title: Role of the macular optical coherence tomography scan in neuro-ophthalmology.
abstract: BACKGROUND
  Recent improvements in optical coherence tomographic (OCT) resolution and automated segmentation software have provided a means of relating visual pathway damage to structural changes in the retinal nerve fiber layer (RNFL) and corresponding soma of the ganglion cells in the inner layers of the macula and also in the outer photoreceptor layer in the macula.
  
  
  METHODS
  Studies correlating retinal structure with function are reviewed in the context of OCT in optic nerve and retinal disorders.
  
  
  RESULTS
  Recently published work provides evidence showing a strong relationship not only between the RNFL and visual threshold in optic nerve disorders but also between visual sensitivity and the inner layers of the retina in the macula, where the cell bodies of ganglion cells reside. Acquired and genetic disorders affecting the outer retina show correlation between visual sensitivity and the thickness of the outer photoreceptors. These relationships help localize unknown causes of visual field loss through segmentation of the retinal layers using spectral domain OCT.
  
  
  CONCLUSIONS
  Advances in relating the structure of the ganglion cell layer in the macula to the corresponding axons in the RNFL and to visual function further our ability to differentiate and localize ambiguous causes of vision loss and visual field defects in neuro-ophthalmology. Ganglion cell layer analysis in volume OCT data may provide yet another piece of the puzzle to understanding structure-function relationships and its application to diagnosis and monitoring of optic nerve diseases, while similar structure-function relationships are also being elucidated in the outer retina for photoreceptor diseases.
authors.affiliation: Department of Ophthalmology, University of Iowa, Iowa City, Iowa, USA. randy-kardon@uiowa.edu
authors.forename: Randy H
authors.initials: RH
authors.lastname: Kardon
mesh_terms: D006801:Humans; D009412:Nerve Fibers / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D012164:Retinal Diseases / Q000175:diagnosis*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014794:Visual Fields; D014795:Visual Pathways / Q000473:pathology
references.citation: J Glaucoma. 2008 Oct-Nov;17(7):519-28
references.pmid: 18854727
references.citation: Can J Neurol Sci. 2008 Sep;35(4):482-7
references.pmid: 18973066
references.citation: Arch Ophthalmol. 2009 Jul;127(7):875-81
references.pmid: 19597108
references.citation: J Glaucoma. 2010 Mar;19(3):158-66
references.pmid: 19661824
references.citation: Invest Ophthalmol Vis Sci. 2008 May;49(5):1879-85
references.pmid: 18263812
references.citation: Invest Ophthalmol Vis Sci. 2011 Sep 09;52(10):7141-7
references.pmid: 21810977
references.citation: Arch Ophthalmol. 2009 Oct;127(10):1307-13
references.pmid: 19822847
references.citation: Arch Neurol. 2008 Jan;65(1):26-35
references.pmid: 18195137
references.citation: Invest Ophthalmol Vis Sci. 2009 Sep;50(9):4254-66
references.pmid: 19443710
references.citation: Invest Ophthalmol Vis Sci. 2007 Aug;48(8):3662-8
references.pmid: 17652736
references.citation: IEEE Trans Med Imaging. 2008 Oct;27(10):1495-505
references.pmid: 18815101
references.citation: Prog Retin Eye Res. 2007 Nov;26(6):688-710
references.pmid: 17889587
references.citation: Arch Neurol. 2009 Nov;66(11):1366-72
references.pmid: 19901168
references.citation: Brain. 2009 Mar;132(Pt 3):628-34
references.pmid: 19224900
references.citation: Clin Ophthalmol. 2010 Oct 21;4:1151-8
references.pmid: 21060664
references.citation: Ophthalmology. 2008 May;115(5):904-10
references.pmid: 17870170
references.citation: Mult Scler. 2008 Aug;14(7):893-905
references.pmid: 18573837
references.citation: Lancet Neurol. 2010 Sep;9(9):921-32
references.pmid: 20723847
references.citation: Inf Process Med Imaging. 2007;20:607-18
references.pmid: 17633733
references.citation: Arch Ophthalmol. 2009 Jan;127(1):45-9
references.pmid: 19139337
references.citation: Nat Clin Pract Neurol. 2008 Dec;4(12):664-75
references.pmid: 19043423
references.citation: Acta Ophthalmol. 2010 Aug;88(5):e177-83
references.pmid: 20491687