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Progression of optic atrophy in traumatic optic neuropathy: retrograde neuronal degeneration in humans

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Abstract

Objective

We used optical coherence tomography (OCT) to document the time course of retrograde neuronal degeneration following indirect optic nerve injury.

Methods

We retrospectively studied patients diagnosed with unilateral indirect traumatic optic neuropathy (TON). Patients with total or near-total optic atrophy were included. All patients underwent complete ophthalmological examinations, including OCT imaging, within 1 day and at 1, 2, 3, 4, 6, 8, 12, 24, and 48 weeks after trauma.

Results

The mean thicknesses of the circumpapillary retinal nerve fiber layer (cpRNFL) and macular retinal ganglion cell-inner plexiform layer (mGCIPL) decreased significantly at 2 weeks after trauma (p = 0.027 and p = 0.043). Changes in mGCIPL thickness preceded changes in cpRNFL thickness. The rates of reduction in mGCIPL and cpRNFL thicknesses were greatest between 2 to 4 weeks and 4 to 6 weeks after trauma. The reduction in mGCIPL thickness then slowed, and stabilized at 12 weeks after trauma. The proportions of cpRNFL and mGCIPL losses at 2, 4, 6, 8, and 12 weeks compared to 24 weeks were 17.1, 33.7, 59.8, 77.9, and 87.9% and 30.0, 73.3, 76.1, 88.3, and 97.9%, respectively.

Conclusions

OCT revealed optic atrophy progression 2 weeks after trauma, which was most rapid from 2 to 6 weeks, and then gradually stabilized. Loss of retinal ganglion cell bodies and dendrites seemed to precede the axonal degeneration. Observations of morphological changes in retinal layers using OCT in TON patients improve our understanding of retrograde neuronal degeneration of the central nervous system.

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Authors and Affiliations

  1. Department of Ophthalmology, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea

    Jae Yun Sung

  2. Department of Ophthalmology, Chungnam National University College of Medicine, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon, 35015, Korea

    Han Min Lee, Sung Bok Lee, Kyoung Nam Kim & Yeon-Hee Lee

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Contributions

YHL contributed to the conception and design of the study; JYS, HML, KNK, and SBL contributed to the acquisition and analysis of data; JYS, HML, and YHL contributed to the drafting of the text and preparing the figures. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yeon-Hee Lee.

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Ethical approval

The study protocol was approved by the Chungnam National University Institutional Review Board of the Hospital. The study adhered to all relevant tenets of the Declaration of Helsinki.

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Informed consent was obtained from each subject.

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The authors declare no competing interests.

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Sung, J.Y., Lee, H.M., Lee, S.B. et al. Progression of optic atrophy in traumatic optic neuropathy: retrograde neuronal degeneration in humans. Neurol Sci 43, 1351–1358 (2022). https://doi.org/10.1007/s10072-021-05448-z

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