Progression of optic atrophy in traumatic optic neuropathy: retrograde neuronal degeneration in humans

Sung, Jae Yun; Lee, Han Min; Lee, Seung-Bok; Kim, Kyoung Nam; Lee, Yeon-Hee

doi:10.1007/s10072-021-05448-z

Cited by 8 publications

(9 citation statements)

References 32 publications

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“…In our study, both pRNFL thickness and GCIPL thickness were decreased in eyes with TON compared to controls. This nding is consistent with many previous studies on TON [16,[21][22][23][24][25][26]. Medierios et al [21] and López-de-Eguileta et al [22] have reported cases of gradual RNFL loss, ganglion cell complex loss, and Bruch's membrane opening-minimum rim width loss measured with OCT in TON patients.…”

Section: Discussionsupporting

confidence: 91%

“…Cunha et al [23] have reported progressive thinning of RNFL and macular thickness in three TON patients. Sung et al [24] and Lee et al [25] have studied OCT measurements of TON patients showing both reductions in RNFL and GCIPL thicknesses. Chan et al [26] reported thinning of RNFL and ganglion cell complex, and also subfoveal choroidal thinning in TON patients with chronic mild traumatic brain injury.…”

Section: Discussionmentioning

confidence: 99%

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Intraretinal microvascular alterations in indirect traumatic optic neuropathy

Park

Kang³

et al. 2023

Preprint

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PURPOSE To quantitatively evaluate macular and peripapillary microvascular alterations in patients with indirect traumatic optic neuropathy (TON) compared to normal controls using optical coherence tomography angiography (OCT-A [Topcon DRI OCT; Triton]) and determine their associations with other ocular parameters. METHODS We enrolled 33 eyes of 33 patients with TON and 34 eyes of 34 healthy controls. OCT-A was used to generate microvascular structure images of the superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), and radial peripapillary capillary (RPC) segment in the macula and peripapillary area. Age, gender, and spherical equivalent refractive errors were statistically adjusted for the analysis. RESULTS OCT-A revealed a significant reduction of the average vessel density in the RPC segment in TON patients compared to controls (48.5% ± 6.28 vs. 57.88% ± 3.06%, P < 0.0001, corrected P < 0.0001). The vessel density of the RPC segment in TON patients was also significantly lower than that in healthy controls in all four quadrants when compared by sectors. The inferior sector vessel density of the RPC segment was significantly associated with visual field defects (P = 0.0253) and visual acuity (P = 0.0369). The temporal sector vessel density of DRCP was also associated with visual field defects (P = 0.0377). The RPC segment in the temporal, superior, and inferior sector vessel density had a significant association with the average pRNFL thickness (P = 0.0092, 0.0171, and < 0.0001, respectively). CONCLUSIONS Patients with indirect TON show significant microvascular alterations compared to controls. This study confirms that TON can induce intraretinal microvascular changes and suggests that OCTA can be a useful biomarker for visual functional and structural changes.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Intraretinal microvascular alterations in indirect traumatic optic neuropathy

Park

Kang³

et al. 2023

Preprint

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“… 29 Thinning of the GCL after TBI is often mild and patchy. 26 Observational reports and animal models demonstrate that GCL thinning is detectable 2 to 4 weeks after primary optic nerve injury, 30 , 31 and after 2 months secondary to trans-synaptic degeneration. 1 , 27 , 28 …”

Section: Discussionmentioning

confidence: 99%

Modifications in Macular Perfusion and Neuronal Loss After Acute Traumatic Brain Injury

Hepschke

Laws

Saliman

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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Purpose Traumatic brain injury (TBI) causes structural damage and functional impairment in the visual system, often with retinal ganglion cell (RGC) degeneration occurring without visual symptoms. RGC degeneration is associated with reduced retinal blood-flow, however, it is not known whether reductions in perfusion precede or are secondary to neurodegeneration. Methods We conducted a prospective observational single-center case series. Patients were included if they were admitted to the hospital after acute TBI and underwent ophthalmic clinical examination, including optical coherence tomography (OCT) and OCT angiography (OCTA) acutely and at follow-up. Ganglion cell layer thickness (GCL) thickness, vascular density in the superficial vascular plexus (SVP), and intermediate capillary plexus (ICP) were quantified. Results Twenty-one patients aged 20 to 65 years (mean = 38 years) including 16 men and 5 women were examined less than 14 days after moderate to severe TBI, and again after 2 to 6 months. Macular structure and perfusion were normal at baseline in all patients. Visual function was abnormal at baseline in three patients and subsequent neurodegeneration and loss of perfusion corresponded to baseline visual function abnormalities. Nine patients (43%) had reduced macular GCL thickness at follow up. Perfusion in the SVP strongly associated with local GCL thickness. The strongest association of the SVP metrics was the sum of vessel density ( P < 0.0001). Conclusions In cases of reduced visual function after TBI, macular perfusion remained normal until reductions in GCL thickness occurred, indicating that perfusion changes were secondary to local GCL loss.

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“…PwE and HC were also excluded due to pregnancy, diabetes mellitus, untreated arterial hypertension, current or former drug abuse, cognitive disability (as mentioned in medical records and/or IQ < 70 in neuropsychological testing), and neurological disease other than epilepsy and migraine. PwE with a change in antiseizure medication within the last 14 days or a recent TCS within the last 48 hours were not included in the study to avoid a potential bias due to assumed acute effects 8,19,20 . A total of 108 PwE and 90 HC underwent the study protocol.…”

Section: Methodsmentioning

confidence: 99%

“…ASM and last experienced seizure, and thus disregarded putative acute effects 8,19,20 : There is ample data that ASM changes, especially sodium channel blockers, can cause focal cerebral edema upon quick withdrawal or reintroduction 21 and co-occurring retinal changes seem possible. Further, tonic-clonic seizures (TCS) may lead to traumatic optic neuropathy and are followed by a blood-brain barrier leakage.…”

Section: Key Pointsmentioning

confidence: 99%

Association between retinal thickness and disease characteristics in adult epilepsy: A cross‐sectional OCT evaluation

Delazer,

Bao,

Lauseker

et al. 2023

Epilepsia Open

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ObjectiveThinning of the peripapillary retinal nerve fiber layer (p‐RNFL), as measured by optical coherence tomography (OCT), was recently introduced as a promising marker for cerebral neuronal loss in people with epilepsy (PwE). However, its clinical implication remains to be elucidated. We thus aimed to (1) systematically characterize the extent of the retinal neuroaxonal loss in a broad spectrum of unselected PwE and (2) to evaluate the main clinical determinants.MethodsIn this prospective study, a spectral‐domain OCT evaluation was performed on 98 well‐characterized PwE and 85 healthy controls (18‐55 years of age). All inner retinal layers and the total macula volume were assessed. Group comparisons and linear regression analyses with stepwise backwards selection were performed to identify relevant clinical and demographic modulators of the retinal neuroaxonal integrity.ResultsPwE (age: 33.7±10.6 years; 58.2% female) revealed a significant neuroaxonal loss across all assessed retinal layers (global pRNFL, p=0.001, Δ=4.24μm; macular RNFL, p<0.001, Δ=0.05mm3; ganglion cell inner plexiform layer, GCIP, p<0.001, Δ=0.11mm3; inner nuclear layer, INL, p=0.03, Δ=0.02mm3) as well as significantly reduced total macula volumes (TMV, p<0.001, Δ=0.18mm3) compared to healthy controls (age: 31.2±9.0 years; 57.6% female). The extent of retinal neuroaxonal loss was associated with the occurrence and frequency of tonic‐clonic seizures and the number of anti‐seizure medications, and was most pronounced in male patients.SignificancePwE presented an extensive retinal neuroaxonal loss, affecting not only the peripapillary but also macular structures. The non‐invasive and economic measurement via OCT bears the potential to establish as a practical tool to inform patient management, as the extent of the retinal neuroaxonal loss reflects aspects of disease severity and sex‐specific vulnerability.

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Progression of optic atrophy in traumatic optic neuropathy: retrograde neuronal degeneration in humans

Cited by 8 publications

References 32 publications

Intraretinal microvascular alterations in indirect traumatic optic neuropathy

Intraretinal microvascular alterations in indirect traumatic optic neuropathy

Modifications in Macular Perfusion and Neuronal Loss After Acute Traumatic Brain Injury

Association between retinal thickness and disease characteristics in adult epilepsy: A cross‐sectional OCT evaluation

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