scholarly journals Optical Coherence Tomography May Help Distinguish Glaucoma from Suprasellar Tumor-Associated Optic Disc

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Michael Mimouni ◽  
Hadas Stiebel-Kalish ◽  
Irena Serov ◽  
Gabriel Chodick ◽  
Mohammad Zbedat ◽  
...  

Purpose. This study aimed to differentiate patients with bilateral disc cupping associated with suprasellar tumor from patients with open-angle glaucoma by analyzing differences in optical coherence tomography (OCT) of the optic nerve. Methods. In this retrospective cross-sectional study, we collected data from the eyes of 25 patients with suprasellar craniopharyngioma or pituitary macroadenomas (group 1) and 35 patients with primary open-angle glaucoma (POAG) (group 2), seen between 2001 and 2015, all with a visual acuity of ≥20/40, for whom Stratus Time-Domain (TD) optic nerve OCT scans were available. The main outcome measures were the retinal nerve fiber layer (RNFL) thickness, disc area, cup volume, cup/disc ratio, and rim area. Results. A total of 31 patients met the inclusion criteria and were included in the study: 16 with suprasellar tumors and 15 with POAG. Both groups were similar in terms of gender and age (P>0.05). The glaucoma group had a borderline greater total RNFL thickness (74.2 μm versus 62.8 μm, P=0.07), disc area (2.70 mm2 versus 2.16 mm2, P=0.004), and cup volume (0.20 mm3 versus 0.08 mm3, P=0.02). In multivariate, glaucoma was associated with increased total RNFL thickness (OR = 1.116 per μm, P=0.008), increased disc area (OR = 2.402 per 100 μm2, P=0.002), and decreased rim area (OR = 0.272 per 100 μm2, P=0.011). Of these, the parameter with the greatest AUC was the disc area (AUC = 0.79). Using the Youden index, the optimal cut-off point identified for stratification was a disc area greater than 2.33 μm2. Conclusions. In patients with bilateral disc cupping, a decreased total RNFL thickness and smaller disc area seem to be associated with suprasellar tumors (when compared with open-angle glaucoma). These findings may aid in early diagnosis of cupping from suprasellar tumors, before compressive visual loss occurs.

Author(s):  
Dipak Patel ◽  
Poonam Rana ◽  
Siddharth Dua ◽  
Roshni Patel

Background: To correlate the findings of optical coherence tomography (OCT) evaluation of retinal nerve fiber layer (RNFL) thickness in primary open angle glaucoma, ocular hypertensive and normal eyes.Methods: A 34 consecutive normal, 26 consecutive ocular hypertensives and 40 consecutive glaucomatous eyes underwent a complete ophthalmic examination, including applanation tonometry, disc evaluation, gonioscopy and perimetry. Thickness of the RNFL around the optic disc was determined with 3.4 mm diameter-wide 3D 2000 TOPCON OCT. Average and segmental RNFL thickness values were compared among all groups.Results: Of the 100 eyes enrolled, the mean RNFL thickness was significantly less in glaucomatous eyes (83.165±15.938) than in normal’s (102.42±15.2) and ocular hypertensive’s (100.45±7.38). RNFL, average thicknesses in all four quadrants in POAG patients were significantly decreased compared with the OHT and the control groups.Conclusions: RNFL measurement with SD-OCT could provide important information for detection of early stages of glaucoma. (pre-perimetric glaucoma) as well as help in evaluating progression of glaucoma.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Michele Figus ◽  
Chiara Posarelli ◽  
Francesco Nasini ◽  
Paolo Perrini ◽  
Mario Miccoli ◽  
...  

Background/Aims. To evaluate optic nerve head with spectral domain optical coherence tomography (OCT) in patients with Chiari I malformation (CMI) compared to healthy controls.Methods. Cross-sectional study. OCT of the optic nerve head of 22 patients with CMI and 22 healthy controls was quantitatively analyzed. The healthy controls were matched for age and sex with the study population. Mean retinal nerve fiber layer (RNFL) thickness was calculated for both eyes; the mean thickness value was also registered for each quadrant and for each subfield of the four quadrants.Results. CMI patients showed a reduction of the RNFL thickness in both eyes. This reduction was more statistically significant (P<0.05) for the inferior quadrant in the right eye and in each quadrant than nasal one in the left eye.Conclusion. A distress of the retinal nerve fibers could explain the observed reduction of the RNFL thickness in patients with CMI; in our series the reduction of the RNFL thickness seems lower when CMI is associated with syringomyelia.


2020 ◽  
pp. bjophthalmol-2020-316455
Author(s):  
Carmen Mendez-Hernandez ◽  
Surina Wang ◽  
Paula Arribas-Pardo ◽  
Liseth Salazar-Quiñones ◽  
Noemi Güemes-Villahoz ◽  
...  

Background/AimsThe aim of this study was to assess the optic nerve head (ONH) and macular vessel density with optical coherence tomography angiography (OCT-A) and the ONH haemoglobin (ONH Hb) amount with Laguna ONhE program in open-angle glaucoma (OAG) patients.MethodsIn this prospective observational cross-sectional study, 67 OAG patients and 41 healthy age-sex frequency matched subjects were examined with OCT-A and retinal photos. The circumpapillary (wcpVD), optic nerve head (iVD) and macular (wmVD) capillary vessel density of OCT-A and ONH colorimetric assessment to determine the ONH Hb amount using the Laguna ONhE program were evaluated.ResultsSignificant differences between normal subjects and glaucoma patients in the wcpVD (22.18±3.42 vs 16.03±2.89%; p<0.001), iVD (18.31±5.56 vs 12.52±4.67%; p<0.001), wmVD (15.60±2.34 vs 13.34±2.32%; p<0.001) and amount of ONH Hb (71.10±1.67 vs 68.86±2.46%; p<0.001) and in the papillary cup (68.14±5.25 vs 64.77±5.08%; p=0.001) were found. The Laguna ONhE glaucoma discriminant function (GDF) index had a negative value in the OAG patients and normal values in healthy subjects (−18.76±13.31 vs 7.98±14.09; p<0.001). The area under the receiver operating characteristic (ROC) curve (AUROC) for discriminating between healthy and glaucomatous eyes was highest for wcpVD (0.93; 95% CI 0.86 to 0.97, p<0.0001), followed by GDF (0.92; 95% CI 0.86 to 0.97, p<0.0001), iVD (0.79; 95% CI 0.70 to 0.86; p<0.0001) and ONH Hb (0.78; 95% CI 0.69 to 0.85, p<0.0001). Pair wise comparisons showed that the AUROC of wcpVD (0.93) was not significantly different than GDF (0.92) (p=0.855).ConclusionLaguna ONhE program and OCT-A have similar diagnostic validity in open-angle glaucoma patients.


2016 ◽  
Vol 73 (7) ◽  
pp. 618-625
Author(s):  
Marija Trenkic-Bozinovic ◽  
Gordana Zlatanovic ◽  
Predrag Jovanovic ◽  
Dragan Veselinovic ◽  
Jasmina Djordjevic-Jocic ◽  
...  

Background/Aim. Glaucoma is a progressive optic neuropathy characterized by damage of the retinal ganglion cells and their axons and glial cells. The aim of this study was to evaluate the differences and connections between changes in the visual field and the thickness of the peripapillary retinal nerve fiber layer (RNFL), using optical coherence tomography (OCT) in patients with primary open-angle glaucoma with normal and elevated intraocular pressure (IOP). Methods. This prospective study included 38 patients (38 eyes) with primary open-angle glaucoma with normal intraocular pressure (NTG) and 50 patients (50 eyes) with primary open-angle glaucoma with elevated intraocular pressure (HTG), paired by the same degree of structural glaucomatous changes in the optic nerve head and by age. OCT protocols ?fast RNFL thickness? and ?fast optic disc? were used for testing. The patients? age, gender, best corrected visual acuity (BCVA), IOP, stereometric and functional parameters were compared. Results. The average age of the examined population was 65.49 ? 9.36 (range 44-83) years. There was no statistically significant difference by age and by gender between the two study groups (p = 0.795 and p = 0.807, respectively). BCVA was higher in patients with NTG but there was no statistically significant difference compared to HTG patients (p = 0.160). IOP was statistically significantly higher in patients with HTG compared to NTG patients (17.40 ? 2.77 mmHg vs 14.95 ? 3.01 mmHg, p = 0.009). The cup/disc (C/D) (p = 0.258), mean deviation (MD) (p = 0.477), corrected patern standard deviation (CPSD) (p = 0.943), disk area (p = 0.515), rim area (p = 0.294), rim volume (p = 0.118), C/D area R (p = 0.103), RNFL Average (p = 0.632), RNFL Superior (p = 0.283) and RNFL Inferior (p = 0.488) were not statistically significantly different between the groups. Conclusion. OCT measurements of the RNFL thickness provide clinically significant information in monitoring of glaucomatous changes. There are no differences in the patterns of RNFL defects per sectors and quadrants between NTG and HTG, measured by OCT.


2020 ◽  
pp. 66-66
Author(s):  
Natasa Civcic-Kalinic ◽  
Miroslav Stamenkovic ◽  
Nada Civcic ◽  
Stefan Brunet

Introduction/Objective. In patients with primary open-angle glaucoma (POAG) we explored the relationship between optic nerve head (ONH) topography parameters and retinal nerve fiber layer (RNFL) thickness with central corneal thickness (CCT). Methods. This retrospective study included 97 patients (97 eyes) with primary open-angle glaucoma. Patients were divided into a thin CCT<540?m (45 eyes) and a thick CCT?540?m (52 eyes) group, using ultrasonic pachymeter. Topographic measurements of the ONH parameters and RNFL thickness was performed using optical coherence tomography (OCT). The outcomes were compared with the thin and thick CCT and correlated with the thin CCT of the subjects. Results. There were significantly lower mean intraocular pressure (IOP) (p<0.0001) and CCT (p<0.0001) in patients with thin CCT compared to patients with thick CCT. Statistically significant differences of ONH parameters were found in thin cornea group compared to thick cornea group in: cup/disc area ratio (p<0.03), vertical cup/disc ratio (p<0.01) and rim volume (p<0.01). Statistically significant differences of RNFL thickness were found in thin cornea group compared to thick cornea group in: average (p<0.001), superior (p<0.03), inferior (p<0.03) and nasal (p<0.01). Significant positive correlation was found between thin CCT and OCT parameters in: optic disc area (r=0.429, p=0.003), cup/disc area ratio (r=0.287, p=0.05), horizontal cup/disc ratio (r=0.472, p<0.001), vertical cup/disc ratio (r=0.578, p<0.001), average RNFL (r=0.796, p<0.001), superior RNFL (r=0.665, p<0.001), inferior RNFL (r=0.650, p<0.001), nasal RNFL (r=0.611, p<0.001) and temporal RNFL thickness (r=0.601, p<0.001). Conclusion. POAG patients with thin cornea will probably develop larger glaucoma changes than those with a thicker cornea. Ultrasonic pachymetry measurements of CCT and OCT analysis of ONH topography parameters and RNFL thickness provide significant information in early diagnosis and monitoring progression of POAG.


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