Evaluation Of The Retinal Nerve Fiber Layer And Macular Thickness In Patients With Transient Monocular Blindness

Year 2015, Volume: 12 Issue: 2, 269 - 273, 30.08.2015

Tuğba Göncü , Halit Oğuz Ali Akal Sevim Çakmak Fatih Mehmet Adıbelli , Özcan Kocatürk

Abstract

Background: Chronic cerebral hypoperfusion was observed in patients with transient ischemic attack. In
order to prevent a subsequent ischemic stroke, early diagnosis and proper management of transient ischemic
attack are essential. Transient monocular blindness (TMB) accounts for 25% of transient ischemic attacks.
Ischemic TMB occurs in the internal carotid territory and is a risk for ischemic stroke. Among patients with
TMB, 27-67% of them had carotid artery stenosis and associated with a risk of ischemic stroke. Optical
coherence tomography (OCT) which is widely used in ophthalmology is a noninvasive and easy technique
that allows imaging of the retinal nerve fiber layer thickness (RNFT) and macular volume.
In the present study, we aimed to evaluate the OCT findings of RNFT, central foveal thickness (CFT) and
macular volume of patients with TMB.
Methods: This is a prospective, comparative study of the 14 patients with TMB and 16 age and sex-matched
healthy subjects. After routine eye examination; RNFT, macular volume and CFT measurements were
performed by OCT.
Results: There was no significant difference between two groups in respect of age and sex (p=0,60 and
p=0,71 respectively). In our study group, the mean total RNFT was significantly higher in comparison to the
control (p=0,008). In respect to sectoral evaluation, RNFT did not differ significantly between the study and
3 the control group (p>0,05). The mean macular volume was 8,6±0,2 mm in the control group and it was
3 9,0±0,6 mm in the study group and this was significantly higher (p<0,001). Similarly, the CFT was
264,2±32,9 μm in the control group and it was 309,2±64,9 μm in the study group and this was significantly
higher (p<0,001).
Conclusion: In the present study, the total RNFT, macular volume and CFT were found to be higher in
patients with TMB compared to the controls. Further studies with larger sample size in which OCT findings
of patients with TMB are evaluated would be beneficial to obtain detailed information.

Keywords

Transient Ischemic Attack, Transient Monocular Blindness (Amaurosis Fugax), Optical Coherence Tomography

Geçici Görme Kaybı Olgularında Optik Koherens Tomografi İle Retina Sinir Lifi Ve Makülanın Değerlendirilmesi

Abstract

Amaç: Geçici iskemik atak olgularında kronik serebral hipoperfüzyonu saptanmıştır. Takip edebilecek
iskemik serebrovasküler hastalık gelişimini engellemek için geçici iskemik atağın erken tanısının konması
ve gerekli müdahalenin yapılması önemlidir. Geçici görme kaybı (GGK) geçici iskemik atakların %25'ini
oluşturmaktadır. İskemiye bağlı oluşan GGK de internal karotid arterin perfüzyon alanında olup serebral
iskemi için risk oluşturmaktadır. Geçici görme kaybı hastalarının %27-67'sinde zeminde karotis arter
hastalığı vardır ve iskemik serebrovasküler hastalık açısından önemli bir risk oluşturur. Optik koherens
tomografi (OKT), oftalmolojide yaygın olarak kullanılan retina sinir lifi kalınlığı (RSLK) ve maküler
hacmin ölçüldüğü noninvasif, kolay bir yöntemdir.
Çalışmamızda GGK tanısı alan olguların OKT ile RSLK, santral foveal kalınlık ve maküla hacminin
değerlendirimesi amaçlanmıştır.
Materyal ve Metod: Prospektif olarak yapılan bu çalışmaya 14 GGK hastası ve kontrol grubu olarak 16
sağlıklı birey dahil edilmiştir. Her iki gruba da rutin oftalmolojik muayeneyi takiben OKT kullanılarak
RSLK, maküla hacmi ve santral foveal kalınlık ölçümleri alınmıştır.
Bulgular: Yaş ve cinsiyet açısından iki grup arasında istatistiksel açıdan anlamlı bir farklılık yoktu (sırasıyla
p=0,60 ve p=0,71). Çalışma grubunda total RSLK, kontrol grubu ile karşılaştırıldığında anlamlı olarak daha
fazla olduğu görüldü (p=0,008). Fakat sektörlere göre RSLK değerlendirildiğinde hiç bir sektör için iki grup
3 arasında anlamlı fark olmadığı görüldü (p>0,05). Kontrol grubunun ortalama maküla hacmi 8,6±0,2 mm
3 iken çalışma grubunda bu değer 9,0±0,6 mm idi (p<0,001). Ortalama santral foveal kalınlık kontrol
grubunda 264,2±32,9 μm iken çalışma grubunda 309,2±64,9 μm idi (p<0,001).
Sonuç: Bu çalışmada GGK hastalarında total RSLK, total maküla hacminin ve santral foveal
kalınlığın anlamlı bir şekilde artmış olduğu izlenmiştir. Daha geniş hasta serilerinde GGK tanısı alan
olguların OKTverilerinin değerlendirilmesi daha detaylı bilgi sağlayacaktır.

Keywords

Geçici İskemik Atak, Geçici Görme Kaybı (Amarozis Fugaks), Optik Koherens Tomografi

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