Usefulness of Optical Coherence Tomography in Optic Nerve Disease

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  • 視神経疾患におけるOCTの有用性

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Abstract

Axonal retrograde degeneration occurs for various reasons in optic nerve disease, leading to retinal ganglion cell, optic nerve atrophy. Optical coherence tomography(OCT)can analyze the circumpapillary retinal nerve fiber layer(cpRNFL)and ganglion cell complex thickness compared to a normal database and is useful for objective evaluation of axonal and ganglion cell loss in optic nerve disease. Inner macular thickness measurements can detect axonal loss in the early stage,while cpRNFL measurements are not able to do this due to disc swelling in the acute stage in optic neuritis and ischemic optic neuropathy. Papillomacular nerve fiber bundle loss can be detected in Leber hereditary optic neuropathy and in toxic optic neuropathy. There are reports of cpRNFL and inner macular thickness loss in multiple sclerosis and neuromyelitis optica. In addition, patients with these diseases with a history of optic neuritis exhibit more severe thinning of the cpRNFL and ganglion cell complex thickness. OCT parameters are correlated with visual acuity, contrast sensitivity, color vision, pupil test results, electrophysiology test results, and magnetic resonance imaging findings. Therefore, OCT is capable of detecting and quantifying axon or ganglion cell loss due to degeneration and demyelination. OCT is also useful for pathological assessment and follow-up and predicting visual functional recovery. OCT images should be evaluated in conjunction with visual functional test results and ophthalmoscopic findings, because there is a subjective element to OCT image evaluation.

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