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M. H. Oltmanns, M. Peden, S. Adams, R. Ratnakaram, S. Kaushal; Disciform Scarring in Macular Degeneration Correlates With Loss of Retinal Nerve Fiber Layer Thickness on Optical Coherence Tomography (OCT). Invest. Ophthalmol. Vis. Sci. 2008;49(13):2233.
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Age-related macular degeneration (ARMD) is a leading cause of visual impairment in the elderly population. Current management of this disease frequently involves evaluation for subretinal manifestations using optical coherence tomography. However, quantification of nerve fiber loss in ARMD may also be a useful tool to follow the disease and predict progression. The purpose of the present study was to determine if a correlation exists between the size of disciform scarring secondary to ARMD and retinal nerve fiber layer (RNFL) thickness, as measured by the StratusTM optical coherence tomography (OCT) system.
Patients with ARMD displaying disciform scarring in one eye and non-exudative disease in the fellow eye were enrolled in the study (n=3). The eyes with non-exudative disease served as controls. Color fundus photos and StratusTM OCT fast RNFL scans were performed on each eye. Disciform scars were measured by figuring size in units of disc areas. Average RNFL thickness was obtained from the OCT data. Visual acuity using a standard Snellen chart at 20 ft was also recorded. None of the eyes in the study had optic nerve appearance suggestive of glaucoma, eliminating this condition as a confounder for nerve fiber layer loss.
CF=count fingersSize of disciform scarring was found to be negatively correlated with RNFL thickness, with a Pearson correlation coefficient of -0.47. However, this relationship was not statistically significant (p>0.05).
Assessing RNFL thickness using OCT technology may prove to be a useful tool in monitoring and predicting progression of ARMD. The current study shows an inverse relationship between disciform scar size and RNFL thickness. As more patients are recruited for this ongoing experiment, the power of the study will increase.
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