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Utility of ganglion cells for the evaluation of anterior visual pathway pathology: a review

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Abstract

The management of optic neuropathy is fundamental to neuro-ophthalmic practice. Following the invention of the ophthalmoscope, clinicians, for a century or more, relied upon fundus examination in the evaluation of optic neuropathy. However, the advent of optical coherence tomography, based on the principle of backscattering of light and interferometry, has revolutionized the analysis of optic nerve and retinal disorders. Optical coherence tomography has proven of particular value in the measurement, at the micron level, of the peripapillary retinal nerve fibre layer and the ganglion cell layer. These measurements have proven critical in the differential diagnosis and monitoring of optic neuropathy. Specifically, thinning of the peripapillary nerve fibre layer provides evidence of axonal loss affecting any sector of the optic nerve. Thinning of the macular ganglion cell layer, on the other hand, shows a more precise correlation with visual deficits due to retrograde degeneration following optic nerve damage, although limited to central retina. In daily practise, optical coherence tomography is of great value in assessing the diagnosis, prognosis and response to treatment in optic neuropathy. Particular advances have been made, for example, in the assessment of optic neuritis, papilloedema and chiasmal compression which have translated to everyday practice. As with any other imaging technology the clinician must have a clear understanding of acquisition artefacts. A further issue is the relatively limited normative database in sub-populations such as the young and individuals with a refractive error > + 5 or < −5 dioptres.

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Abbreviations

AION:

Anterior ischemic optic neuropathy

CON:

Compressive optic neuropath

GCC:

Ganglion cell complex (inner plexiform layer (IPL) + ganglion cell layer (GCL)

ICP:

Intracranial pressure

IHH:

Idiopathic intracranial hypertension

INL:

Inner nuclear layer

IOP:

Intraocular pressure

MMO:

Microcystic macular oedema

NAAION:

Non-Arteritic anterior ischaemic optic neuropathy

OCT:

Optical coherence tomography

OD:

Optic disc

pRNFL:

Peripapillary retinal nerve fibre layer

RGC:

Retinal ganglion cell

VF:

Automated perimetry

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  1. Anne Catherine Chapelle and Gordon T. Plant contributed equally to this work.

Authors and Affiliations

  1. Department of Ophthalmology, Central University Hospital of Liège, University of Liège, Avenue de L’hôpital, 4000, Liège, Belgium

    Anne-Catherine Chapelle & Jean-Marie Rakic

  2. Department of Neurodegeneration and Rehabilitation, Faculty of Brain Sciences, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK

    Gordon Terence Plant

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Chapelle, AC., Rakic, JM. & Plant, G.T. Utility of ganglion cells for the evaluation of anterior visual pathway pathology: a review. Acta Neurol Belg (2024). https://doi.org/10.1007/s13760-024-02522-z

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