The Analysis of Retinal Nerve Fiber Layer in Amblyopia Using Spectral Domain Optical Coherence Tomography

Chan Keum Park; Su Jin Kim

doi:10.3341/jkos.2016.57.10.1631

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Park and Kim: The Analysis of Retinal Nerve Fiber Layer in Amblyopia Using Spectral Domain Optical Coherence Tomography

Original Article

J Korean Ophthalmol Soc 2016;57(10):1631-1639.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.10.1631

The Analysis of Retinal Nerve Fiber Layer in Amblyopia Using Spectral Domain Optical Coherence Tomography

Chan Keum Park, MD¹, Su Jin Kim, MD, PhD²

¹Department of Ophthalmology, Maryknoll Hospital, Busan, Korea

²Department of Ophthalmology, Gyeongsang National University Changwon Hospital, Changwon, Korea

Address reprint requests to Su Jin Kim, MD, PhD Department of Ophthalmology, Gyeongsang National University Changwon Hospital, #11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Korea Tel: 82-55-214-2000, Fax: 82-55-214-1036 E-mail: pearlsj@hanmail.net

Received 4 May 2016 Accepted 20 September 2016

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 determine whether retinal nerve fiber layer (RNFL) thickness and optic nerve head parameters differ in the amblyopic and normal fellow eyes of hyperopic anisometropic amblyopic patients using spectral domain optical coherence tomography (SD-OCT).

Methods

This study included 30 patients with hyperopic anisometropic amblyopia; patient eyes were divided into 30 anisometropic amblyopic eyes and 30 normal fellow eyes. RNFL thickness, disc area, rim area, average cup-to-disc ratio, and cup volume were obtained using SD-OCT. Axial length was obtained using the IOL Master^®, and the interocular differences between group were analyzed.

Results

Nasal quadrant RNFL thickness of amblyopic eyes was significantly thicker than that of normal fellow eyes in amblyopic patients (p = 0.010). Among optic nerve parameters, cup volume of amblyopic eyes was significantly smaller than that of normal fellow eyes (p = 0.021). No significant relationship between refractive error and RNFL thickness was observed, and a significant positive linear relationship was observed between neural rim area and RNFL thickness (rho = 0.426, p = 0.005).

Conclusions

SD-OCT analysis of hyperopic anisometropic amblyopic eyes demonstrated a significant increase in nasal RNFL thickness compared to fellow non-amblyopic eyes. No optic nerve head parameters except cup volume showed significant change.

Keywords: Amblyopia, Optic nerve head parameter, Retinal nerve fiber layer (RNFL) thickness

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Figure 1.

Spearman correlation between spherical equivalent and average circumpapillary retinal nerve fiber layer (cpRNFL) thickness. It doesn't show a significant corelation. D = diopter.

Figure 2.

Spearman correlation between spherical equivalent and sectoral circumpapillary retinal nerve fiber layer (cpRNFL) thickness. Correlation graphs between spherical equivalent and (A) inferior cpRNFL thickness, (B) superior cpRNFL thickness, (C) temporal cpRNFL thickness, (D) nasal cpRNFL thickness. D = diopter.

Figure 3.

Spearman correlation between rim area and circumpapillary retinal nerve fiber layer (cpRNFL) thickness. There is a moderate positieve corelation.

Table 1.

Baseline characteristics in each group

	AE (n = 30)	FE (n = 30)	p-value^*
Age (years)	6.06 ± 1.61	6.06 ± 1.61
Male (n, %)	8 (26.6)	8 (26.6)
BCVA (log MAR)	0.36 ± 0.22	0.03 ± 0.04	<0.001
Spherical equivalent (D)	3.52 ± 1.72	1.61 ± 0.79	<0.001

Values are presented as mean ± SD or n (%) unless otherwise indicated.

AE = amblyopic eye; FE = fellow eye; BCVA = best corrected visual acuity; D = diopter.

^* Wilcoxon signed rank test.

Table 2.

Ocular measurement of amblyopic and normal fellow eye

	AE (n =30)	FE (n = 30)	p-value^*
cpRNFL thickness (μ m)
Inferior	113.56 ± 15.15	117.21 ± 15.37	0.357
Superior	111.89 ± 20.24	113.53 ± 13.86	0.357
Nasal	64.23 ± 8.09	57.59 ± 8.30	0.010
Temporal	59.87 ± 10.63	63.13 ± 6.67	0.305
Average	86.55 ± 10.63	87.90 ± 7.51	0.322
Axial length (mm)	22.10 ± 0.63	22.54 ± 0.65	0.040
Retinal area (mm²)	767.62 ± 44.4 1	798.65 ± 46.25	0.042
ONH parameters
Optic disc area (mm²)	1.67 ± 0.29	1.82 ± 0.24	0.149
Rim area (mm²)	1.27 ± 0.27	1.25 ± 0.14	0.543
Average C/D ratio	0.46 ± 0.08	0.53 ± 0.11	0.082
Cup volume (mm²)	0.084 ± 0.053	0.128 ± 0.059	0.021
Axial length/optic disc area	13.54 ± 1.92	12.55 ± 1.66	0.244
Retinal area/optic disc rim area	469.52 ± 63.96	444.62 ± 62.09	0.394

Values are presented as mean ± SD unless otherwise indicated.

AE = amblyopic eye; FE = fellow eye; cpRNFL = circumpapillary retinal nerve fiber layer; ONH = optic nerve head; C/D = cup-to-disc.

^* Wilcoxon signed rank test.

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