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Retinal nerve fibre layer thickness in conditions of severe ischemia in patients without glaucoma

JOSIP PAVAN ; Department of Ophthalmology, University Hospital Dubrava, Av. G. Šuška 6,10000 Zagreb, Croatia
ADRIAN LUKENDA ; Department of Ophthalmology, University Hospital Dubrava, Av. G. Šuška 6,10000 Zagreb, Croatia
MIRKO ŠARLIJA ; Department of Ophthalmology, University Hospital Dubrava, Av. G. Šuška 6,10000 Zagreb, Croatia
SNJEŽANA KAŠTELAN ; Department of Ophthalmology, University Hospital Dubrava, Av. G. Šuška 6,10000 Zagreb, Croatia
IGOR KNEZOVIĆ ; Department of Ophthalmology, University Hospital Dubrava, Av. G. Šuška 6, 10000 Zagreb, Croatia
JASMINKA SALOPEK-RABATIĆ ; Department of Ophthalmology, University Hospital Dubrava, Av. G. Šuška 6, 10000 Zagreb, Croatia
MARKO ĆURKOVIĆ ; Department of Ophthalmology, University Hospital Dubrava, Av. G. Šuška 6, 10000 Zagreb, Croatia


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Abstract


Introduction: Ischemia, most often caused by carotid disease, contributes to or causes a numerous ocular changes including optic nerve and ganglion cell damage, glaucoma, anterior and posterior segment changes. The perimetric changes in ischemia partially overlap with those caused by glaucoma. New diagnostic tools such as scanning laser polarimetry can detect retinal nerve fiber layer loss in glaucoma up to 6 years earlier than the first perimetric changes. Still, it is not yet clear if and up to what level laser polarimetry can show changes in RNFL caused by ischemia only, and whether these changes differ from the pure glaucomatous ones. In our pilot study we tried to investigate influence of significant carotid stenosis on retinal nerve fiber layer.

Materials and Methods: Eight consecutive patients with carotid stenosis of more than 70% and no other eye disease influencing optic nerve.

Results: RNFL loss can be found in the most of analyzed patients. The
level of the RNFL impairment is not equal in the both eyes of patients having a different degree of stenosis on two sides probably due to the factors such as microvascular status.

Conclusion: RNFL suffers changes in carotid stenosis. The results demand further investigation because the possibility of the precise estimation of ischemical damage to the RNFL can be of crucial importance in diagnosing and treatment of patients having glaucoma and ocular ischemia at the same time.

Keywords

Carotid stenosis; ischemia; RNFL; glaucoma

Hrčak ID:

52750

URI

https://hrcak.srce.hr/52750

Publication date:

31.3.2010.

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