Prospective study on retinal nerve fibre layer thickness changes in isolated unilateral retrobulbar optic neuritis.
OBJECTIVE
To investigate the retinal nerve fibre layer (RNFL) thickness after unilateral acute optic neuritis using optical coherence tomography (OCT).


METHODS
This prospective cohort study recruited consecutive patients with a first episode of isolated, unilateral acute optic neuritis. RNFL thickness and visual acuity (VA) of the attack and normal fellow eye were measured at presentation and 3 months in both the treatment and nontreatment groups.


RESULTS
11 subjects received systemic steroids and 9 were treated conservatively. The baseline RNFL thickness was similar in the attack and fellow eye (P ≥ 0.4). At 3 months, the attack eye had a thinner temporal (P = 0.02) and average (P = 0.05) RNFL compared to the fellow eye. At 3 months, the attack eye had significant RNFL thinning in the 4 quadrants and average thickness (P ≤ 0.0002) compared to baseline. The RNFL thickness between the treatment and nontreatment groups was similar at baseline and 3 months (P ≥ 0.1). Treatment offered better VA at 3 months (0.1 ± 0.2 versus 0.3 ± 0.2 LogMAR, P = 0.04).


CONCLUSIONS
Generalized RNFL thinning occurred at 3 months after a first episode of acute optic neuritis most significantly in the temporal quadrant and average thickness. Visual improvement with treatment was independent of RNFL thickness.
Department of Ophthalmology, Caritas Medical Centre, 111 Wing Hong Street, Kowloon, Hong Kong.
Gordon S K
GS
Yau
Department of Ophthalmology, Caritas Medical Centre, 111 Wing Hong Street, Kowloon, Hong Kong.
Jacky W Y
JW
Lee
Department of Medicine and Geriatric, Caritas Medical Centre, 111 Wing Hong Street, Kowloon, Hong Kong.
Patrick P K
PP
Lau
Department of Ophthalmology, Caritas Medical Centre, 111 Wing Hong Street, Kowloon, Hong Kong.
Victor T Y
VT
Tam
Department of Medicine and Geriatric, Caritas Medical Centre, 111 Wing Hong Street, Kowloon, Hong Kong.
Winnie W Y
WW
Wong
Department of Ophthalmology, Caritas Medical Centre, 111 Wing Hong Street, Kowloon, Hong Kong.
Can Y F
CY
Yuen
D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000187:drug effects / Q000473:pathology*; D009902:Optic Neuritis / Q000188:drug therapy* / Q000473:pathology*; D009929:Organ Size / Q000187:drug effects; D011446:Prospective Studies; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000187:drug effects / Q000473:pathology*; D012680:Sensitivity and Specificity; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
D000893:Anti-Inflammatory Agents