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Correlations between visual morphological, electrophysiological, and acuity changes in chronic non-arteritic ischemic optic neuropathy

  • Neurophthalmology
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Abstract

Purpose

To study whether there is a correlation between the macular and optic nerve morphological condition and the retinal ganglion cells (RGCs) and visual pathways’ function, and to investigate whether visual acuity (VA) changes might be related to the morpho-functional findings in chronic non-arteritic ischemic optic neuropathy (NAION).

Methods

In this retrospective study, 22 patients (mean age 62.12 ± 6.87) with chronic unilateral NAION providing 22 affected and 22 fellow eyes without NAION (NAION-FE), and 20 (mean age 61.20 ± 7.32) healthy control subjects were studied by spectral domain optical coherence tomography (Sd-OCT) for investigating macular thickness (MT) and volume (MV) of the whole (WR), inner (IR) and outer retina (OR), and the peripapillary retinal nerve fiber layer thickness (RNFL-T) measured overall and for all quadrants. Also, simultaneous 60′ and 15′ pattern electroretinogram (PERG) and visual evoked potentials (VEP) and VA were assessed. Differences of MT and MV of WR, IR, OR, and RNFL-T overall and for all quadrants, PERG amplitude (A), VEP implicit time (IT), and A and VA values between NAION eyes and controls were assessed by one-way analysis of variance. Pearson’s test was used for regression analysis. A p value < 0.01 was considered as significant.

Results

In NAION eyes as compared to NAION-FE eyes and controls, significant (p < 0.01) changes of MT, MV of WR and IR, RNFL-T, 60′ and 15′ PERG A, VEP IT and A, and VA were found. No significant (p > 0.01) OR changes were observed between groups. In NAION eyes, significant (p < 0.01) correlations between MV of WR and IR and 15′ PERG A were found. Overall, RNFL-T values were significantly correlated (p < 0.01) with those of 60′ PERG A and VEP IT and A; temporal RNFL-T values were correlated (p < 0.01) with 15′ PERG A and VEP IT and A ones. Temporal RNFL-T, MV-IR, and 15′ PERG A as well as VEP IT were significantly (p < 0.01) correlated with VA. Significant (p < 0.01) linear correlations between 60′ and 15′ PERG A findings and the corresponding values of 60′ and 15′ VEP A were also found.

Conclusion

Our findings suggest that in chronic NAION, there is a morpho-functional impairment of the IR, with OR structural sparing. VA changes are related to the impaired morphology and function of IR, to the temporal RNFL-T reduction and to the dysfunction of both large and small axons forming the visual pathway.

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Data availability

Data and material are available upon request.

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Acknowledgments

Research for this study was supported in part by the Italian Ministry of Health and in part by Fondazione Roma. Authors acknowledge Dr. Valter Valli Fiore and Maria Luisa Alessi for technical help in electrophysiological recordings and graphics, Dr. Federica Petrocchi for executing psychophysical test, and Dr. Ester Elmo for critical revision of the bibliography.

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Authors and Affiliations

  1. Visual Neurophysiology and Neurophthalmology Unit, IRCCS - Fondazione Bietti, Via Livenza 1, 00198, Rome, Italy

    Lucilla Barbano, Lucia Ziccardi & Vincenzo Parisi

Authors
  1. Lucilla Barbano
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  2. Lucia Ziccardi
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  3. Vincenzo Parisi
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Contributions

Conception and design: VP; analysis and interpretation: VP, LB, LZ; review and discussion: VP, LB, LZ; data collection: VP, LB; overall responsibility: VP.

Corresponding author

Correspondence to Lucia Ziccardi.

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The authors declare that they have no conflict of interest.

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All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This research was approved by the local ethics committee on February 14, 2017 (Comitato Etico Centrale IRCCS Lazio, Sezione IFO/Fondazione Bietti, Rome, Italy).

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Barbano, L., Ziccardi, L. & Parisi, V. Correlations between visual morphological, electrophysiological, and acuity changes in chronic non-arteritic ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol 259, 1297–1308 (2021). https://doi.org/10.1007/s00417-020-05023-w

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