Retinal Nerve Fiber Layer Thickness/Minimum Rim Width Ratio Differentiates Glaucoma From Other Optic Neuropathies

Abstract

Précis: Global peripapillary retinal nerve fiber layer thickness (pRNFL)/Bruch membrane opening-minimum rim width (BMO-MRW) ratio is an objective and effective parameter to separate glaucomatous optic neuropathies (GONs) from nonGONs (NGONs).Purpose: This study was undertaken to evaluate the diagnostic capability of the pRNFL/ BMO-MRW ratio to differentiate GONs from NGONs.Patients and Methods: This retrospective study included patients with an optic neuropathy (ON), visual loss for > 6 months and a confirmed single etiology. pRNFL thickness and BMO-MRW were measured with spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany). The diagnostic accuracies of pRNFL, BMO-MRW and the global pRNFL/BMO-MRW ratio were evaluated with the areas under receiver operating characteristics curves.Results: One eye each from 171 patients was investigated: 50 primary open angle glaucomas, 15 normal pressure glaucomas, 50 optic neuritises, 15 nonarteritic anterior ischemic ONs, 24 compressive ONs, 10 dominant optic atrophies, and 7 nutritional ONs. The global pRNFL/BMO-MRW ratio had the highest area under receiver operating characteristics curve [0.97 vs. 0.92; P = 0.01]. It was able to distinguish between GONs and NGONs with a cutoff value of 0.34. Increased mean deviation of the visual field-defect severity was associated with a higher ratio for GONs and a lower ratio for NGONs. Conclusion:Compared with NGONs and for the same degree of pRNFL thinning, lower BMO-MRW was found to be a specific marker of glaucoma, reflecting the neuroglial architecture changes within the optic nerve head typical of glaucoma and supporting fundamental pathophysiological differences.

Peripapillary RNFL cross-sectional area and its association with other parameters in a Chinese population

“…Quantitative analysis of retinal nerve fibers, often by assessment of retinal nerve fiber layer (RNFL) thickness, is of great significance for the diagnosis and long-term monitoring of optic nerve diseases, such as glaucoma [ 1 , 2 ]. RNFL thickness is known to be affected by age, axial length or refractive error, optic disc size and content of non-neuronal components [ 3 – 9 ].…”

Estudo comparativo da largura mínima da rima neural e da profundidade da escavação do disco óptico em olhos com neuropatia óptica compressiva, glaucoma e controles usando a tomografia de coerência óptica

“…[144][145][146][147][148][149][150][151][152] Entretanto, estudos utilizando a nova tecnologia da LMR-AMB direcionados à NONG são mais escassos e têm sido alvo de interesse crescente na literatura. Recentemente, Braga et al 153 e Boussion et al 154 encontraram boa capacidade de discriminação entre NOG e NONG (incluindo um grupo de NOC em ambas as amostras) para as medidas isoladas de LMR e propuseram ainda que a combinação dos parâmetros de LMR e CFNRp auxiliam nessa distinção, com melhores curvas ROC que as medidas isoladas. Leaney et al 155 , obtiveram resultados semelhantes, mas a amostra incluiu neuropatias ópticas variadas no mesmo grupo, não distinguindo por etiologia.…”