title: Retinal Nerve Fiber Layer Thickness is Decreased in Patients With Hematologic Malignancy.
abstract: OBJECTIVE
  To investigate whether retinal nerve fiber layer (RNFL) thickness is decreased in patients with hematologic malignancy using optical coherence tomography (OCT).
  
  
  METHODS
  This prospective, observational cross-sectional study included 65 eyes from 34 patients with hematologic malignancy and 72 healthy control eyes. OCT-measured RNFL thickness parameters (average, 4 quadrants, and 12 clock-hour thickness) and RNFL defect in red-free photo were compared between patients with hematologic malignancy and controls.
  
  
  RESULTS
  Among average, quadrant, and clock-hour map, the only 11-o'clock RNFL in patients with hematologic malignancy was statistically thinner than in controls (P=0.021). The RNFL defect was detected in 21/65 (32.3%) patients with hematologic malignancy and in 5/72 (6.9%) controls (P<0.001). In patients with hematologic malignancy, the mean RNFL thickness was significantly lower in the severe and moderate anemia groups compared with the mild anemia group (P=0.011). In the generalized estimating equations model, the mean hemoglobin level was associated with RNFL thickness while correcting for inter-eye correlation, age, and refraction error (coefficient=3.685, P=0.006).
  
  
  CONCLUSIONS
  The RNFL defect was frequently observed, and the RNFL was thinner in severe anemic patients with hematologic malignancy. These results suggest that chronic anemia may be a factor of RNFL loss.
authors: *Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine †Siloam Eye Center ‡Biostatistics Collaboration Lab, Yonsei University College of Medicine, Seoul, Korea.
authors: Jinu
authors: J
authors: Han
authors: Ji Hyun
authors: JH
authors: Kim
authors: Hanna
authors: H
authors: Yoo
authors: Sueng-Han
authors: SH
authors: Han
authors: Samin
authors: S
authors: Hong
authors: Gong Je
authors: GJ
authors: Seong
authors: Chan Yun
authors: CY
authors: Kim
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D016026:Bone Marrow Transplantation; D003430:Cross-Sectional Studies; D004906:Erythrocyte Count; D004909:Erythrocyte Indices; D005260:Female; D006068:Gonioscopy; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods; D014065:Tonometry, Ocular; D014786:Vision Disorders / Q000503:physiopathology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology
chemical_list: D006454:Hemoglobins