Influence of RNFL Thickness on Visual Acuity and Visual Field in Bilateral Temporal Optic Atrophy

Jae Yong Park; Jin Choi; Won Hyuk Oh; Jae Suk Kim

doi:10.3341/jkos.2016.57.6.969

Journal List > J Korean Ophthalmol Soc > v.57(6) > 1010616

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Park, Choi, Oh, and Kim: Influence of RNFL Thickness on Visual Acuity and Visual Field in Bilateral Temporal Optic Atrophy

Original Article

J Korean Ophthalmol Soc 2016;57(6):969-976.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.6.969

Influence of RNFL Thickness on Visual Acuity and Visual Field in Bilateral Temporal Optic Atrophy

Jae Yong Park, MD, Jin Choi, MD, PhD, Won Hyuk Oh, MD, Jae Suk Kim, MD, PhD

Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea

Address reprint requests to Jin Choi, MD, PhD Department of Ophthalmology, Inje University Sanggye Paik Hospital, #1342 Dongil-ro, Nowon-gu, Seoul 01757, Korea Tel: 82-2-950-1096, Fax: 82-2-935-6904 E-mail: jinchoi@paik.ac.kr

Received 30 December 2015 Revised 14 March 2016 Accepted 14 April 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 investigate the influence of retinal nerve fiber layer (RNFL) thickness on visual acuity and visual field in patients with bilateral temporal optic atrophy.

Methods

Patients with characteristic features of gradual visual loss and temporal atrophy of both optic nerves were enrolled in this study. Among the patients, RNFL thickness of each area was measured with optical coherence tomography, and its influence on the best corrected visual acuity, mean deviation and pattern standard deviation calculated from the refractive test and Humphrey visual field test was analyzed.

Results

The present study included 13 patients with bilateral temporal optic atrophy (26 eyes) and 13 normal controls (26 eyes). Optical coherence tomography was performed to calculate RNFL thickness in the 52 eyes. Among 26 eyes of patients with bilateral temporal optic atrophy, the Humphrey visual field test was performed to calculate the mean deviation and pattern standard deviation. The mean age in the patient group was 66.0 ± 12.3 years (37‒80 years), and 8 (30.8%) patients were male and 18 (69.2%) female. The mean best corrected visual acuity was 30/50 (20/200‒20/20). Simple regression analysis showed that a thinner temporal RNFL thickness was correlated with a lower the best corrected visual acuity (p = 0.015). The mean deviation was low when inferotemporal RNFL was thin (p = 0.005). Pattern standard deviation was high when inferotemporal (p = 0.003), inferonasal (p = 0.04) and nasal (p = 0.008) RNFLs were thin.

Conclusions

Inferotemporal RNFL thickness was significantly correlated with best corrected visual acuity, mean deviation and pattern standard deviation of automated visual field test in patients with bilateral temporal optic neuropathy. Optical coherence tomography can be further used to estimate visual acuity and visual field defects in patients with optic atrophy.

Keywords: Bilateral optic atrophy, Optical coherence tomography, Retinal nerve fiber layer thickness, Visual acuity, Visual field defect

References

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Figure 1.

Representative figure of a 77-year-old male with visual acuity of 14/20 in the right eye and 18/20 in the left eye, showing a mild decrease in the retinal nerve fiber layer (RNFL) thickness. TMP = temporal; SUP = superior; NAS = nasal; INF = inferior; OD = oculus dexter; OS = oculus sinister; S = superior; N = nasal; I = inferior; T = temporal; TS = superotemporal; NS = superonasal; G = general; TI = inferotemporal; NI = inferonasal.

Figure 2.

Representative figure of a 60-year-old female with a visual acuity of 3/20 in the right eye and 6/20 in the left eye, showing a severe decrease in the retinal nerve fiber layer (RNFL) thickness. TMP = temporal; SUP = superior; NAS = nasal; INF = inferior; OD = oculus dexter; OS = oculus sinister; S = superior; N = nasal; I = inferior; T = temporal; TS = superotemporal; NS = superonasal; G = general; TI = inferotemporal; NI = inferonasal.

Figure 3.

Scatterplots showing each linear regression analysis model.(A) Relationship between temporal retinal nerve fiber layer thickness (RNFLT) and best corrected visual acuity (BCVA): thinner temporal RNFLT was correlated with lower BCVA. (B) Relationship between inferotemporal RNFLT and mean deviation (MD): MD was low when inferotemporal RNFLT was thin. (C) Relationship between inferotemporal RNFLT and pattern standard deviation (PSD): PSD was high when inferotemporal RNFLT was thin. (D) Relationship between inferonasal RNFLT and PSD: PSD was high when inferonasal RNFLT was thin. (E) Relationship between nasal RNFLT and PSD: PSD was high when nasal RNFLT was thin.

Table 1.

Demographics of bilateral optic atrophy patients

Characteristics	Value
Number of subjects	13
Number of eyes	26
Sex (male/female)	4/9
Age (years)	66.00 ± 12.26 (37–80)
BCVA (decimal)	0.58 (0.1–1.0)
IOP (mm Hg)	14.35 ± 1.67 (10–17)

Values are presented as mean ± SD (range) unless otherwise indicated.

BCVA = best corrected visual acuity; IOP = intraocular pressure.

Table 2.

Retinal nerve fiber layer (RNFL) parameters and analysis using a mixed effect model

Parameters	Bilateral optic atrophy (μ m)	Control (μ m)	p-value
Superotemporal RNFLT	119.58 ± 23.90	130.67 ± 2.06	0.070
Temporal RNFLT	35.63 ± 10.07	71.25 ± 1.87	0.000
Inferotemporal RNFLT	109.88 ± 28.58	137.33 ± 2.96	0.003
Inferonasal RNFLT	101.21 ± 28.35	103.83 ± 1.01	0.579
Nasal RNFLT	61.96 ± 14.70	72.00 ± 2.13	0.002
Superonasal RNFLT	104.25 ± 31.037	102.00 ± 1.76	0.687

Values are presented as mean ± SD unless otherwise indicated.

RNFLT = retinal nerve fiber layer thickness.

Table 3.

Spearman correlation coefficient between the best corrected visual acuity and retinal nerve fiber layer (RNFL) thickness of each region

Parameters	R	p-value
Superotemporal RNFLT	0.089	0.664
Temporal RNFLT	−0.451	0.021
Inferotemporal RNFLT	−0.201	0.325
Inferonasal RNFLT	0.177	0.386
Nasal RNFLT	0.005	0.982
Superonasal RNFLT	0.166	0.417

RNFLT = retinal nerve fiber layer thickness.

Table 4.

Pearson correlation coefficient between the visual field defect parameters and retinal nerve fiber layer (RNFL) thickness of each region

Parameters	MD		PSD
Parameters	R	p-value	R	p-value
Superotemporal RNFLT	0.230	0.258	−0.350	0.079
Temporal RNFLT	0.016	0.940	−0.262	0.196
Inferotemporal RNFLT	0.538	0.005	−0.583	0.002
Inferonasal RNFLT	0.231	0.256	−0.415	0.035
Nasal RNFLT	0.345	0.085	−0.504	0.009
Superonasal RNFLT	0.306	0.128	−0.253	0.212

MD = mean deviation; PSD = pattern standard deviation; RNFLT = retinal nerve fiber layer thickness.

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