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Kim, Kim, and Hwang: Retinal Nerve Fiber Layer and Macular Ganglion Cell Thicknesses in Situs Inversus of Optic Discs
Original Article

J Korean Ophthalmol Soc 2017;58(4):437-442.

Published online: 8 September 2017

DOI: https://doi.org/10.3341/jkos.2017.58.4.437

Retinal Nerve Fiber Layer and Macular Ganglion Cell Thicknesses in Situs Inversus of Optic Discs

Min Kyung Kim, M.D., Jae Min Kim, M.D., Young Hoon Hwang, M.D.

Myung-Gok Eye Research Institute, Department of Ophthalmology, Kim’s Eye Hospital, Konyang University College of Medicine, Seoul, Korea

Address reprint requests to Young Hoon Hwang, MD Department of Ophthalmology, Kim’s Eye Hospital, #136 Yeongsin-ro, Yeongdeungpo-gu, Seoul 07301, Korea Tel: 82-2-2639-7777, Fax: 82-2-2633-3976 E-mail: brainh@hanmail.net

Received 1 December 201610 January 2017       Accepted 16 March 2017

Copyright © 2017 Korean Ophthalmological Society

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 circumpapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thicknesses as measured by optical coherence tomography in eyes with situs inversus of optic discs.

Methods

RNFL and macular GCIPL thicknesses were measured in eyes with situs inversus of optic discs without other ocular abnormalities (situs inversus group) and in age- and refractive error-matched healthy eyes (control group). RNFL thickness (global area, superior, nasal, inferior, and temporal quadrants) and GCIPL thickness (global area, superior-temporal, superior, superior-nasal, inferior-nasal, inferior, and inferior-temporal sectors and minimum) were compared between the groups.

Results

Nine eyes of 5 subjects with situs inversus of optic discs and 20 healthy eyes of 20 subjects (10 eyes for control groups A and B, respectively) were enrolled. No significant difference was found in superior or inferior quadrant RNFL thickness (p > 0.05); however, the situs inversus group showed a thicker RNFL in the nasal quadrant and a thinner RNFL in the temporal quad-rant (p < 0.01). In macular GCIPL thickness, no significant difference was found in the superotemporal or inferiotemporal sector or for minimum thickness (p < 0.05); however, the situs inversus group showed thicker GCIPL in the global area, superior, super-onasal, inferonasal, and inferior sectors than the control groups (p < 0.01).

Conclusions

In eyes with situs inversus of optic discs, distribution of circumpapillary RNFL and macular GCIPL thickness were different from eyes without this condition. When assessing RNFL and macular GCIPL thicknesses in eyes with situs inversus of optic discs, caution is needed.

Keywords: Optic nerve head, Retinal ganglion cell, Retinal nerve fiber layer, Situs inversus

References

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Figure 1.
An example of optic disc in a healthy eye (left col-umn) and an eye with situs inversus of optic disc (right col-umn). Disc photograph (A), red-fee fundus photograph (B), and circumpapillary retinal nerve fiber layer thickness dis-tribution as measured by Cirrus high– definition optical coher-ence tomography(C).
jkos-58-437f1.tif
Figure 2.
An example of macular ganglion cell-inner plexi-form layer thickness distribution. Presented by thickness map (A) and sector map (B) of Cirrus high– definition optical co-herence tomography in a healthy eye (left column) and an eye with situs inversus of optic disc (right column) presented in Figure 1.
jkos-58-437f2.tif
Table 1.
Comparison of clinical data between control and situs inversus groups
Control group A (n = 10) Control group B (n = 10) Situs inversus group (n = 9) p-value* p-value†
Age (years) 43.0 (39.0, 46.3) 44.5 (29.0, 52.0) 48.0 (33.0, 49.0) 0.905 0.842
Sex (female:male) 5:5 5:5 4:6 1.000 1.000
Refractive error (diopter) -0.63 (-1.00, -0.38) -1.00 (-1.57, -0.69) -1.00 (-2.00, -0.25) 0.315 0.720
Visual field indices
Mean deviation (dB) -0.79 (-1.89, 0.30) -1.19 (-1.68, -0.08) -0.85 (-1.28, 0.72) 0.497 0.182
Pattern standard deviation (dB) 1.55 (1.48, 1.94) 1.44 (1.14, 1.89) 1.67 (1.30, 2.21) 0.661 0.243
Visual field index (%) 99.0 (99.0, 99.25) 99.5 (99.0, 100.0) 100.0 (98.5, 100.0) 0.400 0.968

Data are presented as median and interquartile range or number of eyes.

* Mann-Whitney U-test: comparison between the control group A and situs inversus group;

† Mann-Whitney U-test: comparison between the control group B and situs inversus group.

Table 2.
Comparison of circumpapillary retinal nerve fiber layer thickness (μ m) between control and situs inversus groups
Control group A (n = 10) Control group B (n = 10) Situs inversus group (n = 9) p-value* p-value†
Average 95.5 (87.5, 99.5) 100.0 (95.8, 108.3) 102.0 (94.5, 105.5) 0.211 0.905
Superior quadrant 124.0 (114.5, 143.3) 130.0 (119.8, 134.5) 118.0 (111.0, 143.0) 0.720 0.604
Nasal quadrant 60.0 (51.5, 70.3) 64.5 (62.5, 76.3) 82.0 (71.5, 105.0) 0.004 0.010
Inferior quadrant 122.0 (110.0, 132.5) 130.5 (125.5, 142.5) 126.0 (123.0, 146.0) 0.211 0.661
Temporal quadrant 70.5 (61.0, 77.0) 79.0 (73.0, 84.5) 56.0 (52.0, 60.5) 0.001 <0.001
Clock-hour sectors
12 135.5 (120.0, 155.0) 122.5 (102.8, 137.8) 131.0 (118.5, 156.5) 0.661 0.400
1 112.5 (104.8, 122.0) 111.5 (94.8, 114.0) 146.0 (101.5, 188.0) 0.133 0.065
2 68.0 (58.3, 82.3) 75.0 (68.5, 88.0) 99.0 (81.0, 132.5) 0.006 0.013
3 52.5 (43.5, 61.0) 59.5 (55.0, 68.0) 76.0 (57.5, 88.0) 0.022 0.156
4 65.0 (52.0, 66.8) 62.5 (57.3, 73.3) 92.0 (70.5, 103.0) 0.002 0.017
5 89.5 (85.8, 109.5) 88.5 (84.8, 106.5) 141.0 (115.0, 173.0) 0.002 0.002
6 137.0 (108.0, 163.8) 128.5 (123.8, 161.5) 162.0 (156.5, 167.0) 0.095 0.043
7 135.0 (130.8, 156.5) 165.0 (149.5, 173.5) 90.0 (80.0, 101.5) <0.001 <0.001
8 70.0 (62.8, 80.8) 79.5 (72.0, 92.3) 54.0 (41.5, 58.0) 0.001 <0.001
9 57.0 (51.0, 62.3) 57.5 (51.3, 70.0) 52.0 (47.0, 58.0) 0.133 0.133
10 75.5 (68.8, 89.0) 93.0 (89.5, 103.5) 66.0 (60.5, 71.0) 0.022 <0.001
11 120.0 (114.8, 133.0) 151.5 (139.0, 168.0) 89.0 (77.5, 112.5) 0.002 <0.001

Data are presented as median and interquartile range.

* Mann-Whitney U-test: comparison between the control group A and situs inversus group;

† Mann-Whitney U-test: comparison between the con-trol group B and situs inversus group.

Table 3.
Comparison of macular ganglion cell-inner plexiform layer thickness (μ m) between control and situs inversus groups
Control group A (n = 10) Control group B (n = 10) Situs inversus group (n = 9) p-value* p-value†
Average 82.0 (81.0, 87.0) 84.5 (81.8, 86.0) 90.0 (83.5, 91.5) 0.035 0.028
Minimum 81.5 (79.8, 83.8) 82.0 (80.0, 85.0) 84.0 (80.5, 87.0) 0.315 0.447
Superotemporal 82.5 (79.8, 85.3) 84.0 (79.8, 86.0) 83.0 (81.5, 88.0) 0.356 0.549
Superior 82.5 (81.5, 85.8) 84.0 (82.3, 85.3) 89.0 (86.0, 93.0) 0.010 0.008
Superonasal 85.0 (83.8, 88.5) 87.0 (84.75, 88.0) 94.0 (88.5, 95.5) 0.004 0.013
Inferonasal 83.5 (81.8, 87.3) 85.5 (82.3, 86.0) 93.0 (85.0, 96.5) 0.028 0.017
Inferior 80.0 (78.8, 85.3) 82.0 (79.5, 85.3) 89.0 (81.0, 91.5) 0.033 0.059
Inferotemporal 81.5 (79.0, 86.5) 83.5 (81.5, 86.3) 86.0 (80.0, 88.5) 0.315 0.661

Data are presented as median and interquartile range.

* Mann-Whitney U-test: comparison between the control group A and situs inversus group;

† Mann-Whitney U-test: comparison between the con-trol group B and situs inversus group.

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