Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2021; 9(21): 5830-5839
Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5830
Macular ganglion cell complex injury in different stages of anterior ischemic optic neuropathy
Wei Zhang, Xin-Quan Sun, Xiao-Yan Peng
Wei Zhang, Xiao-Yan Peng, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
Wei Zhang, Beijing Aier Intech Eye Hospital, Beijing 100021, China
Xin-Quan Sun, China-Japanese Friendship Hospital, Beijing 100029, China
Author contributions: Sun XQ contributed to the conception of the study; Peng XY designed the work; Zhang W contributed to the acquisition of the data; all authors contributed to the analysis and interpretation of data; Zhang W drafted the initial manuscript; Sun XQ and Peng XY revised the manuscript critically for important intellectual content; All authors have read the manuscript and gave their final approval of the version to be published.
Institutional review board statement: This study was reviewed and approved by the Institutional Ethical Review Boards of Beijing Aier Intech Eye Hospital, Beijing, China.
Informed consent statement: Informed consent statement was waived.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Yan Peng, PhD, Doctor, Professor, Beijing Ophthalmology and Visual Science Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No. 17 Hougou Lane, Chongnei Street, Beijing 100005, China. drzhangwei2014@163.com
Received: January 1, 2021
Peer-review started: January 1, 2021
First decision: January 24, 2021
Revised: March 4, 2021
Accepted: June 17, 2021
Article in press: June 17, 2021
Published online: July 26, 2021
Abstract
BACKGROUND

Anterior ischemic optic neuropathy (AION) is a group of ophthalmic diseases in which the optic nerve is injured causing blindness. However, the pathogenesis, clinical manifestations, and clinical treatments of AION are yet elusive. Only a few related experimental or clinical reports are available on the disease. In this study, spectral domain optical coherence tomography (SD-OCT) was used to examine the morphology of thickness swelling and atrophic changes of macular ganglion cell complex (mGCC) in the different stages of AION that were then compared with the visual fields. Thus, the clinical value of mGCC examination was alleged to be similar to that of the visual field.

AIM

To explore the mGCC injury at different stages in AION and the clinical significance.

METHODS

Cases with AION were analyzed in a retrospective study. SD-OCT was used to analyze the correlation between mGCC and peripapillary retinal nerve fiber layer thicknesses at different stages of AION and the changes in the corresponding stages of visual fields.

RESULTS

A total of 21 cases (28 eyes) presented AION. The onset time of AION was defined as early stage (within 3 wk of onset), middle stage (from 3 wk to 2 mo), and late stage (disease span > 2 mo). In the early stage, the mGCC thickness of SD-OCT was within the normal high limit, and the perioptic nerve fibers thickness was more than the normal. The changes in the visual field in early stage were not consistent with the swelling changes in mGCC and peri-disc nerve fibers. In addition, atrophy and thinning appeared in mGCC, and the perioptic nerve fibers were swollen. However, the thickness was lower in the middle period than that in the early stage. The change in visual field was consistent with that of mGCC in this period. In the late stage, mGCC shrank and thinned, and the thickness of the nerve fibers around the optic disc in the corresponding region shrank and thinned.

CONCLUSION

The changes in mGCC thickness in patients with AION showed early, middle, and late stages of development by SD-OCT. Although the early stage visual field changes of AION were not consistent with the swelling changes of mGCC, the horizontal delimitation or annular atrophy of mGCC was consistent with that in the middle and late stage of the disease. The atrophy of peripheral nerve fibers was later than that of the mGCC atrophy.

Keywords: Anterior ischemic optic neuropathy, Macular ganglion cell complex, Visual field, Spectral domain optical coherence tomography, Eyes

Core Tip: This study to explore the macular ganglion cell complex (mGCC) injury at different stages in anterior ischemic optic neuropathy and the clinical significance. The onset time of anterior ischemic optic neuropathy was defined as early stage, middle stage, and late stage. The early stage visual field changes of anterior ischemic optic neuropathy were not consistent with the swelling changes of mGCC. The horizontal delimitation or annular atrophy of mGCC was consistent with that in the middle and late stage of the disease. The atrophy of peripheral nerve fibers was later than that of the mGCC atrophy.