Macular Ganglion Cell Layer and Peripapillary Retinal Nerve Fibre Layer Thickness in Patients with Unilateral Posterior Cerebral Artery Ischaemic Lesion: An Optical Coherence Tomography Study

Abstract

The purpose of this study is to evaluate the macular ganglion cell layer (GCL) and peripapillary retinal nerve fibre layer (RNFL) thickness in patients with unilateral posterior cerebral artery (PCA) ischaemic lesions using spectral-domain optical coherence tomography (SD-OCT). A prospective, case-control study of patients with unilateral PCA lesion was conducted in the neuro-ophthalmology clinic of Centro Hospitalar Lisboa Central. Macular and peripapillary SD-OCT scans were performed in both eyes of each patient. Twelve patients with PCA lesions (stroke group) and 12 healthy normal controls were included in this study. Peripapillary RNFL comparison between both eyes of the same subject in the stroke group found a thinning in the superior-temporal (p = 0.008) and inferior-temporal (p = 0.023) sectors of the ipsilateral eye and nasal sector (p = 0.003) of the contralateral eye. Macular GCL thickness comparison showed a reduction temporally in the ipsilateral eye (p = 0.004) and nasally in the contralateral eye (p = 0.002). Peripapillary RNFL thickness was significantly reduced in both eyes of patients with PCA compared with controls, affecting all sectors in the contralateral eye and predominantly temporal sectors in the ipsilateral eye. A statistically significant decrease in macular GCL thickness was found in both hemiretinas of both eyes of stroke patients when compared with controls (p < 0.05). This study shows that TRD may play a role in the physiopathology of lesions of the posterior visual pathway. ARTICLE HISTORY

Long distance retrograde degeneration of the retino-geniculo-cortical pathway in homonymous hemianopia

“…Human studies of patients with occipital lobe lesion have reported GCC measurements comparable to our finding of 4.1 µm of GCC thinning at 1 year of lesion onset. Anjos et al studied 12 posterior cerebral artery stroke patients and found 15.5 µm of GCC thinning at 4.3 years after lesion onset when comparing abnormal to control hemiretinas of each patient (methodology identical to our study) [46]. A study by Herro et al of 9 patients between 3-14 months after occipital stroke reported 5.3 µm of GCC thinning between affected and unaffected hemi-retinas [33].…”

Evaluation of Significance Maps and the Analysis of the Longitudinal Time Course of the Macular Ganglion Cell Complex Thicknesses in Acquired Occipital Homonymous Hemianopia Using Spectral-domain Optical Coherence Tomography

“…OCT studies of acquired occipital lobe lesions in humans have demonstrated circumpapillary retinal nerve fibre layer (cpRNFL) thinning with the use of TD-OCT, 4-6 and SD-OCT. [7][8][9]17 In the SD-OCT studies, inner retinal thinning was observed in both the peripapillary and macular areas, in accordance with the patients' hemianopic visual field defects. [9][10][11][12][13][14][15][16]18,23 GCC thinning has been demonstrated in the hemiretinae corresponding to the affected hemifields. Furthermore, macular measurements showed localised defects of RGCs more clearly than peripapillary measurements.…”

“…In these SD-OCT studies, inner retinal thinning was observed in both the peripapillary and macular areas, in accordance with the patients' hemianopic visual field defects. [9][10][11][12][13][14][15][16][17][18] More recently, sweptsource OCT (SS-OCT), which permits even faster scanning, has been used to study inner retinal thinning in homonymous hemianopia. 19 Recent advancements in spectral-domain optical coherence tomography (SD-OCT) has enabled the assessment of the RGC layer and the ganglion cell complex (GCC), which includes the retinal layers from the internal limiting membrane to the inner plexiform layer.…”

Change in peripapillary and macular choroidal thickness change in children with type 1 diabetes mellitus without visual impairment or diabetic retinopathy

“…Our study showed a significant increase in PPNO and PPII CT. The nasal optic nerve receives nearly all the axons of the retinal ganglion cells in the nasal hemisphere; therefore, oxygen consumption was higher than that of other areas of the optic disc and more sensitive to hypoxia (Anjos et al 2016). In case of abnormal glucose metabolism, a significant local choroidal hemangiectasis is expected.…”