June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
A Comparison of Transition Zones from Relatively Healthy to Severely Affected Retinal Nerve Fiber Layer in Glaucoma and NAION Patients
Author Affiliations & Notes
  • Monica Chen
    Biochemistry, Columbia University, New York, NY
  • Ali Raza
    Neurobiology and Behavior, Columbia University, New York, NY
  • Elaine Su
    School of Medicine, Columbia University, New York, NY
  • Jeffrey Odel
    Ophthalmology, Columbia University, New York, NY
  • C. Gustavo De Moraes
    Ophthalmology, NYU School of Medicine, New York, NY
  • Jeffrey Liebmann
    Ophthalmology, NYU School of Medicine, New York, NY
    Einhorn Clinical Research Center, New York Eye & Ear Infirmary, New York, NY
  • Robert Ritch
    Einhorn Clinical Research Center, New York Eye & Ear Infirmary, New York, NY
    Ophthalmology, New York Medical College, Valhalla, NY
  • Donald Hood
    Psychology and Ophthalmology, Columbia University, New York, NY
  • Footnotes
    Commercial Relationships Monica Chen, None; Ali Raza, None; Elaine Su, None; Jeffrey Odel, Bayer (C); C. Gustavo De Moraes, None; Jeffrey Liebmann, Alcon Laboratories, Inc. (C), Allergan, Inc. (C), Allergan, Inc. (F), Carl Zeiss Meditech, Inc (F), Heidelberg Engineering, GmbH (F), Topcon Medical Systems, Inc. (F), National Eye Institute (F), New York Glaucoma Research Institute (F), SOLX, Inc. (C), Bausch & Lomb, Inc (C), Diopsys, Inc. (C), Diopsys, Inc. (F), Merz, Inc. (C), Glaukos, Inc. (C), Quark, Inc. (C); Robert Ritch, None; Donald Hood, Topcon, In (F)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2352. doi:
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      Monica Chen, Ali Raza, Elaine Su, Jeffrey Odel, C. Gustavo De Moraes, Jeffrey Liebmann, Robert Ritch, Donald Hood; A Comparison of Transition Zones from Relatively Healthy to Severely Affected Retinal Nerve Fiber Layer in Glaucoma and NAION Patients. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2352.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To study structural changes in the transition zone (TZ) from relatively healthy to severely affected regions in glaucoma and non-arteritic anterior ischemic optic neuropathy (ION) using frequency domain optical coherence tomography (fdOCT).

 
Methods
 

Peripapillary fdOCT scans (black circle, Fig. 1) were obtained from 17 eyes of 13 glaucoma patients (62.1±15.2 yrs) with central arcuate defects on 10-2 fields, 8 eyes of 7 ION patients (67.1±10.7 yrs), and 54 eyes of 54 controls (53.2±8.1 yrs). Macular vertical line scans (black bar, Fig. 1) were obtained from the glaucoma patients and 16 eyes of 16 controls (55.5±10.7 yrs). Using a hand-corrected algorithm,[1,2] retinal nerve fiber layer (RNFL) thicknesses were obtained across the TZ in the macular (M) and peripapillary (P) region.

 
Results
 

For the glaucoma (GL) M (blue) and P (green) and the ION P (red) analyses in Fig. 2A, the patients’ RNFL thickness profiles were averaged after shifting relative to the point (tz0) where thicknesses fell below a 95% confidence limit in controls. Absolute thickness loss was determined by subtracting the mean control thickness (Fig. 2B) and relative thickness loss by dividing the absolute thickness loss by the mean control thickness (Fig. 2C). The rate of thickness change at the edge of TZ (slope) was determined in a 0.2 mm window near tz0 (dotted lines). The slopes were: dissimilar for the shifted data (Fig. 2A): -.002 (GL M), -.051 (GL P), and -.106 (ION P); less discrepant for absolute thickness loss (Fig. 2B): -.042, -.113, and -.075; but relatively similar for relative thickness loss (Fig. 2C): -.116, -.102, -.085 %/μm. Surprisingly, there was a modest correlation (R2=.33) between the slopes of the relative thickness losses for GL P and GL M.

 
Conclusions
 

When expressed as relative thickness loss, the slopes of the TZs are similar for macula and peripapillary regions affected by glaucoma and for peripapillary regions affected by glaucoma and ION. This suggests that while different numbers of axons are affected in each TZ, about the same relative number of axons is lost. TZ analyses may constrain models of mechanisms of diseases affecting the RNFL. 1. Raza et al AO 2011; 2. Yang et al Opt Exp 2010.

 
 
Fig. 1. RNFL thickness of a glaucoma patient.
 
Fig. 1. RNFL thickness of a glaucoma patient.
 
 
Fig. 2. RNFL thickness relative to tz0.
 
Fig. 2. RNFL thickness relative to tz0.
 
Keywords: 613 neuro-ophthalmology: optic nerve • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 610 nerve fiber layer  
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