Skip to main content

Advertisement

SpringerLink
Log in

Ganglion cell analysis at acute episode of nonarteritic anterior ischemic optic neuropathy to predict irreversible damage. A prospective study

  • Neurophthalmology
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To assess the capability of ganglion cell–inner plexiform layer (GCIPL) thickness analysis by optical coherence tomography (OCT) to detect early neuronal loss in nonarteritic anterior ischemic optic neuropathy (NAION).

Methods

Sixteen patients with unilateral NAION participated in this prospective study. Complete ophthalmologic evaluation including visual acuity, visual field (VF) test, and spectral domain optical coherence tomography (SD-OCT) of peripapillary retinal nerve fiber layer (pRNFL) and GCIPL thickness were performed in the acute phase (within 1 week: 2.7 ± 2.1 days) and at 2 weeks, 1 month, 3 and 6 months after diagnosis. The mean time elapsed from acute episode to irreversible damage detection by GCIPL and pRNFL analysis was registered. Correlations between the GCIPL thinning and functional parameters such as best-corrected visual acuity (BCVA) and visual field indices [mean deviation (MD) and visual field index (VFI)] in acute and chronic phase were also analyzed.

Results

NAION eyes showed a significant thinning of the mean GCIPLminimum (min) compared to the unaffected eyes as early as 2.2 days after symptoms onset (p = 0.017) and at each follow-up visit. (p ≤ 0.003). The mean GCIPL average (av) was also thinner in NAION eyes compared to uninvolved eyes at 1 (p = 0.003), 3 (p = 0.002) and 6 months (p < 0.001). At the acute phase, 100 % of NAION eyes showed significant pRNFL thickening, while abnormal thinning was evident in GCIPLav, GCIPLmin, and GCIPL deviation map analysis in 31.3, 56.3, and 62.5 % of NAION eyes. The abnormal thinning rates increased to 43.8, 75, and 81.3 % at 2 weeks and to 62.5, 100, and 100 % at 1 month, respectively. At 2 weeks, GCIPLmin thickness significantly correlated with both acute and chronic BCVA, MD, and VFI. Furthermore, the mean superior and inferior GCIPL thicknesses at 2 weeks associated with corresponding mean inferior and superior hemifield MD at 6 months.

Conclusions

GCIPL analysis by SD-OCT can be considered as a useful biomarker to establish ganglion cell damage. GCIPL min and GCIPL deviation map are abnormally thinner in 56.3 % and 62.5 % of eyes at presentation, respectively. Therefore, both parameters are abnormally thinned in more than 50 % of eyes at presentation. At 2 weeks, GCIPL min thickness significantly correlated with chronic BCVA, MD and VFI; therefore, GCIPL min thickness can predict final visual dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Rebolleda G, Diez-Alvarez L, Casado A, Sánchez-Sánchez C, de Dompablo E, Gónzalez-López JJ et al (2015) OCT: new perspectives in neuro-ophthalmology. Saudi J Ophthalmol 29(1):9–25

    Article  PubMed  Google Scholar 

  2. Rebolleda G, Negrete FM (2013) Macular segmentation in neuro-ophthalmology: descriptive or predictive? Arch Soc Esp Oftalmol 8(88):289–290, English Ed

    Article  Google Scholar 

  3. Rebolleda G, de Dompablo E, Muñoz-Negrete FJ (2015) Ganglion cell layer analysis unmasks axonal loss in anterior optic neuritis. J Neuroophthalmol 35(2):165–167

    PubMed  Google Scholar 

  4. Gabilondo I, Martínez-Lapiscina EH, Fraga-Pumar E, Ortiz-Perez S, Torres-Torres R, Andorra M et al (2015) Dynamics of retinal injury after acute neuritis. Ann Neurol 77(3):517–528

    Article  PubMed  Google Scholar 

  5. Larrea BA, Iztueta MG, Indart LM, Alday NM (2014) Early axonal damage detection by ganglion cell complex analysis with optical coherence tomography in nonarteritic anterior ischaemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol 252(11):1839–1846

    Article  PubMed  Google Scholar 

  6. Keller J, Oakley JD, Russakoff DB, Andorrà-Inglés M, Villoslada P, Sánchez-Dalmau BF (2015) Changes in macular layers in the early course of non-arteritic ischaemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. doi:10.1007/s00417-015-3066-3

    PubMed  Google Scholar 

  7. Park SW, Ji YS, Heo H (2015) Early macular ganglion cell–inner plexiform layer analysis in non-arteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. doi:10.1007/s00417-015-3230-9

    Google Scholar 

  8. Akbari M, Abdi P, Fard MA, Afzali M, Ameri A, Yazdani-Abyaneh A et al (2016) Retinal ganglion cell loss precedes retinal nerve fiber thinning in nonarteritic anterior ischemic optic neuropathy. J Neuroophthalmol 36(2):141–146

  9. Kim KE, Jeoung JW, Park KH, Kim DM, Kim SH (2014) Diagnostic classification of macular ganglion cell and retinal nerve fiber layer analysis: differentiation of false-positives from glaucoma. Ophthalmology 122(3):502–510

    Article  PubMed  Google Scholar 

  10. Papchenko T, Grainger BT, Savino PJ, Gamble GD, Danesh‐Meyer HV (2012) Macular thickness predictive of visual field sensitivity in ischaemic optic neuropathy. Acta Ophthalmol 90(6):e463–e469

    Article  PubMed  Google Scholar 

  11. Ho JK, Stanford MP, Shariati MA, Dalal R, Liao YJ (2013) Optical coherence tomography study of experimental anterior ischemic optic neuropathy and histologic confirmation. Invest Ophthalmol Vis Sci 54(9):5981–5988

    Article  PubMed  PubMed Central  Google Scholar 

  12. Zhang C, Guo Y, Slater BJ, Miller NR, Bernstein SL (2010) Axonal degeneration, regeneration and ganglion cell death in a rodent model of anterior ischemic optic neuropathy (rAION). Exp Eye Res 91(2):286–292

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Fard MA, Fakhree S, Ameri A (2013) Posterior pole retinal thickness for detection of structural damage in anterior ischaemic optic neuropathy. Neuro-Ophthalmology 37:183–191

    Article  Google Scholar 

  14. Aggarwal D, Tan O, Huang D, Sadun AA (2012) 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 53(8):4539–4545

    Article  PubMed  PubMed Central  Google Scholar 

  15. Gonul S, Koktekir BE, Bakbak B, Gedik S (2013) Comparison of the ganglion cell complex and retinal nerve fibre layer measurements using Fourier domain optical coherence tomography to detect ganglion cell loss in non-arteritic anterior ischaemic optic neuropathy. Br J Ophthalmol 97(8):1045–1050

    Article  PubMed  Google Scholar 

  16. Rebolleda G, Sánchez-Sánchez C, González-López JJ, Contreras I, Muñoz-Negrete FJ (2015) Papillomacular bundle and inner retinal thicknesses correlate with visual acuity in nonarteritic anterior ischemic optic neuropathy. Invest Ophthalmol Vis Sci 56(2):682–692

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Hospital Universitario Ramón y Cajal, Carretera de Colmenar Km 9.100, 28034, Madrid, Spain

    Elisabet De Dompablo, J. García-Montesinos, F. J. Muñoz-Negrete & G. Rebolleda

Authors
  1. Elisabet De Dompablo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. García-Montesinos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. J. Muñoz-Negrete
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Rebolleda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elisabet De Dompablo.

Ethics declarations

Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

De Dompablo, E., García-Montesinos, J., Muñoz-Negrete, F.J. et al. Ganglion cell analysis at acute episode of nonarteritic anterior ischemic optic neuropathy to predict irreversible damage. A prospective study. Graefes Arch Clin Exp Ophthalmol 254, 1793–1800 (2016). https://doi.org/10.1007/s00417-016-3425-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-016-3425-8

Keywords

Search

Navigation