J Korean Ophthalmol Soc.  2016 Jun;57(6):969-976. 10.3341/jkos.2016.57.6.969.

Influence of RNFL Thickness on Visual Acuity and Visual Field in Bilateral Temporal Optic Atrophy

• Park JY
• Choi J
• Oh WH
• Kim JS

• KMID: 2290501
• DOI: http://doi.org/10.3341/jkos.2016.57.6.969

Abstract

PURPOSE
To investigate the influence of retinal nerve fiber layer (RNFL) thickness on visual acuity and visual field in patients with bilateral temporal optic atrophy.
METHODS
Patients with characteristic features of gradual visual loss and temporal atrophy of both optic nerves were enrolled in this study. Among the patients, RNFL thickness of each area was measured with optical coherence tomography, and its influence on the best corrected visual acuity, mean deviation and pattern standard deviation calculated from the refractive test and Humphrey visual field test was analyzed.
RESULTS
The present study included 13 patients with bilateral temporal optic atrophy (26 eyes) and 13 normal controls (26 eyes). Optical coherence tomography was performed to calculate RNFL thickness in the 52 eyes. Among 26 eyes of patients with bilateral temporal optic atrophy, the Humphrey visual field test was performed to calculate the mean deviation and pattern standard deviation. The mean age in the patient group was 66.0 ± 12.3 years (37-80 years), and 8 (30.8%) patients were male and 18 (69.2%) female. The mean best corrected visual acuity was 30/50 (20/200-20/20). Simple regression analysis showed that a thinner temporal RNFL thickness was correlated with a lower the best corrected visual acuity (p = 0.015). The mean deviation was low when inferotemporal RNFL was thin (p = 0.005). Pattern standard deviation was high when inferotemporal (p = 0.003), inferonasal (p = 0.04) and nasal (p = 0.008) RNFLs were thin.
CONCLUSIONS
Inferotemporal RNFL thickness was significantly correlated with best corrected visual acuity, mean deviation and pattern standard deviation of automated visual field test in patients with bilateral temporal optic neuropathy. Optical coherence tomography can be further used to estimate visual acuity and visual field defects in patients with optic atrophy.

Keyword

Bilateral optic atrophy; Optical coherence tomography; Retinal nerve fiber layer thickness; Visual acuity; Visual field defect

MeSH Terms

Atrophy
Female
Humans
Male
Nerve Fibers
Optic Atrophy*
Optic Nerve
Optic Nerve Diseases
Retinaldehyde
Tomography, Optical Coherence
Visual Acuity*
Visual Field Tests
Visual Fields*
Retinaldehyde

Figure

• 

  Figure 1. Representative figure of a 77-year-old male with visual acuity of 14/20 in the right eye and 18/20 in the left eye, showing a mild decrease in the retinal nerve fiber layer (RNFL) thickness. TMP = temporal; SUP = superior; NAS = nasal; INF = inferior; OD = oculus dexter; OS = oculus sinister; S = superior; N = nasal; I = inferior; T = temporal; TS = superotemporal; NS = superonasal; G = general; TI = inferotemporal; NI = inferonasal.

• 

  Figure 2. Representative figure of a 60-year-old female with a visual acuity of 3/20 in the right eye and 6/20 in the left eye, showing a severe decrease in the retinal nerve fiber layer (RNFL) thickness. TMP = temporal; SUP = superior; NAS = nasal; INF = inferior; OD = oculus dexter; OS = oculus sinister; S = superior; N = nasal; I = inferior; T = temporal; TS = superotemporal; NS = superonasal; G = general; TI = inferotemporal; NI = inferonasal.

• 

  Figure 3. Scatterplots showing each linear regression analysis model.(A) Relationship between temporal retinal nerve fiber layer thickness (RNFLT) and best corrected visual acuity (BCVA): thinner temporal RNFLT was correlated with lower BCVA. (B) Relationship between inferotemporal RNFLT and mean deviation (MD): MD was low when inferotemporal RNFLT was thin. (C) Relationship between inferotemporal RNFLT and pattern standard deviation (PSD): PSD was high when inferotemporal RNFLT was thin. (D) Relationship between inferonasal RNFLT and PSD: PSD was high when inferonasal RNFLT was thin. (E) Relationship between nasal RNFLT and PSD: PSD was high when nasal RNFLT was thin.

Reference

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