Microvascular and structural alterations in the optic nerve head of advanced primary open-angle glaucoma compared with atrophic non-arteritic anterior ischemic optic neuropathy

Hondur, Gözde; Şen, Emine; Budakoglu, Ozlem

doi:10.1007/s00417-021-05122-2

Cited by 5 publications

(9 citation statements)

References 33 publications

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“…Our data demonstrated no significant difference in the average pRNFL thickness between the NAION and POAG eyes (P=0.196). This finding is consistent with those of previous studies [5,[17][18][19][20][21][22][23][24][25][26][29][30][32][33]41] . Currently, POAG has been reported to be associated with multiple risk factors including race, age, elevated intraocular pressure, family history, myopia, and diastolic perfusion pressure, etc [3,[42][43][44][45][46][47] .…”

Section: Discussionsupporting

confidence: 94%

“…However, the results indicated that the two studies by Fard et al [19,24] (more deviated from the estimate line; Figure 7B) contributed to the heterogeneity mostly of the superior pRNFL thickness (I 2 =54.7%). Nevertheless, heterogeneity was largely reduced after excluding these two studies separately Hondur 2021 [18] -6.50 (-10.70, -2.30) 0.002 -6.05 -13.08, 0.97) 0.09 60%…”

Section: Discussionmentioning

confidence: 99%

“…Among them, spectral-domain optical coherence tomography (SD-OCT), which is the latest generation of OCT, provides a high-resolution and enhance-depth visualization of the retina and the ONH [14][15][16] . With the utilization of SD-OCT in daily routine diagnosis, several studies have demonstrated that the attenuation of average pRNFL thickness is common in NAION and glaucoma [5,13,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] , where NAION may mimic with POAG [34] . However, the pattern and severity of sectoral pRNFL thickness thinning were inconsistent [18][19][20]22,[24][25][26][28][29] , which may help reveal the different underlying mechanisms that induce optic damage in these two ophthalmic neuropathies and help differentiate NAION from POAG in a non-invasive manner.…”

Section: Oct Differentiates Naion and Poagmentioning

confidence: 99%

“…With the utilization of SD-OCT in daily routine diagnosis, several studies have demonstrated that the attenuation of average pRNFL thickness is common in NAION and glaucoma [5,13,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] , where NAION may mimic with POAG [34] . However, the pattern and severity of sectoral pRNFL thickness thinning were inconsistent [18][19][20]22,[24][25][26][28][29] , which may help reveal the different underlying mechanisms that induce optic damage in these two ophthalmic neuropathies and help differentiate NAION from POAG in a non-invasive manner. Therefore, we performed this systematic review and Metaanalysis to compare the average and sectoral pRNFL thickness in patients with NAION and those with POAG with similar VF mean deviation (MD), facilitating a better understanding of the biomechanisms that lead to the different patterns of neurodegeneration.…”

Section: Oct Differentiates Naion and Poagmentioning

confidence: 99%

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Optical coherence tomography evaluation of retinal nerve fiber layer thickness in non-arteritic anterior ischemic optic neuropathy and primary open angle glaucoma: a systematic review and Meta-analysis

Tong¹,

He²,

Chen³

et al. 2022

Int J Ophthalmol

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AIM: To assess the differences in average and sectoral peripapillary retinal nerve fiber layer (pRNFL) thickness using spectral domain optical coherence tomography (SD-OCT) in patients with non-arteritic anterior ischemic neuropathy (NAION) compared with those with primary open angle glaucoma (POAG). METHODS: A comprehensive literature search of the PubMed, Cochrane Library, and Embase databases were performed prior to October, 2021. Studies that compared the pRNFL thickness in NAION eyes with that in POAG eyes with matched mean deviation of the visual fields were included. The weighted mean difference (WMD) with 95% confidence interval (CI) was used to pool continuous outcomes. RESULTS: Ten cross-sectional studies (11 datasets) comprising a total of 625 eyes (278 NAION eyes, 347 POAG eyes) were included in the qualitative and quantitative analyses. The pooled results demonstrated that the superior pRNFL was significantly thinner in NAION eyes than in POAG eyes (WMD=-6.40, 95%CI: -12.22 to -0.58, P=0.031), whereas the inferior pRNFL was significant thinner in POAG eyes than in NAION eyes (WMD=11.10, 95%CI: 7.06 to 15.14, P≤0.001). No difference was noted concerning the average, nasal, and temporal pRNFL thickness (average: WMD=1.45, 95%CI: -0.75 to 3.66, P=0.196; nasal: WMD= -2.12, 95%CI: -4.43 to 0.19, P=0.072; temporal: WMD= -1.24, 95%CI: -3.96 to 1.47, P=0.370). CONCLUSION: SD-OCT based evaluation of inferior and superior pRNFL thickness can be potentially utilized to differentiate NAION from POAG, and help to understand the different pathophysiological mechanisms between these two diseases. Further longitudinal studies and studies using eight-quadrant or clock-hour classification method are required to validate the obtained findings.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Oct Differentiates Naion and Poagmentioning

confidence: 99%

Section: Oct Differentiates Naion and Poagmentioning

confidence: 99%

See 2 more Smart Citations

Optical coherence tomography evaluation of retinal nerve fiber layer thickness in non-arteritic anterior ischemic optic neuropathy and primary open angle glaucoma: a systematic review and Meta-analysis

Tong¹,

He²,

Chen³

et al. 2022

Int J Ophthalmol

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show abstract

“…Several studies have compared the OCTA findings in glaucoma and NAION in the presence of similar functional and structural damages, but sometimes with contradictory results. While significant lower radial peripapillary capillary (RPC) VD has been reported in open-angle glaucoma (OAG) and normal tension glaucoma (NTG) compared to NAION [ 14 , 15 ], other studies suggest the reverse [ 16 ] or no difference [ 17 ]. Regarding the macular microvasculature, comparable conclusions can be found in the literature with a greater loss in the macular superficial capillary plexus (SCP) VD in OAG compared to NAION [ 16 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

A Deep Learning System Using Optical Coherence Tomography Angiography to Detect Glaucoma and Anterior Ischemic Optic Neuropathy

Bunod

Lubrano²,

Pirovano³

et al. 2023

JCM

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Introduction. Glaucoma and non-arteritic anterior ischemic optic neuropathy (NAION) are optic neuropathies that can both lead to irreversible blindness. Several studies have compared optical coherence tomography angiography (OCTA) findings in glaucoma and NAION in the presence of similar functional and structural damages with contradictory results. The goal of this study was to use a deep learning system to differentiate OCTA in glaucoma and NAION. Material and methods. Sixty eyes with glaucoma (including primary open angle glaucoma, angle-closure glaucoma, normal tension glaucoma, pigmentary glaucoma, pseudoexfoliative glaucoma and juvenile glaucoma), thirty eyes with atrophic NAION and forty control eyes (NC) were included. All patients underwent OCTA imaging and automatic segmentation was used to analyze the macular superficial capillary plexus (SCP) and the radial peripapillary capillary (RPC) plexus. We used the classic convolutional neural network (CNN) architecture of ResNet50. Attribution maps were obtained using the “Integrated Gradients” method. Results. The best performances were obtained with the SCP + RPC model achieving a mean area under the receiver operating characteristics curve (ROC AUC) of 0.94 (95% CI 0.92–0.96) for glaucoma, 0.90 (95% CI 0.86–0.94) for NAION and 0.96 (95% CI 0.96–0.97) for NC. Conclusion. This study shows that deep learning architecture can classify NAION, glaucoma and normal OCTA images with a good diagnostic performance and may outperform the specialist assessment.

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Differentiating ischemic optic neuropathy from glaucoma using diagnostic tests

Smeets,

Margot,

Barbosa-Breda

et al. 2024

Ophthalmic Res

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Introduction: Anterior ischemic optic neuropathy (AION) can mimic glaucoma and consequently cause difficulties in differential diagnosis. The purpose of this paper is to summarize differences in diagnostic tests that can help perform a correct diagnosis. Methods: The search strategy was performed according to the PRISMA 2009 guidelines and four databases were used: Medline, Embase, Web of Science and Cochrane. 772 references were eligible; 39 were included after screening with respect to inclusion criteria that included English language and published in the 20 years before search date. Results: Ninety percent (n=35) of included studies used optical coherence tomography (OCT). Glaucomatous eyes had a significantly greater cup area, volume and depth, cup-to-disc ratio, and a lower rim volume and area, and a thinner Bruch’s Membrane opening-minimum rim width. Retinal nerve fibre layer (RNFL) thinning in glaucomatous eyes occurred primarily at the superotemporal, inferotemporal and inferonasal sectors, while AION eyes demonstrated mostly superonasal thinning. Glaucoma eyes showed greater macular ganglion cell layer thickness, except at the inferotemporal sector. OCT-angiography measurements demonstrated a significant decrease in superficial and deep macular vessel density (VD) in glaucoma compared to AION with similar degree of visual field (VF) damage; and the parapapillary choroidal VD was spared in AION eyes compared to glaucomatous eyes. Conclusion: By use of OCT imaging, optic nerve head (ONH) parameters seem most informative to distinguish between glaucoma and AION. Although both diseases affect the RNFL thickness, it seems to do so in different sectors. Differences in structure and vascularity of the macula can also help in making the differential diagnosis.

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Microvascular and structural alterations in the optic nerve head of advanced primary open-angle glaucoma compared with atrophic non-arteritic anterior ischemic optic neuropathy

Cited by 5 publications

References 33 publications

Optical coherence tomography evaluation of retinal nerve fiber layer thickness in non-arteritic anterior ischemic optic neuropathy and primary open angle glaucoma: a systematic review and Meta-analysis

Optical coherence tomography evaluation of retinal nerve fiber layer thickness in non-arteritic anterior ischemic optic neuropathy and primary open angle glaucoma: a systematic review and Meta-analysis

A Deep Learning System Using Optical Coherence Tomography Angiography to Detect Glaucoma and Anterior Ischemic Optic Neuropathy

Differentiating ischemic optic neuropathy from glaucoma using diagnostic tests

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