Akbari Mohammadreza, Abdi Parisa, Fard Masoud Aghsaei, Afzali Marjan, Ameri Ahmad, Yazdani-Abyaneh Alireza, Mohammadi Massod, Moghimi Sasan
Eye Research Center, Department of Neuro-Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Neuroophthalmol. 2016 Jun;36(2):141-6. doi: 10.1097/WNO.0000000000000345.
Loss of retinal ganglion cell-inner plexiform layer (GCIPL) thickness has been shown in different optic neuropathies. In this study, we evaluated the capability of GCIPL analysis by optical coherence tomography (OCT) to detect early neuronal loss during the time course of nonarteritic anterior ischemic optic neuropathy (NAION).
Twenty-four patients with unilateral NAION participated in this prospective, comparative study. Affected and unaffected eyes underwent spectral domain OCT measurement of the retinal nerve fiber layer (RNFL), total macula, and GCIPL thicknesses. These measurements were recorded in the acute phase (within 7 days) and at 1, 3, and 6 months.
At the initial presentation and 1, 3, and 6 months, the mean RNFL thickness in the NAION eyes was 236.5 μm ± 74.2, 157.1 μm ± 45.7, 61.4 μm ± 6.1, and 55.0 μm ± 19.5, respectively. Similar to RNFL, thinning of the mean total macular thickness in inner and outer rings started after 3 months and thicknesses decreased to 307.7 μm ± 15.3 and 273.1 μm ± 21.2 after 3 months and to 309.1 μm ± 15.0 and 273.4 μm ± 13.8 after 6 months, compared with unaffected contralateral eyes, respectively (all P < 0.0001). Thinning of the GCIPL was first evident in the affected NAION eyes at 1 month, and the mean inner and outer GCIPL thicknesses were 62.8 μm ± 14.6 and 53.9 μm ± 7.2 at 1 month in the NAION eyes compared with unaffected eyes (P < 0.001). After 3 and 6 months, the inner and outer GCIPL thicknesses were 51.1 μm ± 8.1 and 47.4 μm ± 5.31, and 50.6 μm ± 11.5 and 47.9 μm ± 5.6, respectively.
Thinning of the GCIPL is first detectable at 1 month after NAION and persists for 3 months. GCIPL thinning occurs before RFNL thinning in NAION.
视网膜神经节细胞 - 内丛状层（GCIPL）厚度的减少已在不同的视神经病变中得到证实。在本研究中，我们评估了光学相干断层扫描（OCT）分析GCIPL以检测非动脉性前部缺血性视神经病变（NAION）病程中早期神经元丢失的能力。
24名单侧NAION患者参与了这项前瞻性对照研究。对患眼和未患眼进行视网膜神经纤维层（RNFL）、整个黄斑以及GCIPL厚度的光谱域OCT测量。这些测量在急性期（7天内）以及1、3和6个月时进行记录。
在初次就诊时以及1、3和6个月时，NAION患眼中RNFL的平均厚度分别为236.5μm±74.2、157.1μm±45.7、61.4μm±6.1和55.0μm±19.5。与RNFL相似，内、外环整个黄斑平均厚度在3个月后开始变薄，3个月后厚度分别降至307.7μm±15.3和273.1μm±21.2，6个月后分别降至309.1μm±15.0和273.4μm±13.8，与对侧未患眼相比（所有P<0.0001）。GCIPL变薄在患侧NAION眼中于1个月时首次明显可见，与未患眼相比，NAION患眼中1个月时GCIPL内、外平均厚度分别为62.8μm±14.6和53.9μm±7.2（P<0.001）。3个月和6个月后，GCIPL内、外厚度分别为51.1μm±8.1和47.4μm±5.31，以及50.6μm±11.5和47.9μm±5.6。
NAION后1个月可首次检测到GCIPL变薄，并持续3个月。在NAION中，GCIPL变薄发生在RFNL变薄之前。
