Longitudinal Evaluation of Retinal Structure in Patients with Traumatic Optic Neuropathy Using Optical Coherence Tomography

Sung Ha Hwang; Jong Yeon Lee; Mijung Chi

doi:10.3341/jkos.2018.59.1.73

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Hwang, Lee, and Chi: Longitudinal Evaluation of Retinal Structure in Patients with Traumatic Optic Neuropathy Using Optical Coherence Tomography

Original Article

Journal of the Korean Ophthalmological Society 2018; 59(1): 73-80.

Published online: 12 January 2018

DOI: https://doi.org/10.3341/jkos.2018.59.1.73

Longitudinal Evaluation of Retinal Structure in Patients with Traumatic Optic Neuropathy Using Optical Coherence Tomography

Sung Ha Hwang, MD, Jong Yeon Lee, MD, PhD, Mijung Chi, MD, PhD

Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea.

Address reprint requests to Mijung Chi, MD, PhD. Department of Ophthalmology, Gachon University Gil Medical Center, #21 Namdong-daero 774beon-gil, Namdong-gu, Incheon 21565, Korea. Tel: 82-32-460-2751, Fax: 82-32-460-3009, cmj@gilhospital.com

Received 27 April 2017 Revised 29 September 2017 Accepted 15 December 2017

The Korean Ophthalmological Society

(open-access):

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

We used optical coherence tomography (OCT) for longitudinal evaluation of structural changes in the peripapillary retinal nerve fiber layer (RNFL), the macular ganglion cell-inner plexiform layer (GC-IPL), and the macula in patients with traumatic optic neuropathy.

Methods

From May 2012 to April 2015, the medical records of 20 patients with monocular traumatic optic neuropathy who were followed up for over 6 months were retrospectively analyzed. Best-corrected visual acuity was checked and Cirrus high-definition optical coherence tomography (HD-OCT) was used to measure the thicknesses of the peripapillary RNFL, macular GC-IPL, and macula of both eyes at the first visit (within 4 weeks after trauma), at 10 and 24 weeks after trauma, and at the final visits. The differences over time in the parameters of the traumatic and fellow eyes were analyzed.

Results

The final best-corrected visual acuities of the traumatic and fellow eyes differed significantly from those at the first visit (p = 0.007). The average thicknesses of the peripapillary RNFL, the macular GC-IPL, and the macula differed significantly between the traumatic and fellow eyes commencing 10 weeks after trauma (p < 0.001, p = 0.002, p = 0.003, respectively).

Conclusions

Significant changes in visual acuity preceded structural changes in the retina. Objective assessment of retinal structural changes using OCT yields helpful information on the clinical course of patients with traumatic optic neuropathy.

Keywords: Ganglion cell-inner plexiform layer, Optical coherence tomography, Retinal nerve fiber layer, Traumatic optic neuropathy

Figures and Tables

Figure 1

Linear progression of mean retinal nerve fiber layer (RNFL) thickness (µm) of traumatic eye and the fellow eye. Mean RNFL thickness showed significant difference at 10 weeks, 24 weeks after trauma and final follow-up. ^*Wilcoxon signed rank test (p < 0.05).

Figure 2

Linear progression of mean Ganglion Cell and Internal plexiform layer (GC-IPL) thickness (µm) of traumatic eye and the fellow eye. Mean GC-IPL thickness showed significant difference at 10 weeks, 24 weeks after trauma and final follow-up. ^*Wilcoxon signed rank test (p < 0.05).

Figure 3

Linear progression of mean macular thickness (µm) of traumatic eye and the fellow eye. Mean macular thickness showed significant difference at 10 weeks, 24 weeks after trauma and final follow-up. ^*Wilcoxon signed rank test (p < 0.05).

Table 1

Clinical characteristics of the patients

Values are presented as mean ± SD unless otherwise indicated.

Table 2

Visual acuity of the traumatic eyes and the fellow eyes at the first visit after trauma

Values are presented as n (%).

Table 3

Comparison of the logMAR visual acuities between traumatic eye and the fellow eye

Values are presented as mean ± SD unless otherwise indicated.

^*p-values by Wilcoxon signed rank test, significant p-value level is <0.05; ^†Adjusted p-value by linear mixed model, significant p-value level is <0.05.

Table 4

Comparison of RNFL thickness between traumatic eye and the fellow eye

Values are presented as mean ± SD unless otherwise indicated.

RNFL = retinal nerve fiber layer.

^*p-value by Wilcoxon signed rank test, significant p-value level is <0.05; ^†Adjusted p-value by linear mixed model, significant p-value level is <0.05.

Table 5

Comparison of GC-IPL thickness between traumatic eye and the fellow eye

Values are presented as mean ± SD unless otherwise indicated.

GC-IPL = ganglion cell and internal plexiform layer.

^*p-value by Wilcoxon signed rank test, significant p-value level is <0.05; ^†Adjusted p-value by linear mixed model, significant p-value level is <0.05.

Table 6

Comparison of macular thickness between traumatic eye and the fellow eye

Values are presented as mean ± SD unless otherwise indicated.

^*p-value by Wilcoxon signed rank test, significant p-value level is <0.05; ^†Adjusted p-value by linear mixed model, significant p-value level is <0.05.

Table 7

Comparison of thickness of each layer of traumatic eye according to the visual acuity (good/poor) on the first visit

Values are presented as mean ± SD unless otherwise indicated. ‘good’ means ‘visual acuity with 0.1 or higher’ and ‘poor’ means ‘visual acuity with finger count (FC) or lower’.

RNFL = retinal nerve fiber layer; GC-IPL = ganglion cell and internal plexiform layer.

^*p-value was calculated by Wilcoxon signed rank test, significant p-value level is <0.05; ^†Adjusted p-value by linear mixed model, significant p-value level is <0.05.

Notes

^{Conflicts of Interest} The authors have no conflicts to disclose.

References

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Longitudinal Evaluation of Retinal Structure in Patients with Traumatic Optic Neuropathy Using Optical Coherence Tomography

Abstract

Purpose

Methods

Results

Conclusions

Figures and Tables

Figure 1

Linear progression of mean retinal nerve fiber layer (RNFL) thickness (µm) of traumatic eye and the fellow eye. Mean RNFL thickness showed significant difference at 10 weeks, 24 weeks after trauma and final follow-up. *Wilcoxon signed rank test (p < 0.05).

Figure 2

Linear progression of mean Ganglion Cell and Internal plexiform layer (GC-IPL) thickness (µm) of traumatic eye and the fellow eye. Mean GC-IPL thickness showed significant difference at 10 weeks, 24 weeks after trauma and final follow-up. *Wilcoxon signed rank test (p < 0.05).

Figure 3

Linear progression of mean macular thickness (µm) of traumatic eye and the fellow eye. Mean macular thickness showed significant difference at 10 weeks, 24 weeks after trauma and final follow-up. *Wilcoxon signed rank test (p < 0.05).

Table 1

Clinical characteristics of the patients

Table 2

Visual acuity of the traumatic eyes and the fellow eyes at the first visit after trauma

Table 3

Comparison of the logMAR visual acuities between traumatic eye and the fellow eye

Table 4

Comparison of RNFL thickness between traumatic eye and the fellow eye

Table 5

Comparison of GC-IPL thickness between traumatic eye and the fellow eye

Table 6

Comparison of macular thickness between traumatic eye and the fellow eye

Table 7

Comparison of thickness of each layer of traumatic eye according to the visual acuity (good/poor) on the first visit

Notes

References

Linear progression of mean retinal nerve fiber layer (RNFL) thickness (µm) of traumatic eye and the fellow eye. Mean RNFL thickness showed significant difference at 10 weeks, 24 weeks after trauma and final follow-up. ^*Wilcoxon signed rank test (p < 0.05).

Linear progression of mean Ganglion Cell and Internal plexiform layer (GC-IPL) thickness (µm) of traumatic eye and the fellow eye. Mean GC-IPL thickness showed significant difference at 10 weeks, 24 weeks after trauma and final follow-up. ^*Wilcoxon signed rank test (p < 0.05).

Linear progression of mean macular thickness (µm) of traumatic eye and the fellow eye. Mean macular thickness showed significant difference at 10 weeks, 24 weeks after trauma and final follow-up. ^*Wilcoxon signed rank test (p < 0.05).