Scanning laser polarimetry, but not optical coherence tomography predicts permanent visual field loss in acute nonarteritic anterior ischemic optic neuropathy

Mark J Kupersmith; Susan Anderson; Mary Durbin; Randy Kardon

doi:10.1167/iovs.13-12253

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Scanning laser polarimetry, but not optical coherence tomography predicts permanent visual field loss in acute nonarteritic anterior ischemic optic neuropathy

Journal article

Open access

Peer reviewed

Scanning laser polarimetry, but not optical coherence tomography predicts permanent visual field loss in acute nonarteritic anterior ischemic optic neuropathy

Mark J Kupersmith, Susan Anderson, Mary Durbin and Randy Kardon

Investigative ophthalmology & visual science, Vol.54(8), pp.5514-5519

08/15/2013

DOI: 10.1167/iovs.13-12253

PMCID: PMC3747791

PMID: 23838768

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Published (Version of record) Open Access

Abstract

Scanning laser polarimetry (SLP) reveals abnormal retardance of birefringence in locations of the edematous peripapillary retinal nerve fiber layer (RNFL), which appear thickened by optical coherence tomography (OCT), in nonarteritic anterior ischemic optic neuropathy (NAION). We hypothesize initial sector SLP RNFL abnormalities will correlate with long-term regional visual field loss due to ischemic injury. We prospectively performed automated perimetry, SLP, and high definition OCT (HD-OCT) of the RNFL in 25 eyes with acute NAION. We grouped visual field threshold and RNFL values into Garway-Heath inferior/superior disc sectors and corresponding superior/inferior field regions. We compared sector SLP RNFL thickness with corresponding visual field values at presentation and at >3 months. At presentation, 12 eyes had superior sector SLP reduction, 11 of which had inferior field loss. Six eyes, all with superior field loss, had inferior sector SLP reduction. No eyes had reduced OCT-derived RNFL acutely. Eyes with abnormal field regions had corresponding SLP sectors thinner (P = 0.003) than for sectors with normal field regions. During the acute phase, the SLP-derived sector correlated with presentation (r = 0.59, P = 0.02) and with >3-month after presentation (r = 0.44, P = 0.02) corresponding superior and inferior field thresholds. Abnormal RNFL birefringence occurs in sectors corresponding to regional visual field loss during acute NAION when OCT-derived RNFL shows thickening. Since the visual field deficits show no significant recovery, SLP can be an early marker for axonal injury, which may be used to assess recovery potential at RNFL locations with respect to new treatments for acute NAION.

Predictive Value of Tests

Acute Disease

Scotoma - diagnosis

Prospective Studies

Follow-Up Studies

Optic Neuropathy, Ischemic - diagnosis

Tomography, Optical Coherence

Humans

Optic Neuropathy, Ischemic - physiopathology

Male

Retinal Ganglion Cells - pathology

Scotoma - etiology

Scotoma - physiopathology

Visual Fields

Female

Optic Neuropathy, Ischemic - complications

Scanning Laser Polarimetry - methods

Aged

Optic Disk - pathology

Details

Title: Subtitle: Scanning laser polarimetry, but not optical coherence tomography predicts permanent visual field loss in acute nonarteritic anterior ischemic optic neuropathy
Creators: Mark J Kupersmith - New York Eye and Ear Infirmary and INN at Roosevelt Hospital, New York, New York, USA. mkuper@chpnet.org
Susan Anderson
Mary Durbin
Randy Kardon
Resource Type: Journal article
Publication Details: Investigative ophthalmology & visual science, Vol.54(8), pp.5514-5519
DOI: 10.1167/iovs.13-12253
PMID: 23838768
PMCID: PMC3747791
NLM abbreviation: Invest Ophthalmol Vis Sci
ISSN: 0146-0404
eISSN: 1552-5783
Publisher: United States
Grant note: U10 EY017281 / NEI NIH HHS
Language: English
Date published: 08/15/2013
Academic Unit: Iowa Neuroscience Institute; Ophthalmology and Visual Sciences
Record Identifier: 9983980060502771

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