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

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

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.

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.
jkos-57-969f1.tif
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.
jkos-57-969f2.tif
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.
jkos-57-969f3.tif
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
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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