The Analysis of Peripapillary RNFL, Macula and Macular Ganglion Cell Layer Thickness in Patients with Monocular Amblyopia Using SD-OCT

Ji Man Park; Young Je Choi; Dae Hyun Kim

doi:10.3341/jkos.2016.57.1.98

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Park, Choi, and Kim: The Analysis of Peripapillary RNFL, Macula and Macular Ganglion Cell Layer Thickness in Patients with Monocular Amblyopia Using SD-OCT

Original Article

J Korean Ophthalmol Soc 2015;57(1):98-105.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2016.57.1.98

The Analysis of Peripapillary RNFL, Macula and Macular Ganglion Cell Layer Thickness in Patients with Monocular Amblyopia Using SD-OCT

Ji Man Park, M.D, Young Je Choi, M.D, Dae Hyun Kim, M.D, PhD

Department of Ophthalmology, Chosun University School of Medicine, Gwangju, Korea

Address reprint requests to Dae Hyun Kim, MD, PhD Department of Ophthalmology, Chosun University Hospital, #365 Pilmun-daero, Dong-gu, Gwangju 61453, Korea Tel: 82-62-220-3190, Fax: 82-62-225-9839 E-mail: eyelovehyun@hanmail.net

‗ This work was supported by a grant from the Clinical Medicine Research Institute of the Chosun University Hospital, 2014.

Received 11 August 201522 September 2015 Accepted 9 December 2015

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), macula and macular ganglion cell layer (mGCL)-inner plexiform layer (IPL) thickness differ in the amblyopic and normal fellow eyes of unilateral amblyopic patients using spectral domain optical coherence tomography (SD-OCT).

Methods

80 patients with 160 eyes were included in this study; the distribution of patients was 17 patients with strabismic am-blyopia, 17 patients with strabismic non-amblyopia, 23 patients with anisometropic amblyopia, and 23 patients with anisome-tropic non-amblyopia. Macular, RNFL, and mGCL-IPL thickness were obtained by SD-OCT, and the interocular thickness differ-ences of each group were analyzed. After treatment, the changes of OCT parameters were evaluated in amblyopic patients.

Results

Average macular, average RNFL, and average mGCL-IPL thickness of amblyopic eyes were thicker than for normal fel-low eyes in amblyopic patients (40 patients total; p < 0.001, p < 0.001, p = 0.002, respectively). In 23 patients with anisometropic amblyopia, average macular, average RNFL, and average mGCL-IPL thickness of amblyopic eyes were thicker than the normal fellow eye ( p = 0.008, p < 0.001, p = 0.002). In the 17 patients with strabismic amblyopia, average macular and average RNFL thickness of amblyopic eyes were thicker than the normal fellow eye ( p = 0.016, p < 0.006, respectively). No interocular thickness differences were observed in the control groups. Interocular differences between amblyopic and normal eyes remained un-changed after the amblyopic eyes were treated.

Conclusions

Average RNFL and average mGCL-IPL thickness of amblyopic eyes were thicker than normal fellow eyes, but no differences were observed for macular in amblyopic patients. There was no change in the OCT parameter in amblyopic eyes af-ter treatment.

Keywords: Amblyopia, Macular central thickness, Macular ganglion cell layer-inner plexiform layer, Retinal nerve fiber layer

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Table 1.

Baseline characteristics in each group

	Ambylopic eyes (n = 40)	Anisometropic amblyopia (n = 23)	Anisometropic controls (n = 23)	Strabismic amblyopia (n = 17)	Strabismic controls (n = 17)
Age (years)	10.98 ± 4.77	11.25 ± 4.45	10.16 ± 3.94	10.59 ± 4.88	11.00 ± 4.94
Female (%)	27.5	21.8	21.8	35.3	35.3
BCVA (log MAR)	0.46 ± 0.25	0.45 ± 0.18	0.07 ± 0.10	0.48 ± 0.25	0.06 ± 0.04
Spherical equivalent (D)^*	1.28 ± 3.98	1.31 ± 4.44	1.04 ± 4.36	1.23 ± 3.38	1.03 ± 2.68
Deviation angle (PD)				23.69 ± 9.18	21.40 ± 6.70
Refraction difference (D)		2.64 ± 0.91	2.02 ± 0.90

Values are presented as mean ± SD unless otherwise indicated.

BCVA = best corrected visual acuity; D = diopter; PD = prism diopter.

^* Spherical equivalent of amblyopic eye in amblyopia patients and of abnormal eye in controls.

Table 2.

OCT parameters of amblyopic and normal fellow eye in amblyopia patient (n = 80 eyes)

	AE (n = 40)	FE (n = 40)	p-value^*
RNFL thickness (μ m)
Inferior	132.93 ± 19.19	125.58 ± 12.90	0.004
Superior	128.85 ± 19.31	121.28 ± 15.76	0.003
Nasal	71.40 ± 19.00	65.65 ± 12.73	0.007
Temporal	71.28 ± 16.78	71.95 ± 13.75	0.794
Average	101.13 ± 12.33	93.18 ± 9.32	<0.001
Macular thickness (μ m)
CST	242.38 ± 14.80	241.78 ± 18.01	0.835
Ganglion thickness (μ m)
Average	84.90 ± 5.25	80.50 ± 5.25	<0.001
S	84.58 ± 6.78	82.68 ± 6.22	0.058
SN	86.60 ± 6.46	84.35 ± 6.43	<0.001
ST	81.38 ± 5.48	80.33 ± 5.37	0.097
I	80.55 ± 6.34	79.40 ± 6.09	0.279
IN	83.85 ± 6.23	81.75 ± 5.34	0.001
IT	80.98 ± 5.27	80.95 ± 5.97	0.969
Minimum	78.10 ± 6.15	77.72 ± 6.15	0.612

Values are presented as mean ± SD unless otherwise indicated.

OCT = optical coherence tomography; AE = amblyopic eye; FE = fellow eye; RNFL = retinal nerve fiber layer; CST = central subfield thickness; S = superior; SN = superior nasal; ST = superior temporal; I = inferior; IN = inferior nasal; IT = inferior temporal.

^* Paired t-test.

Table 3.

OCT parameters of eyes with anisometropic amblyopia and control groups

	AA (n = 23)	FE (n = 23)	p-value^*	CE (n = 23)	CFE (n = 23)	p-value^*
RNFL (μ m)
Inferior	134.96 ± 20.42	127.22 ± 10.77	0.047	134.32 ± 10.77	131.21 ± 14.75	0.228
Superior	128.22 ± 17.31	123.26 ± 14.14	0.133	137.11 ± 12.46	132.26 ± 15.73	0.110
Nasal	73.61 ± 22.29	66.26 ± 14.50	0.008	68.37 ± 10.37	68.16 ± 13.20	0.949
Temporal	73.00 ± 19.78	72.78 ± 15.09	0.958	79.26 ± 13.51	76.47 ± 14.03	0.475
Average	102.43 ± 12.06	92.43 ± 8.05	0.008	105.47 ± 8.25	102.05 ± 10.85	0.120
Macula (μ m)
CST	242.74 ± 14.25	242.70 ± 14.25	0.986	248.37 ± 19.28	247.79 ± 22.87	0.807
Ganglion (μ m)
Average	83.78 ± 4.81	80.96 ± 4.17	<0.001	83.47 ± 4.81	82.79 ± 4.97	0.185
S	85.83 ± 5.86	82.22 ± 5.37	0.003	84.84 ± 5.63	83.68 ± 5.16	0.134
SN	87.70 ± 5.44	84.57 ± 5.10	<0.001	85.84 ± 5.41	85.00 ± 4.89	0.202
ST	82.74 ± 4.54	81.00 ± 4.15	0.009	82.47 ± 5.28	80.95 ± 4.91	0.010
I	80.73 ± 5.89	80.35 ± 5.24	0.791	82.89 ± 6.12	81.89 ± 5.92	0.304
IN	85.04 ± 5.95	82.61 ± 4.75	0.008	83.84 ± 5.31	84.11 ± 6.38	0.697
IT	81.48 ± 5.06	81.70 ± 4.31	0.784	82.42 ± 5.27	81.58 ± 5.36	0.274
Minimum	79.39 ± 5.07	78.87 ± 5.02	0.581	81.16 ± 4.71	80.16 ± 4.20	0.146

Values are presented as mean ± SD unless otherwise indicated.

OCT = optical coherence tomography; AA = amblyopic eye with anisometropia; FE = fellow eye; CE = control eye with ansiometropia; CFE = control fellow eye; RNFL = retinal nerve fiber layer; CST = central subfield thickness; S = superior; SN = superior nasal; ST = superior temporal; I = inferior; IN =inferior nasal; IT = inferior temporal.

^* Paired t-test.

Table 4.

OCT parameters of eyes with strabismic amblyopia and control groups

	SA (n = 17)	FE (n = 17)	p-value^*	CE (n = 17)	CFE (n = 17)	p-value^*
RNFL (μ m)
Inferior	130.18 ± 17.61	123.35 ± 15.41	0.030	127.33 ± 15.68	128.53 ± 18.80	0.629
Superior	129.71 ± 22.25	118.59 ± 17.82	0.008	125.00 ± 13.63	120.27 ± 17.86	0.139
Nasal	68.41 ± 13.42	64.82 ± 10.23	0.291	63.93 ± 11.37	62.20 ± 9.75	0.526
Temporal	68.94 ± 11.76	70.82 ± 12.06	0.501	67.80 ± 14.76	69.87 ± 17.81	0.262
Average	103.35 ± 12.85	94.47 ± 10.83	0.016	96.27 ± 9.37	95.13 ± 9.36	0.351
Macula (μ m)
CST	241.88 ± 15.95	242.88 ± 18.64	0.752	252.13 ± 18.38	251.87 ± 17.97	0.903
Ganglion (μ m)
Average	82.71 ± 6.02	80.88 ± 6.53	0.241	84.40 ± 6.26	83.73 ± 5.50	0.417
S	82.88 ± 7.71	83.29 ± 7.35	0.801	87.27 ± 7.33	84.93 ± 7.18	0.031
SN	85.12 ± 7.54	84.06 ± 8.05	0.310	89.13 ± 7.34	85.47 ± 8.93	0.075
ST	79.53 ± 6.21	79.41 ± 6.70	0.922	83.40 ± 8.53	83.53 ± 5.63	0.941
I	80.29 ± 7.08	78.12 ± 7.05	0.165	80.40 ± 6.43	81.73 ± 5.21	0.398
IN	82.24 ± 6.42	80.59 ± 6.00	0.088	83.40 ± 5.96	82.60 ± 8.05	0.689
IT	80.29 ± 5.64	79.94 ± 7.72	0.755	83.27 ± 7.93	84.60 ± 5.43	0.517
Minimum	76.35 ± 7.89	76.18 ± 7.29	0.886	78.47 ± 6.14	80.20 ± 7.06	0.213

Values are presented as mean ± SD unless otherwise indicated.

OCT = optical coherence tomography; SA = amblyopic eye with strabismus; FE = fellow eye; CE = control eye with strabismus; CFE = control fellow eye; RNFL = retinal nerve fiber layer; CST = central subfield thickness; S = superior; SN = superior nasal; ST = superior temporal; I = inferior; IN =inferior nasal; IT = inferior temporal.

^* Paired t-test.

Table 5.

OCT parameters differences of amblyopic and normal fellow eyes at 1st visit and after treatment

	1st visit			After treatment			p-value^*
	AE (n = 13)	FE (n = 13)	I.D	AE (n = 13)	FE (n = 13)	I.D
RNFL (μ m)
Inferior	139.38 ± 21.60	125.54 ± 8.62	13.84	134.31 ± 24.92	123.31 ± 15.17	11.00	0.404
Superior	125.77 ± 24.10	119.77 ± 14.19	6.00	125.85 ± 24.54	118.38 ± 13.23	7.47	0.557
Nasal	72.15 ± 15.39	63.46 ± 9.58	8.69	65.38 ± 10.99	61.92 ± 8.54	3.46	0.071
Temporal	66.46 ± 12.85	68.92 ± 12.16	-2.46	68.38 ± 14.06	68.77 ± 15.33	-0.39	0.546
Average	100.92 ± 12.27	94.54 ± 6.79	6.38	98.85 ± 11.61	93.54 ± 7.31	5.31	0.482
Macula (μ m)
CST	244.23 ± 16.00	249.46 ± 20.83	-5.23	245.15 ± 14.59	245.77 ± 18.76	-0.62	0.222
Ganglion (μ m)
Average	83.77 ± 5.79	82.85 ± 4.67	0.92	81.31 ± 6.47	83.31 ± 5.43	-2.00	0.264
Minimum	77.62 ± 6.48	77.38 ± 6.10	0.23	77.15 ± 6.71	76.62 ± 8.31	0.53	0.861

Values are presented as mean ± SD unless otherwise indicated.

OCT = optical coherence tomography; AE = amblyopic eye; FE = fellow eye; I.D = interocular differences (OCT parameters of amblyopic eye– OCT parameter of fellow eye); RNFL = retinal nerve fiber layer; CST = central subfield thickness.

^* Comparison of interocular difference at 1st visit and after treatment with independent t-test.

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