Optical Coherence Tomography Findings in the Patients with Non-Arteritic Ischemic Optic Neuropathy

Yıl 2023, Cilt: 10 Sayı: 1, 6 - 14, 10.04.2023

Tolga Ceylan , Vuslat Gürlü , Göksu Alaçamlı

https://doi.org/10.47572/muskutd.1003199

Öz

We aimed to evaluate peripapillary retina nerve fiber layer thickness and the morphological changes of optic nerve head of the cases with non arteritic ischemic optic neuropathy by optic coherence tomography, and to compare with normal cases consisting of similar age groups. 50 eyes of 42 cases that received diagnosis of non arteritic ischemic optic neuropathy and 50 eyes of 50 normal cases in the Department of Ophthalmology were included in the study. 80.96% of the group with non arteritic ischemic optic neuropathy was hipertensive patients, 52% of the control group was hipertensive patients. Total, hemispheric and sectorial peripapillary retina nerve fiber layer thickness of the cases with non arteritic ischemic optic neuropathy was significantly thinner. The maximum thinning rate was 40.75% and that was upper quadrant. In the evaluation of optic nerve head, average cup/disc ratios were similar between two groups. Optic disc area of the group with non arteritic ischemic optic neuropathy was 2.23±0.89 mm2, in the control group that was 2.75±0.52 mm2. Statistically, average optic disc area of the group with non arteritic ischemic optic neuropathy was found smaller (p=0.042). Peripapillary retinal nerve fiber layer thinning that especially localized in the upper quadrant as determined by optic cohorence tomography and the smallness of optic disc space in cases with non-arteritic ischemic optic neuropathy can be used as helper method in the diagnosis of nonarteritic ischemic optic neuropathy.

Anahtar Kelimeler

Non Arteritic İschemic Optic Neuropathy, Optic Coherence Tomography, Retinal Nerve Fiber Layer

Non-Arteritik İskemik Optik Nöropatili Olgulardaki Optik Koherens Tomografi Bulguları

Öz

Bu çalışmada; nonarteritik iskemik optik nöropatili olguların peripapiller retina sinir lifi tabakası kalınlığını ve optik diskin morfolojik değişiklerini optik koherens tomografi ile benzer yaş grubundan oluşan kontrol grubu ile karşılaştırmayı amaçladık. Çalışmaya Göz Hastalıkları Anabilim Dalı’nda nonarteritik iskemik optik nöropati tanısı almış 42 olgunun 50 gözü ve 50 normal olgunun 50 gözü dahil edildi. Nonarteritik iskemik optik nöropatili olgu grubunda %80.96’sı hipertansiyon hastasıyken, kontrol grubunun %52.00’sinde hipertansiyon mevcuttu. Nonarteritik iskemik optik nöropatili olgu grubunun, total, yarı alan ve sektöryel peripapiler retina sinir lifi tabakası kalınlığı kontrol grubuna göre anlamlı derecede ince bulundu. Sinir lifi tabakasındaki incelmenin en belirgin olduğu kadran %40.75 oranı ile üst kadrandı. Optik disk incelemesinde iki grup arasında ortalama cup/disk oranları birbirine benzerdi. Optik disk alanı nonarteritik iskemik optik nöropatili grupta 2.23±0.89 mm2 olup, kontrol grubunda 2.75±0.52 mm2 olarak bulundu. Nonarteritik iskemik optik nöropatili grubun optik disk alanı ortalaması istatistiksel olarak anlamlı şekilde daha küçük olarak saptandı (p=0.042). Nonarteritik iskemik optik nöropati geçirmiş olgularda optik koherens tomografi ile saptanan, özellikle üst kadranda lokalize belirgin peripapilller retina sinir lifi tabakası incelmesi ve optik disk alanının küçüklüğü nonarteritik iskemik optik nöropati tanısında yardımcı yöntem olarak kullanılabilir.

Anahtar Kelimeler

Nonarteritik İskemik Optik Nöropati, Optik Koherens Tomografi, Retina Sinir Lifi Tabakası

Kaynakça

• 1. Margalit E, Sadda SR. Retinal and optic nerve diseases. Artif Organs. 2003;27(11):963-74.
• 2. Hayreh SS. Blood flow in the optic nerve head and factors that may influence it. Prog Retin Eye Res. 2001;20(5):595-624.
• 3. Knox DL, Kerrison JB, Green WR. Histopathologic studies of ischemic optic neuropathy. Trans Am Ophthalmol Soc. 2000;98:203–20.
• 4. Amold AC. Pathogenesis of nonarteritic anterior ischemic optic neuropathy. J Neuro-Ophthalmol. 2003;23(2):157-63.
• 5. Radius RL. Anatomy and pathophysiology of the retina and optic nerve. In: Ritch R, Shields MB, Krupin T, eds. The Glaucomas. 1 1989; 89-132. St Louis.
• 6. Cibis G, Beaver H, Johns K, et al. Kraniyal sinirler: Santral ve periferik bağlantılar (çeviri: Ünver YB). Aydın P (Editör). Oftalmoljinin Esas ve İlkeleri. Ankara: Güneş Tıp Kitapevleri. 2009; 93-102.
• 7. Hayreh SS. Ischemic optic neuropathy. Prog Retin Eye Res. 2009;28:34–62.
• 8. Hayreh SS. Posterior ciliary artery circulation in health and disease: the Weisenfeld lecture. Invest Ophthalmol. 2004;45:749-57.
• 9. Onda E, Cioffi GA, Bacon DR, et al. Microvasculature of the human optic nerve. Am J Ophtalmol. 1995;120:92-102.
• 10. Singh S, Dass R. The central artery of the retina. A study of its distribution and anastomoses. Br J Ophthalmol. 1960;44:280-90.
• 11. Snell RS, Lemp MA. The eyeball. Clinical Anatomy of Ophtalmology, Malden MA: Blackwell Science. 1998;23:175-95.
• 12. Hayreh SS. The central artery of the retina its role in the blood supply of the optic nerve. Br J Ophthalmol. 1963;47:651-63.
• 13. Haefliger IO, Meyer P, Flammer J, et al. The vascular endothelium asa regulator of the ocular circulation: a new concept ophthalmology? Surv Ophthalmol. 1994;39:123-32.
• 14. Hayreh SS, Bill A, Sperber GO. Effects of high intraocular pressure on the glucose metabolism in the retina and optic nerve in old atherosclerotic monkeys. Graefes Arch Clin Exp Ophthalmol. 1994;232:745-52.
• 15. Hayreh SS. Factors influencing blood flow in the optic nerve head. J Glaucoma. 1997;6:412-25.
• 16. Boghen DR, Glaser JS. Ischaemic optic neuropathy. Brain. 1975;98:689-708.
• 17. Jonas JB, Hayreh SS, Tao Y, et al. Optic nerve head change in non-arteritic anterior ischemic optic neuropathy and its influence on visual outcome. PloS One. 2012;7(5):374-9.
• 18. Hayreh SS, Podhajsky PA, Zimmerman B. Ocular manifestations of giant cell arteritis. Am J Ophthalmol. 1998;125:509-20.
• 19. Hayreh SS, Podhajsky PA, Raman R, et al. Giant cell arteritis: validity and reliability of various diagnostic criteria. Am J Ophthalmol. 1997;123:286-96.
• 20. Salvarani C, Cantini F, Hunder GG. Polymyalgia rheumatica and giant-cell arteritis. Lancet. 2008;372:234–45.
• 21. Hattenhauer MG, Leavitt JA, Hodge DO. Incidence of nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1997;123:103–7.
• 22. Preechawat P, Bruce BB, Newman NJ. Anterior ischemic optic neuropathy in patients younger than 50 years. Am J Ophthalmol. 2007;144:953–60.
• 23. Johnson LN, Arnold AC. Incidence of nonarteritic and arteritic anterior ischemic optic neuropathy: population-based study in the state of Missouri and Los Angeles County, California. J Neuroophthalmol. 1994;14:38–44.
• 24. Amold AC. Pathogenesis of nonarteritic anterior ischemic optic neuropathy. JNeuro-Ophthalmol. 2003;23(2):157-63.
• 25. Hayreh SS, Podhajsky P, Zimmerman MB. Role of nocturnal arterial hypotension in optic nerve head ischemic disorders. Ophthalmologica. 1999;213:79-96.
• 26. Hayreh SS, Zimmerman MB, Podhajsky P. Nocturnal arterial hypotension and its role in optic nerve head and ocular ischemic disorders. Am J Ophthalmol. 1994;117:603-24.
• 27. Hayreh SS. Inter-individual variation in blood supply of the optic nerve head: Its importance in various ischemic disorders of the optic nerve head, and glaucoma, low-tension glaucoma and allied disorders. Doc Ophthalmol. 1985;59:217–46.
• 28. Hayreh SS, Zimmermen MB. Nonarteritic anterior ischemic opticneuropathy: Clinical characteristic in diabetic patients versus nondiabetic patients. Ophthalmology. 2008;115:1818-25.
• 29. Hayreh SS, Podhajsky PA, Zimmerman B. Nonarteritic anterior ischemic optic neuropathy: time of onset of visual loss. Am J Ophthalmol. 1997;124:641-7.
• 30. Newman J, Dickersin K, Kaufman D, et al. Characteristics of patients with nonarteritic anterior ischemic optic neuropathy eligible for the Ischemic Optic Neuropathy Decompression Trial. Arch Ophthalmol. 1996;114:1366–74.
• 31. Hayreh SS, Zimmerman MB. Optic disc edema in nonarteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2007:245;1107-21.
• 32. Hayreh SS. Ischemic optic neuropathy. Prog Retin Eye Res. 2009;28:34–62.
• 33. Hayreh SS, Zahoruk RM. Anterior ischemic optic neuropathy: VI. In juvenile diabetics. Ophthalmologica. 1981;182:13–28.
• 34. Arnold AC, Levin LA. Treatment of ischemic optic neuropathy. Semin Ophthalmol. 2002;17:39-46.
• 35. Fujimoto JG, Pitris C, Boppart SA, et al. Optical coherence tomography: an emerging technology for biomedical imaging and optical biopsy. Neoplasia. 2000;2:9-25.
• 36. Mumcuoglu T, Erdurman C, Durukan H. Optik koherens tomografi prensipleri ve uygulamadaki yenilikler. T Oft Gaz. 2008;38:168-75.
• 37. Bogen DR, Glaser JS. Ischaemic optic neuropathy. The clinical profile and history. Brain. 1975;98:689-708.
• 38. Guyer DR, Miller NR, Auer CL. The risk of cerebrovascular and cardiovascular disease in patients with anterior ischemic optic neuropathy. Arch Ophthalmol. 1985;103:1136-42.
• 39. Hayreh SS, Joos KM, Podhajsky PA. Systemic diseases associated with nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1994;118:766–80.
• 40. Jacobson DM, Vierkant RA, Belongia EA. Nonarteritic anterior ischemic optic neuropathy. A case-control study of potential risk factors. Arch Ophthalmol. 1997;115:1403–7.
• 41. Hayreh SS, Zimmerman MB. Nonarteritic anterior ischemic optic neuropathy: natural history of visual outcome. Ophthalmology. 2008;115:298–305.
• 42. Chi QM, Tomita G, Inazumi K, et al. Evaluation of the effect of aging on the retinal nerve fiber layer thickness using scanning laser polarimetry. J Glaucoma. 1995;4:406-13.
• 43. Bellusci C, Savini G, Carbonelli M, et al. Retinal nerve fiber layer thickness in nonarteritic anterior ischemic optic neuropathy: OCT characterization of the acute and resolving phases. Graefes Arch Clin Exp Ophthalmol. 2008;246(5):641-7.
• 44. Kusuhara NA, Nakamura M, Kanamori A, et al. Evaluation of optic nerve head configuration in various types of optic neuropathy with Heidelberg Retina Tomograph. Eye. 2007;11:1-7.
• 45. Alasil T, Tan O, Lu AT, et al. Correlation of Fourier domain optical coherence tomography retinal nerve fiber layer maps with visual fields in nonarteritic ischemic optic neuropathy. Ophthalmic Surg Lasers Imaging. 2008;39(4):S71–9.
• 46. Iorga RE, Moraru A, Ozturk MR, et al. The role of Optical Coherence Tomography in optic neuropathies. Rom J Ophthalmol. 2018;62(1):3-14.
• 47. García-Basterra I, García-Ben A, Ríus-Díaz F, et al. Prospective analysis of macular and optic disc changes after non-arteritic anterior ischemic optic neuropathy. J Fr Ophtalmol. 2020;43(1):35-42.
• 48. Duman R, Yavas GF, Veliyev I, et al. Structural changes of macula and optic disk of the fellow eye in patients with nonarteritic anterior ischemic optic neuropathy. Int Ophthalmol. 2019;39(6):1293-8.
• 49. Pérez-Sarriegui A, Muñoz-Negrete FJ, Noval S, et al. Automated evaluation of choroidal thickness and minimum rim width thickness in nonarteritic anterior ischemic optic neuropathy. J Neuro Ophthalmol. 2018;38(1):7-12.
• 50. Lee Y, Park KA, Oh SY. Changes in the structure of retinal layers over time in non-arteritic anterior ischaemic optic neuropathy. Eye. 2021;35(6):1748-57.
• 51. Akbulut S, Pekel G, Pekel E, et al. Alterations in retinal and choroidal thickness following nonarteritic anterior ischemic optic neuropathy. Int Ophthalmol. 2021;41(8):2723-8.
• 52. Quigley HA, Miller NR, Gren WR. The pattern of optic nerve fiber loss in anterior ischemic optic neuropathy. Am J Ophthalmol. 1985;100:769-76.
• 53. Aggarwal D, Tan O, Huang D. Patterns of ganglion cell complex and nerve fiber layer loss in nonarteritic ischemic optic neuropathy by Fourier-domain optical coherence tomography. Invest Ophthalmol Vis Sci. 2012;53:4539-45.
• 54. Bellusci C, Savini G, Carbonelli M, et al. Retinal nerve fiber layer thickness in nonarteritic anterior ischemic optic neuropathy: OCT characterization of the acute and resolving phases. Graefes Arch Clin Exp Ophthalmol. 2008;246:641–7.
• 55. Sadun AA, Wang MY. Abnormalities of the optic disc. Handb Clin Neurol. 2011;102:117–57.
• 56. Jiang J, Wang Z, Chen Y, et al. Patterns of retinal ganglion cell damage in nonarteritic anterior ischemic optic neuropathy assessed by Swept-source optical coherence tomography. J Neuro Ophthalmol. 2021;41(1):37-47.
• 57. Mansour A, Shoch D, Logani S. Optic disk size in ischemic optic neuropathy. Am J Ophthalmol. 1988;106:587-9.
• 58. Jonas JB, Gusek GC, Naumann GOH. Anterior ischemic optic neuropathy: nonarteritic form in small and giant cell arteritis in normal sized optic discs. Int Ophthalmol. 1988;12:119-25.
• 59. Danesh-Meyer HV, Savino PJ, Spaeth GL, et al. Comparison of arteritis and nonarteritic anterior ischemic optic neuropathies with the Heidelberg Retina Tomograph. Ophthalmology. 2005;112:1104-12.
• 60. Contreras I, Rebolleda G, Noval S, et al. Optic disc evaluation by optical coherence tomography in nonarteritic anterior ischemic optic neuropathy. Invest Ophthalmol Vis Sci. 2007;48(9):4087-92.
• 61. Barkana Y, Harizman N, Gerber Y, et al. Measurements of optic disk size with HRT II, Stratus OCT, and funduscopy are not interchangeable. Am J Ophthalmol. 2006;142:375–80.
• 62. Paunescu LA, Schuman JS, Price LL. Reproducibility of nevre fiber thickness, macular thickness, and optic nerve head measurements using Stratus OCT. Invest Ophthalmol Vis Sci. 2004;45:1716–24.