Progression of transsynaptic retinal degeneration with spectral-domain optical coherence tomography

Abstract

Purpose To illustrate the progression of retrograde transsynaptic retinal degeneration using spectral- domain optical coherence tomography (SD-OCT). Observations A 60 year-old man with a stroke was followed over a 17-month period using SD-OCT of the macula, ganglion cell layer (GCC), and retinal nerve fiber layer. Transsynaptic retinal degeneration progressed over this time. Conclusions and Importance Retrograde transsynaptic retinal degeneration may occur in patients with homonymous visual field loss caused by post-geniculate neurologic disease. This is best detected as homonymous thinning of the retina, corresponding to the pattern of visual field loss, using SD-OCT of the GCC and macula. The retinal changes occur at a variable time following the onset of neurologic disease.

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.…”

Patterns of retrograde axonal degeneration in the visual system

“…In vivo evidence for presence of acquired retrograde trans-synaptic axonal degeneration (RTD) in the visual system is recent (Jindahra et al 2009;Mehta and Plant 2005). This work has been reproduced (Goto et al 2016;Park et al 2013;Schwartz et al 2017). But the true existence of RTD has still not been confirmed conclusively demonstrated because of an overlooked detail of the vascular supply of the visual system.…”

“…Taken together there remains the possibility that some of the Retinal Nerve Fibre Layer atrophy (RNFL) observed in previous studies (Goto et al 2016;Jindahra et al 2009;Park et al 2013;Schwartz et al 2017) could be caused by direct retrograde axonal degeneration, rather than by RTD. To date the most robust evidence for RTD comes from experimental studies lesioning the posterior visual pathway (Buren 1963).…”

“…An important limitation of all above studies in patients with an ischaemic stroke of the middle (MCA) and posterior cerebral artery (PCA) territories (Goto et al 2016;Jindahra et al 2009;Park et al 2013;Schwartz et al 2017) is that a direct ischaemic insult to the optic tract and lateral geniculate nucleus (LGN) remains possible (Luco et al 1992;Pula and Yuen 2017).…”

“…quired RTD in humans truly exists. The design of this prospective longitudinal study permitted to circumvent crucial confounders which have affected previous work(Goto et al 2016;Jindahra et al 2009;Mehta and Plant 2005;Park et al 2013;Schwartz et al 2017). In all patients a baseline scan was acquired prior to the intervention.…”