Wang Fei, Zhang Hongtao, Cao Shanshan, Zhou Huanfen, Xu Quangang, Wei Shihui, Peng Chunxia
Healthcare of ophthalmology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Department of Ophthalmology, Chinese People Liberation Army General Hospital, the Third Medical Center, Beijing, China.
Int J Neurosci. 2025 Jun 22:1-10. doi: 10.1080/00207454.2025.2520029.
The existence of retrograde trans-synaptic degeneration (RTD) had been a controversial due to no structural continuity of two neurons in human. The study aimed to detect the macular retinal ganglion cell layer (mRGCL) loss in homonymous hemianopia (HH) patients caused by acquired cerebral lesions using optical coherence tomography (OCT) to explore RTD characteristics.
A total of 40 HH patients (80 eyes) were enrolled this study. All the patients underwent OCT examination to evaluate the peripapillary retinal nerve fiber layer (pRFNL) and mRGCL loss. Their VF defects (mean deviations [MDs]) were assessed by Humphrey Perimeter.
pRNFL and mRGCL thicknesses in HH patients reduced markedly compared to that in healthy eyes. Temporal mRGCL thicknesses in ipsilateral eyes reduced 4.77 ± 7.98 μm ( = 0.002) in contrast to their contralateral eyes. Nasal mRGCL thickness in contralateral eyes reduced 5.75 ± 10.44 μm ( = 0.004), compared to their ipsilateral eyes. Additionally, trauma ( = 0.08) and tumor ( = 0.030) cerebral lesions caused more pRNFL loss than that of cerebrovascular diseases. VF defects (MD) had linear correlations to mRGCL thicknesses in nasal hemisphere in contralateral eyes ( = 0.397, = 0.0404). The mRGCL and pRNFL loss occurred as early as 2-3 months after cerebral lesions occurred and progressed over time.
RTD caused by acquired cerebral lesions were objectively detected by OCT and its characteristics were consistent to anatomic features of visual pathway. The mRGCL loss due to RTD correlated to VF defects and trauma and tumors caused greater injuries in pRNFL. Visual pathway could be an ideal model and OCT is a useful tool for RTD.
由于人类两个神经元之间不存在结构连续性，逆行性跨突触变性（RTD）的存在一直存在争议。本研究旨在利用光学相干断层扫描（OCT）检测获得性脑损伤所致同向性偏盲（HH）患者黄斑视网膜神经节细胞层（mRGCL）的缺失情况，以探讨RTD的特征。
本研究共纳入40例HH患者（80只眼）。所有患者均接受OCT检查，以评估视乳头周围视网膜神经纤维层（pRFNL）和mRGCL的缺失情况。采用 Humphrey视野计评估其视野缺损（平均偏差[MD]）。
与健康眼相比，HH患者的pRNFL和mRGCL厚度明显降低。患侧眼的颞侧mRGCL厚度比其对侧眼减少了4.77±7.98μm（P = 0.002）。对侧眼的鼻侧mRGCL厚度比其患侧眼减少了5.75±10.44μm（P = 0.004）。此外，创伤性（P = 0.08）和肿瘤性（P = 0.030）脑损伤导致的pRNFL缺失比脑血管疾病更多。视野缺损（MD）与对侧眼鼻侧半球的mRGCL厚度呈线性相关（P = 0.397，r = 0.0404）。mRGCL和pRNFL的缺失在脑损伤发生后2 - 3个月就已出现，并随时间进展。
OCT可客观检测获得性脑损伤所致的RTD，其特征与视觉通路的解剖学特征一致。RTD导致的mRGCL缺失与视野缺损相关，创伤和肿瘤对pRNFL造成的损伤更大。视觉通路可能是RTD的理想模型，OCT是检测RTD的有用工具。
