Clinical Characteristics of Patients with Transsynaptic Retrograde Degeneration of Optic Neuropathy Secondary to Lateral Geniculate Body and Posterior Central Visual Pathway Injury
Objective To investigate the clinical characteristics of patients with transsynaptic retrograde degeneration of optic neuropathy (TRDON) secondary to lateral geniculate body and posterior central visual pathway injury.The thickness changes of the retinal nerve fiber layer (RNFL) and the retinal ganglion cell layer (RGCL) were observed.Methods This study was designed as a retrospective clinical study.From September 2022 to September 2023,clinical data of patients who were diagnosed with the lateral geniculate body and posterior central visual pathway injury through relevant examinations and met the inclusion and exclusion criteria in the Department of Neurology and Neuro-Ophthalmology of the First Hospital of Xi'an were collected.All included patients underwent best corrected visual acuity,non-contact indirect intraocular pressure measurement,slit lamp microscope,fundus photography,relative afferent pupillary defect,visual field,color vision,optical coherence tomography (OCT),and head imaging examination.The "easily observed TRDON" assessment was performed in the optic disc RNFL and macular lutea RGCL,and the normalized asymmetry score (NAS) of the binocular RGCL was calculated.Results A total of 15 cases (30 eyes) with the lateral geniculate body and posterior central visual pathway injury were included.The included patients were aged between 42 and 78 years,with a median age of 58 (51-68) years.The time of onset (defined as the time from the appearance of visual symptoms to the time of seeing a doctor) ranged from 0.1 to 96.5 months,and the median time of onset was 12.0 (0.5-36.0) months.In 11 cases (73.3％) of patients[20 eyes (66.7％)],the macular lutea RGCL met the criteria of "easily observed TRDON".Among them,the onset time for 10 cases was≥5 months.Nine cases of OCT showed thinning of the macular lutea RGCL in both eyes,consistent with the areas of visual field defects.One case of OCT showed thinning of the macular lutea RGCL in single eye,consistent with the areas of visual field defects.Moreover,both eyes of the nine cases had positive NAS values,and one eye of the one case had a positive NAS value.Seven patients (46.7％)[10 eyes (33.3％)]met the criteria of "easily observed TRDON" in the optic disc RNFL.Among them,three patients showed thinning of the optic disc RNFL in both eyes on OCT,while four patients showed thinning of the optic disc RNFL in only one eye.However,the correlation between the areas of thinning and the areas of visual field defects was poor.Conclusions TRDON was secondary to the lateral geniculate body and posterior central visual pathway injury,which is characterized by thin thickness of RGCL in the macular lutea in both eyes,consistent with the visual field defects.The occurrence of TRDON is time-related,typically manifesting after 5 months from the disease onset.
万方数据
维普
