprasellar and parasellar tumors), and other ocular conditions (e.g. high myopia; age-related macular degeneration). Two different histologic classifications were identified. Parapapillary atrophy was demonstrated in glaucoma and glaucoma-like neuropathies, but not in other types of optic nerve disorders.

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