Abstract
Abstract: :
Purpose: To investigate the characteristics of retinal nerve fiber layer (RNFL) damage in patients with autosomal dominant optic atrophy (DOA), and to identify differences in the characteristics of RNFL damage between DOA and normal tension glaucoma (NTG). Methods: RNFL were examined by optical coherence tomography (OCT) in 20 eyes of ten patients who were clinically or genetically diagnosed as having DOA. Areas with an RNFL thickness outside of 95% normal limits were evaluated topographically. Correlations between the RNFL thickness of quadrants and the degree of disc pallor, and between the RNFL thickness of the temporal quadrant and those of the other three quadrants were determined. Finally, RNFL thicknesses of all quadrants were compared bilaterally. Results: OCT images were obtained in 9 patients. Of the 18 eyes of those 9 patients, the OCT–measured nerve fiber layer thicknesses of the temporal 30° sector and of the temporal quadrant were outside of 95% normal limits in 16 eyes. RNFL damage was also observed in the three other quadrants. Significant correlations were found between the OCT RNFL thicknesses of the temporal, superior, and inferior quadrants and the degree of disc pallor (R2 range = 27.1–51.1%, all Ps < 0.05). Additionally, the RNFL thickness of the superior, inferior, and nasal quadrants were highly correlated with that of the temporal quadrant (R2 range = 45.5–48.6%, all Ps < 0.005). In terms of the bilateral comparison, the RNFL thicknesses of corresponding quadrants showed no difference between right and left eyes and were highly correlated bilaterally (R2 range = 72.3–87.1%, all Ps < 0.005). Conclusions: Our data indicates that progressive RNFL damage occurs globally from the early stage of disease in DOA. Furthermore, several findings that are uncommon in glaucoma, such as early RNFL damage in the temporal region and the bilateral topographic symmetry of RNFL damage were consistently observed. Thus, we conclude that an examination of the RNFL by OCT may be useful for differentiating DOA from NTG.
Keywords: neuro-ophthalmology: optic nerve • nerve fiber layer • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)