Early axonal damage detection by ganglion cell complex analysis with optical coherence tomography in nonarteritic anterior ischaemic optic neuropathy

Purpose To investigate the ability of ganglion cell complex (GCC) analysis by optical coherence tomography (OCT) to detect early axonal damage in nonarteritic anterior ischaemic optic neuropathy (NAION), and to assess the relationship of GCC measurements with visual field defects and function parame...

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Bibliographic Details
Published in:	Graefe's archive for clinical and experimental ophthalmology Vol. 252; no. 11; pp. 1839 - 1846
Main Authors:	Larrea, Begoña Arana, Iztueta, Marta Galdos, Indart, Lorea Martinez, Alday, Nerea Martinez
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-11-2014 Springer Nature B.V
Subjects:	Acute Disease Aged Arteritis - diagnosis Arteritis - physiopathology Axons - pathology Chronic Disease Early Diagnosis Female Humans Male Medicine Medicine & Public Health Middle Aged Nerve Fibers - pathology Neurophthalmology Ophthalmology Optic Disk - pathology Optic Neuropathy, Ischemic - diagnosis Optic Neuropathy, Ischemic - physiopathology Retinal Ganglion Cells - pathology Retrospective Studies Tomography, Optical Coherence Visual Acuity - physiology Visual Field Tests Visual Fields - physiology Ganglion cell complex (GCC) Nonarteritic anterior ischaemic optic neuropathy (NAION) Diagnosis Axonal damage Optical coherence tomography (OCT)
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Summary:	Purpose To investigate the ability of ganglion cell complex (GCC) analysis by optical coherence tomography (OCT) to detect early axonal damage in nonarteritic anterior ischaemic optic neuropathy (NAION), and to assess the relationship of GCC measurements with visual field defects and function parameters. Methods Twenty-two patients with NAION participated in this retrospective case-series study. Patients underwent spectral-domain OCT measurement of retinal nerve fibre layer (RNFL) and GCC average and minimum thicknesses, best-corrected visual acuity, Ishihara test and Humphrey visual field (SITA Standard 24–2). These measurements were recorded in the acute (2–6 weeks after the ischaemic episode) and chronic (≥6 months later) phases. Spearman’s coefficients were used to assess the relationship between GCC thickness and visual field defects. Results In the acute phase, none of the patients showed atrophy of the optic disc, while early damage was observed in the GCC average and minimum thickness in 54.54 % and 77.27 % of patients. At 6 months, the rate of patients with RNFL below normal limits increased to 90 % in the RNFL, and 92.85 % and 100 % in the GCC average and minimum GCC respectively. Spearman’s coefficients indicated significant relationships of GCC in the acute phase with visual field index and mean deviation in both acute and chronic phases. A significant correlation was also found with location of the defects. Conclusions GCC thickness measurement by OCT is capable of detecting early axonal damage in NAION eyes in the acute phase that cannot be detected by RNFL. GCC defects are significantly correlated with visual field globally and the defect location.
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ISSN:	0721-832X 1435-702X
DOI:	10.1007/s00417-014-2697-0