Longitudinal changes in peri-papillary retinal nerve fiber layer thickness in patients with unilateral branch retinal vein occlusion

Islam Goda; Emad A Saliem; Shaimaa M Mostafa; Ahmed Mahmoud Amin; Mohamed Yahia Omran; Basheer Eltantawy; Haitham Beshr Soliman; Esam Ghanem Abu El-Wafa; Ahmed Abdelaleem Abdelgbar; Hamdy Osman Abdel-Rahman Osman; Ahmad Mohammed Madianah Alkady; Mostafa Farid Mohammed Alneklawi; Nour Eldin Abdel Hamid; Akram Fekry Elgazzar; Walid Shaban Abdella; Mohamed G A Saleh

doi:10.51329/mehdiophthal1471

Longitudinal changes in peri-papillary retinal nerve fiber layer thickness in patients with unilateral branch retinal vein occlusion

Med Hypothesis Discov Innov Ophthalmol. 2023 Dec 31;12(2):62-69. doi: 10.51329/mehdiophthal1471. eCollection 2023 Summer.

Authors

Islam Goda¹, Emad A Saliem², Shaimaa M Mostafa³, Ahmed Mahmoud Amin⁴, Mohamed Yahia Omran⁵, Basheer Eltantawy⁵, Haitham Beshr Soliman⁵, Esam Ghanem Abu El-Wafa², Ahmed Abdelaleem Abdelgbar², Hamdy Osman Abdel-Rahman Osman², Ahmad Mohammed Madianah Alkady⁴, Mostafa Farid Mohammed Alneklawi⁴, Nour Eldin Abdel Hamid⁴, Akram Fekry Elgazzar⁵, Walid Shaban Abdella⁵, Mohamed G A Saleh¹

Affiliations

¹ Department of Ophthalmology, Faculty of Medicine, Assiut University, Assiut, Egypt.
² Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt.
³ Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Assiut, Egypt.
⁴ Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
⁵ Department of Ophthalmology, Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

Abstract

Background: Associations between retinal venous occlusion (RVO), elevated intraocular pressure, and glaucoma have been reported. Further investigations into structural alterations in the fellow eyes of individuals with unilateral RVO have revealed that the peripapillary retinal nerve fiber layer is thinner than in healthy eyes, suggesting that there may be systemic risk factors common to both RVO and glaucoma. We aimed to evaluate changes in peripapillary retinal nerve fiber layer thickness (pRNFLT) among individuals with unilateral branch retinal vein occlusion (BRVO).

Methods: This prospective observational study recruited 30 individuals (60 eyes) with newly diagnosed unilateral BRVO and macular edema, and a control group of 30 healthy individuals (30 eyes) with no abnormalities on fundus examination or concurrent systemic comorbidities. After baseline measurements, the participants were reassessed at 6, 12, and 24 months by measuring global and sectoral pRNFLT using spectral-domain optical coherence tomography.

Results: The mean age and sex distributions were comparable between the patient and control groups (both P > 0.05). When compared to fellow eyes, global and sectoral pRNFLT in eyes with BRVO were significantly higher at baseline (all P < 0.05). Over time, pRNFLT decreased dramatically, and by the conclusion of the two-year follow-up, there was a significant reduction from baseline in the affected eyes (all P < 0.05). Likewise, affected eyes experienced a significant improvement in best-corrected distance visual acuity and central macular thickness over the two-year follow-up (both P ≤ 0.001). Comparing the global and all-sector pRNFLT of fellow eyes in the patient group with those of normal eyes in the control group, there were no significant differences at any visit, except in the temporal sector, which revealed a significant reduction in pRNFLT at 24 months in the fellow eyes of patients with unilateral BRVO (P = 0.02).

Conclusions: Patients with unilateral BRVO experienced a significant reduction in pRNFLT in the affected eyes and, to a lesser extent, in the fellow eyes, compared with that of the control arm, suggesting that they are prone to retinal nerve fiber layer damage. The reduction in pRNFLT in the normal fellow eyes of patients with BRVO may be attributed to age or concurrent systemic comorbidities. Further studies with long follow-up periods are required to shed light on the etiology of functional and structural changes in both the retinal nerve fiber layer and ganglion cell complex in the normal and affected eyes of patients with unilateral BRVO.

Keywords: branch retinal vein occlusion; intraocular pressures; optical coherence tomography; peripapillary retinal nerve fiber layer thickness; retinal edema; retinal vein occlusions; visual acuities.