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Stéphanie Michau, Pascal Perney, Hélène Donnadieu-Rigolle, Max Villain, Vincent Daien; Diagnostic performance of ganglion cell and retinal nerve fiber layer thickness in alcoholic optic neuropathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3883.
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© ARVO (1962-2015); The Authors (2016-present)
To explore the diagnostic performance of optic nerve parameters in early alcoholic optic neuropathy.
395 eyes of 200 patients were included prospectively during hospitalisation for alcohol withdrawal from January 2010 to October 2013 in the University Hospital of Montpellier. The definition of alcoholic optic neuropathy was the assocation of alterated visual field with impaired color vision. Optic nerve variables were assessed by visual-evoked potential, Heidelberg Retina Tomograph III (HRT-III), spectral-domain optic coherence tomography (SD-OCT) (ganglion cell layer [GCL] and retinal nerve fiber layer [RNFL]) and scanning laser polarimetry (GDx). Optic nerve variables were compared between patients with and without optic neuropathy by age- and sex-adjusted analysis of covariance. Diagnostic performance was determined by area under the receiver operating characteristic curve (AUC), sensitivity and specificity.
In total, 47 (24%) patients presented alcoholic ON (mean (SD) age of 47 (11) years; 33 men). Peripheral neuropathy was more frequent in patients with than without alcoholic ON (p<.001) and GCL and RNFL were thinner (mean (SD) of 12.91 (0.7) vs 14.78 (0.3) µm, p=0.015; and 90.27 (2.1) vs 99.57 (1.08) µm, p<.001, respectively). The AUC was highest for superior GCL (AUC=0.78; (95% CI, 0.67-0.89)) and global RNFL thickness from SD-OCT (AUC=0.72; (95% CI 0.62-0.82)) and had the best sensitivity-specificity pair 82.1-62.0% and 79.4-63.4%, respectively. The AUC for GDx and HRTIII ranged from 0.52 to 0.68.
Objective examination including GCL and RNFL thickness on SD-OCT could be useful to improve the diagnostic of alcoholic ON.
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