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Retinal Nerve Fiber Layer Thickness in Various Retinal Diseases

Lim, Hyung-Bin, MD1,2; Sung, Jae-Yun, MD1; Ahn, Seung-Il, MD3; Jo, Young-Joon, MD, PhD1,4; Kim, Jung-Yeul, MD, PhD1,4*

doi: 10.1097/OPX.0000000000001181
Original Investigations

SIGNIFICANCE Peripapillary retinal nerve fiber layer (RNFL) thickness measurements may be influenced by the range and severity of lesions that are observed distinctively in each retinal disease.

PURPOSE We investigated the effects of various macular (central serous chorioretinopathy, macular hole, epiretinal membrane, wet age-related macular degeneration) and retinal vascular (branch retinal vein occlusion, central retinal vein occlusion, diabetic macular edema) diseases on peripapillary RNFL thickness measurements using spectral-domain optical coherence tomography.

METHODS Six hundred thirty-one eyes from 464 patients with various retinal diseases and 167 controls of similar age were included in this retrospective study. Using spectral-domain optical coherence tomography, we measured the thickness of the macula and the RNFL in both various retinal disease eyes and normal control eyes. Four sectorial and average RNFL thicknesses were compared between each disease and age-matched control eyes. The macular thicknesses were also compared.

RESULTS In the macular disease group, superior (P = .033) and temporal (P = .024) quadrant RNFL thicknesses of central serous chorioretinopathy and temporal (P < .001) quadrant RNFL thicknesses of epiretinal membrane were greater than the age-matched control eyes. No RNFL measurements in macular hole or wet age-related macular degeneration differed significantly from the controls. In the retinal vascular disease group, all sectorial and average RNFL thicknesses of diabetic macular edema and central retinal vein occlusion were greater than those of the controls (all P < .05). In branch retinal vein occlusion, superior (P = .012) and temporal (P < .001) quadrant RNFL thicknesses were greater than those of the controls.

CONCLUSIONS Peripapillary RNFL thickness measurements may be influenced by the range and severity of lesions that are observed distinctively in each retinal disease. It also appeared that macular disease had a local effect on RNFL thickness, whereas retinal vascular disease had a diffuse effect on RNFL thickness.

1Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea

2Department of Ophthalmology, Armed Forces Capital Hospital, Seongnam, Republic of Korea

3Maleunnoon Eye Clinic, Daejeon, Republic of Korea

4Research Institute for Medical Science, Chungnam National University College of Medicine, Daejeon, Republic of Korea *kimjy@cnu.ac.kr

Supplemental Digital Content: Appendix Table A1, available at http://links.lww.com/OPX/A332, gives the macular thickness of the Early Treatment Diabetic Retinopathy Study subfields in normal controls and disease eyes.

Submitted: April 19, 2017

Accepted: October 22, 2017

Funding/Support: None of the authors have reported funding/support.

Conflict of Interest Disclosure: None of the authors have reported a conflict of interest.

Author Contributions: Conceptualization: HBL, JYK; Data Curation: HBL, JYS, JYK; Formal Analysis: HBL, JYS, YJJ, JYK; Investigation: HBL; Supervision: HBL, SIA, YJJ, JYK; Writing – Original Draft: HBL, JYK; Writing – Review & Editing: HBL, SIA, YJJ, JYK.

Supplemental Digital Content: Direct URL links are provided within the text.

© 2018 American Academy of Optometry