Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea.
Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Sci Rep. 2024 May 27;14(1):12069. doi: 10.1038/s41598-024-62704-w.
Optical coherence tomography (OCT) displays the retinal nerve fiber layer (RNFL) or macular ganglion cell and inner plexiform layer (GCIPL) thickness below 1st percentile in red color. This finding generally indicates severe inner-retinal structural changes and suggests poor visual function. Nevertheless, some individuals show preserved visual function despite these circumstances. This study aimed to identify the correlation between best-corrected visual acuity (BCVA) and inner-retinal thickness based on OCT parameters in various optic neuropathy patients with extremely low RNFL/GCIPL thickness, and determine the limitation of OCT for predicting visual function in these patients. 131 patients were included in the study. The mean BCVA in logMAR was 0.55 ± 0.70 with a broad range from - 0.18 to 3.00. Among the OCT parameters, temporal GCIPL (r = - 0.412) and average GCIPL (r = - 0.366) exhibited the higher correlations with BCVA. Etiological comparisons of optic neuropathies revealed significantly lower BCVA in LHON (all p < 0.05). Idiopathic optic neuritis (ON) and MOGAD exhibited better and narrower BCVA distributions compared to the other optic neuropathies. OCT had limited utility in reflecting BCVA, notwithstanding significant inner-retinal thinning after optic nerve injuries. Caution is needed in interpreting OCT findings, especially as they relate to the etiology of optic neuropathy.
光学相干断层扫描 (OCT) 以红色显示视网膜神经纤维层 (RNFL) 或黄斑神经节细胞和内丛状层 (GCIPL) 厚度低于第 1 百分位数。这种发现通常表明严重的内视网膜结构变化，并提示视力功能不佳。然而，一些人尽管存在这些情况，但仍表现出保留的视力功能。本研究旨在确定在各种视神经病变患者中，基于 OCT 参数的最佳矫正视力 (BCVA) 与内视网膜厚度之间的相关性，这些患者的 RNFL/GCIPL 厚度极低，以及确定 OCT 在预测这些患者的视力功能方面的局限性。共有 131 名患者纳入本研究。LogMAR 平均 BCVA 为 0.55±0.70，范围从-0.18 到 3.00。在 OCT 参数中，颞侧 GCIPL（r=-0.412）和平均 GCIPL（r=-0.366）与 BCVA 相关性更高。视神经病变的病因比较显示，LHON 的 BCVA 显著降低（均 p<0.05）。特发性视神经炎（ON）和 MOGAD 与其他视神经病变相比，BCVA 分布更好且更窄。尽管视神经损伤后内视网膜明显变薄，但 OCT 在反映 BCVA 方面的作用有限。在解释 OCT 结果时需要谨慎，尤其是与视神经病变的病因有关时。
