Nonarteritik iskemik optik nöropati ve glokomatöz optik atrofide optik koherens tomografi bulguları

Yıl 2022, , 140 - 145, 18.03.2022

Sedat Özmen , Emine Doğan , Burçin Köklü Çakır , Nilgün Özkan , Erkan Çelik

https://doi.org/10.31832/smj.909319

Öz

Amaç: Nonarteritik iskemik optik nöropatiye (NAİON) ve glokoma ikincil optik atrofi gelişmiş olgularda optik sinir başı parametrelerinin optik koherens tomografi (OKT) ile değerlendirilmesi.
Materyal-Metod: Glokom (Grup 1) ve NAİON (Grup 2) nedeniyle optik atrofi gelişen olguların dosyaları geriye dönük olarak tarandı. Olguların en iyi düzeltilmiş görme keskinliği (EİDGK), göz içi basıncı (GİB), merkezi kornea kalınlığı, OKT ile retina sinir lif tabakası (RSLT) ve ganglion hücre kompleks kalınlığı parametreleri kaydedildi. Ortalama ve bölgesel (üst, üst temporal, alt, alt temporal, temporal, nazal, üst nazal, ve alt nazal) RSLT ve ganglion hücre kompleks kalınlıkları gruplar arasında karşılaştırıldı.
Bulgular: Grup 1’de yer alan 30 (14 kadın, 16 erkek) olgunun yaş ortalaması 66.2±12 iken, Grup 2’de yer alan 36 (16 kadın, 20 erkek) olgunun 61.6±13.05 idi. EİDGK Grup 1’de 0.43±0.3, Grup 2’de 0.16±0.1 olup; gruplar arasında istatistiksel fark mevcuttu (p <0.01). Ortalama RSLT Grup 1’de 50.8±10 µ, Grup 2’de 59.05±11 µ olup; iki grup arasında istatistiksel olarak anlamlı fark yoktu. (p:0.21). Ortalama ganglion hücre kompleksi kalınlığı gruplarda sırasıyla 50.2±10.4, 48±15 µ olup; NAİON daha düşük bulundu (p:0.04). Alt kadran RSLT kalınlığı Grup 1’de daha düşüktü (p:0.02). Grup 1’de alt temporal kadran ganglion hücre kalınlığı, Grup 2’de üst kadran ganglion hücre kalınlığı belirgin olarak düşük bulundu (p <0.01, p:0.09). Diğer kadranlarada iki grup arasında anlamlı fark yoktu.
Tartışma: RSLT kalınlık ortalaması açısından gruplar arasında fark bulunmazken alt kadran RSLT kalınlığı glokomatöz gözlerde daha ince bulundu. Ortalama ve üst kadran ganglion hücre kompleks kalınlığı NAİON grubunda daha düşük tespit edildi.

Anahtar Kelimeler

optik nöropati, retina sinir lifi tabakası, ganglion hücre tabakası

Optical Coherence Tomography Findings of Nonarteritic Ischemic Optic Neuropathy

Öz

Abstract:
Objective: To evaluate the optical coherence tomography (OCT) parameters in patients with nonartheritic ischemic optic neuropathy (NAION) and glaucomatous optic atrophy.
Material-Method: Datas of patients diagnosed with glaucomatous optic atrophy (Group 1) and NAION (Group 2) and followed-up at the the glaucoma department between 2017-2020 were retrospectively analyzed. Detailed ophthalmologic examination including demographic data, best corrected visual acuity (BCVA), intraocular pressure (IOP), central corneal thickness (CCT) obtained by ultrasonic pachymetry, retinal nerve fiber layer (RNFL) and ganglion cell complex thickness obtained by OCT (Carl Zeiss Meditec, Dublin, CA, USA). The mean and regional (superior, superotemporal, inferior, inferotemporal, temporal, nasal, superonasal, and inferonasal) RNFL and ganglion cell complex thicknesses were compared between the groups.

Results: The mean age of 30 patients (14 female and 16 male) in Group 1 was 66.2 ± 12 and the mean age of 36 patients (20 male, 16 female) in Group 2 was 61.6 ± 13.05 years. Age and gender were similar between the groups (p=0.25). The mean BCVA was 0.43 ± 0.3 and 0.16 ± 0.1 in groups, respectively (p <0.01). The mean RNFL was 50.8 ± 10 µ in Group 1 and 59.05 ± 11 µ in Group 2 (p:021). The mean ganglion cell thickness was 50.2 ± 10.4 and 48 ± 15 µ in Group 1 and Group 2, respectively. It was found to be significantly thinner in Group 2 (p:0.04). The mean inferior quadrant RNFL thickness was 53.96 ± 13 and 74.18 ± 23 µ, in Group 1 and Group 2, respectively and it was significantly thinner in Group 1 (p: 0.02). There was no significant difference between the two groups in the other quadrants’ RNFL thickness. The mean inferotemporal quadrant ganglion cell thickness was significantly thinner in Group 1 and the mean superoquadrant ganglion cell thickness was significantly thinner in Group 2 (p1 <0.01, p2:0.09).
Discussion: The mean ganglion cell complex thickness was found to be thinner in the NAION group. This may indicate that the ganglion cell complex is more susceptible to ischemia-related damage.

Anahtar Kelimeler

optic neuropathy, retinal nerve fiber layer, ganglion cell layer

Kaynakça

• 1, Dağ MY, Biler ED, Alkan Z, Üretmen Ö, Köse S, Afrashi Optic Disc and Retinal Nerve Fiber Layer Thickness Evaluation of the Fellow Eyes in Non-Arteritic Ischemic Optic Neuropathy, TJO 2015; 45 (3) :111-15
• 2. Köktekir BE, Yavuzer K, Gönül Ş, Bakbak B,Gedik Ş, The association of non-arteritic anterior ıschemic optic neuropathy and cystoid macular edema , Retina-vitreus.2013;21:307-10 3. Kartı Ö,Karahan E,Uyar M,Kusbeci T, Nonarteritic Anterior Ischemic Optic Neuropathy Treatments and Current Innovations ,Glokom-Katarakt,2015;10:265-74
• 4.Jurisich D,Laus NK,Sesar I, Kuzman T.Comparision of optic nerve head morphology in patients with primary open angle glaucoma and non arteritic anterior ischemic optic neuropathy. Acta Clin Croat,2017;56:227-235
• 5.Dursun B,Keklikçi SU, Dursun ME,Yıldırım M,Erdem S. Comparasion of computerized visual field and optical coherence tomography in diagnosis and follow-up of primary open-angle glaucoma. Dicle Tıp 2016; 43 (3): 441-51
• 6.Lee EY, Han CJ, Park DY,Kee C. Difference in Topographic Pattern of Prelaminar and Neuroretinal Rim Thinning Between Nonarteritic AnterioRIschemic Optic Neuropathy and Glaucoma.Investigative Ophtalmology&Visual Science. 2019; 60 (7) ,2461-67
• 7.Resch H, Mitsch C, Pereira I, Schwarzhans F, Wasserman L ,Hommer A, et all. Optic nerve head morphology in primary openangle glaucoma and nonarteritic anterior ischaemic optic neuropathy measured with spectral domain optical coherence tomography.Acta Ophalmologica,2018;96-1018-24
• 8. Danesh-Meyer HV, Boland MV, Savino PJ, et al. Optic disc morphology in open-angle glaucoma compared with ante¬rior ischemic optic neuropathies. Invest Ophthalmol Vis Sci 2010;51:2003-10.
• 9. Saito H, Tomidokoro A, Sugimoto E, Aihara M, Tomita G, Fujie K et all, Optic Disc Topography and Peripapillary Retinal Nerve Fiber Layer Thickness in Nonarteritic Ischemic Optic Neuropathy and Open-Angle Glaucoma. Ophtalmology ;2006, 113(8) 1340-44
• 10. Cristopher K, Shun L, Carol Y,Lui C, Robert NW,Quanliang Q et all Retinal Nerve Fiber Layer Imaging With Spectral-Domain Optical Coherence Tomography: A Variability and Diagnostic Performance Study. Ophtalmology;2009, 116(7) 1257-63
• 11. Horowitz J, Fishelzon-Arev T, Rath EZ, et al. Comparison of optic nerve head topography findings in eyes with non-arteritic anterior ischemic optic neuropathy and eyes with glaucoma. Graefes Arch Clin Exp Ophthalmol 2010; 248:845-51.
• 12. Fard MA, Afzali M, Abdi P, Chen R, Yaseri M, Azeripour E et all. Optic Nerve Head Morphology in Nonarteritic Anterior Ischemic Optic Neuropathy Compared to Open-Angle Glaucoma. 2016,57 (11) 4632-40