Changes in Optic Nerve Parameter Measurements on Spectral-Domain Optical Coherence Tomography, after Cataract Surgery

Kyung Sik Lee; Yong Min Kim; Ji Hyun Kim; Ji Min Ahn; Woo Suk Chung; Jung Bum Choi; Kyoung Soo Park

doi:10.3341/jkos.2013.54.10.1573

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Lee, Kim, Kim, Ahn, Chung, Choi, and Park: Changes in Optic Nerve Parameter Measurements on Spectral-Domain Optical Coherence Tomography, after Cataract Surgery

Original Article

J Korean Ophthalmol Soc 2013;54(10):1573-1580.

Published online: 3 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.10.1573

Changes in Optic Nerve Parameter Measurements on Spectral-Domain Optical Coherence Tomography, after Cataract Surgery

Kyung Sik Lee, MD¹, Yong Min Kim, MD², Ji Hyun Kim, MD², Ji Min Ahn, MD², Woo Suk Chung, MD², Jung Bum Choi, MD², Kyoung Soo Park, MD²

¹Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

²Siloam Eye Hospital, Seoul, Korea

Address reprint requests to Kyoung Soo Park, MD, Siloam Eye Hospital, #181 Deungchon-ro, Gangseo-gu, Seoul 157-836, Korea, Tel: 82-2-2650-0880, Fax: 82-2-2650-0895, E-mail: march789@siloam.co.kr

Received 8 February 2013 Revised 16 May 2013 Accepted 5 August 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To assess changes in peripapillary retinal nerve fiber layer (RNFL) thickness and optic nerve head parameters after cataract surgery by using spectral-domain optical coherence tomography (OCT).

Methods

Twenty-nine eyes of 26 patients, who underwent cataract surgery, were imaged with spectral-domain OCT before and after surgery to measure peripapillary RNFL thickness and optic nerve head parameters, signal strength (SS), quadrant, 12 clock-hour RNFL thickness, rim area, disc area, cup/disc area ratio, vertical cup/disc ratio, and cup volume.

Results

The postoperative RNFL thickness and SS were higher than before surgery (p < 0.05). Regarding optic nerve head parameters, rim area was 0.07 ± 0.10 mm² higher than before surgery and disc area, cup/disc area ratio, vertical cup/disc ratio, cup volume were 0.07 ± 0.15 mm², 0.04 ± 0.04, 0.03 ± 0.05, 0.04 ± 0.06 mm³, respectively, lower than before surgery (p < 0.05).

Conclusions

Cataracts may decrease peripapillary RNFL thickness measurement and SS on OCT scans and change other optic nerve head parameters. Peripapillary RNFL thickness and optic nerve head parameter measurements should be interpreted with caution in eyes with significant cataracts.

Keywords: Cataract surgery, Optical coherence tomography, Optic nerve

References

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Table 1.

Clinical characteristics of patients

	Cirrus HD-OCT, Zeiss
Numbers (eyes : patients)	29 : 26
Age (years)	68.55 ± 9.24
Sex (male : female)	10 : 16
Eye (right : left : both)	10 : 13 : 3
Preoperative SE (diopter)	1.04 ± 1.18
Preoperative BCVA (log MAR)	0.33 ± 0.29
Preoperative IOP (mm Hg)	12.62 ± 3.02
Types of lens opacities (cortical : nuclear : posterior)	24 : 3 : 2
Types of Intraocular lens (BioVue4PAL® : Teklens II^®)	20 : 9
Follow up (days)	31.48 ± 12.95

Values are presented as mean ± SD.

SD = standard deviation; SE = spherical equivalent; BCVA = best corrected visual acuity; IOP = intraocular pressure.

Table 2.

Comparison of RNFL parameter between preoperative, postoperative data measured by Cirrus HD-OCT

Parameter		Preoperative	Postoperative	Difference	p-value^*
Signal strength		3.48 ± 1.18	5.67 ± 1.46	2.19 ± 1.72	<0.001
RNFL (μm)	Superior	100.40 ± 15.48	108.91 ± 19.00	8.52 ± 13.79	0.001
	Nasal	60.78 ± 11.10	67.24 ± 11.37	6.47 ± 5.40	<0.001
	Inferior	102.45 ± 16.67	116.03 ± 18.34	13.59 ± 12.29	<0.001
	Temporal	60.81 ± 10.01	66.05 ± 13.04	5.24 ± 7.07	0.001
Clock hour	1	93.43 ± 24.39	103.21 ± 27.65	9.78 ± 13.54	0.001
	2	71.64 ± 15.35	78.74 ± 15.15	7.10 ± 7.22	<0.001
	3	53.07 ± 10.54	58.85 ± 11.58	5.78 ± 5.73	<0.001
	4	57.43 ± 10.69	64.69 ± 12.36	7.26 ± 7.93	<0.001
	5	94.19 ± 25.58	103.21 ± 28.33	9.02 ± 12.20	0.001
	6	112.48 ± 25.82	123.16 ± 28.38	10.67 ± 17.79	0.001
	7	100.74 ± 27.59	121.45 ± 29.96	20.71 ± 17.26	<0.001
	8	60.03 ± 13.26	67.76 ± 16.46	7.72 ± 7.19	<0.001
	9	51.67 ± 11.93	55.93 ± 12.31	4.26 ± 7.39	0.001
	10	70.48 ± 13.25	74.60 ± 15.33	4.12 ± 13.85	0.003
	11	101.31 ± 23.70	110.02 ± 25.34	8.71 ± 24.46	0.012
	12	104.36 ± 21.02	113.67 ± 22.46	9.31 ± 14.25	0.004
	Average	81.05 ± 9.46	89.53 ± 11.51	8.48 ± 6.58	<0.001

Values are presented as mean ± SD.

^* Calculated by Wilcoxon's signed-ranks test.

Table 3.

Comparison of ONH parameter between preoperative, postoperative data measured by Cirrus HD-OCT

Parameter		Preoperative	Postoperative	Difference	p-value^*
ONH	Rim area (mm²)	1.13 ± 0.21	1.20 ± 0.24	0.07 ± 0.10	0.002
	Disc area (mm²)	2.08 ± 0.52	2.01 ± 0.48	−0.07 ± 0.15	0.003
	Cup / disc area ratio	0.63 ± 0.15	0.58 ± 0.17	−0.04 ± 0.04	<0.001
	Vertical cup / disc ratio	0.59 ± 0.14	0.56 ± 0.16	−0.03 ± 0.05	0.001
	Cup volume (mm³)	0.26 ± 0.27	0.23 ± 0.24	−0.04 ± 0.06	0.001

Values are presented as mean ± SD.

^* Calculated by Wilcoxon's signed-ranks test.

Table 4.

Spearman's correlation between change in average RNFL thickness and signal strength (SS), IOP (intraocular pressure)

Factor	Rho	p-value^*
Preoperative SS	0.03	0.88
Postoperative SS	0.21	0.28
SS change	0.14	0.46
IOP change	−0.23	0.22

^* *Calculated by Spearman's correlation.

Table 5.

Spearman's correlation between change in optic nerve parameters and signal strength (SS), IOP (intraocular pressure)

Factor		Rho	p-value^*
Rim area	Preoperative SS	0.02	0.94
	Postoperative SS	−0.11	0.57
	SS change	−0.23	0.22
	IOP change	0.04	0.84
Disc area	Preoperative SS	0.17	0.37
	Postoperative SS	−0.33	0.08
	SS change	−0.51	0.005
	IOP change	0.06	0.77
CDAR	Preoperative SS	0.15	0.44
	Postoperative SS	−0.10	0.60
	SS change	−0.16	0.40
	IOP change	−0.29	0.13
VCDR	Preoperative SS	0.26	0.17
	Postoperative SS	−0.09	0.66
	SS change	−0.25	0.19
	IOP change	−0.33	0.08
Cup volume	Preoperative SS	0.21	0.28
	Postoperative SS	−0.19	0.34
	SS change	−0.30	0.11
	IOP change	0.13	0.51

^* Calculated by Spearman's correlation.

CDAR = cup / disc area ratio; VCDR = vertical cup / disc ratio.

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