Ganglion Cell Layer Analysis in Nonarteritic Anterior Ischemic Optic Neuropathy in Diabetic Patients: From the Acute to Resolving Phases | Abstract

Journal of Research in Medical and Dental Science
eISSN No. 2347-2367 pISSN No. 2347-2545

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.

Ganglion Cell Layer Analysis in Nonarteritic Anterior Ischemic Optic Neuropathy in Diabetic Patients: From the Acute to Resolving Phases

Author(s): Moutei Hassan*, Bennis Ahmed, Chraibi Fouad, Abdellaoui Meriem, Idriss Andaloussi Benatiya and Belahsen Mohammed Faouzi


Purpose: The aim of the present study was to assess tomographic changes in CGC in diabetic patients with non-arteritic anterior ischemic optic neuropathy (NOIA-NA) over a 6-month period and to investigate possible correlations with visual acuity and DM. Materials and methods: This is a prospective observational study, conducted at a diabetes referral centre between January 2017 and January 2020. All patients received a complete ophthalmological examination including measurement of best corrected visual acuity (BCVA), a standard automated visual field, and optical coherence tomography of the papilla (the peripapillary retinal nerve fibre layer RNFLp) and macula (the ganglion cell layer). Patients were monitored at 3 and 6 months. At each follow-up visit, visual acuity measurement, OCT, and CV were performed. CGC measurements in the affected eyes were compared with those of a control group. Correlations between the thinning of the CGC and functional parameters such as MAVC and mean deviation (MD) in the acute and chronic phases were analyzed. Results: We included 80 eyes of 80 diabetic patients with NOIA-NA corresponding to our inclusion criteria. The average age was 60.78 ± 6.88 years with extremes ranging from 40 to 75 years, sex ratio F/H=1.28. The mean CGC thickness was 76.93 ± 2.96 μm and 80.03 ± 1.03 μm in affected and control eyes, respectively (P=0.001). Compared to the normative OCT baseline, 62.5% of affected eyes showed thinning of the CGC thickness. In contrast, 100% of the eyes showed RNFLp thickening. The rate of CGC thinning increased over time, such that by the third month, 100% of the eyes with NOIA-NA in our study were classified as abnormal. The CGC was significantly thinner between the initial visit and 3 months (76.93 ± 2.96 µm vs. 67.12 ± -3.33 µm P<0.001) and significantly thinner between the third month follow-up and 6 months (67.12 ± -3.33 µm vs. 66.56+/-3.4 µm P<0.03). The mean percentage of CGC loss after the acute episode was 12.75% (9.81 µm) at 3 months and 13.47% (10.37 µm) at 6 months. CGC at the initial visit was found to be significantly associated with VA (r=-0.682; p<0.001) and DM (r=0.946; p<0.001). Similarly, mean CGC thickness at 3 months and 6 months follow-up was significantly associated with VA (r=-0.633, p<0.001 at 3 months and r=-0.654, p<0.001 at 6 months) and DM (r=0.877, p<0.001 at 3 months and r=0.811; p<0.001 at 6 months). Conclusion: This study indicates that early lesions of the CGC occur in diabetic patients with NOIA-NA in the acute phase, that these lesions can be accurately measured with OCT, and that the significant correlation between CGC changes and visual field deficits and VA represents an important structure-function relationship and underscores the importance of OCT in the evaluation of the functional and structural course of eyes with NOIA-NA.

Share this article

cappadocia tours
cappadocia hotels
cappadocia balloon flights

agar io

wormax io