Citation:Tong YX,Zhang XY,He Y,Chen ZL,Jiang B.Optical coherence tomography evaluation of retinal nerve fiber layer thickness in non-arteritic anterior ischemic optic neuropathy and primary open angle glaucoma: a systematic review and Meta-analysis.Int J Ophthalmol 2022;15(8):1370-1380,doi:10.18240/ijo.2022.08.22
Optical coherence tomography evaluation of retinal nerve fiber layer thickness in non-arteritic anterior ischemic optic neuropathy and primary open angle glaucoma: a systematic review and Meta-analysis
Received:June 17, 2021  Revised:January 27, 2022
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DOI:10.18240/ijo.2022.08.22
Key Words:non-arteritic anterior ischemic optic neuropathy  primary open angle glaucoma  optical coherence tomography  peripapillary retinal nerve fiber layer thickness
Fund Project:Supported by National Natural Science Foundation of China (No.82070967; No.81770930); National Natural Science Foundation of Hunan Province Grant (No.2020jj4788); China Hunan Provincial Science and Technology Department (No.2020SK2086).
              
AuthorInstitution
Yu-Xin Tong Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha , Hunan Province, China; Hunan Clinical Research Center of Ophthalmic Disease, Changsha , Hunan Province, China
Xin-Yu Zhang Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha , Hunan Province, China; Hunan Clinical Research Center of Ophthalmic Disease, Changsha , Hunan Province, China
Yi He Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha , Hunan Province, China
Zong-Lin Chen Department of General Surgery, Second Xiangya Hospital, Central South University, Changsha , Hunan Province, China
Bing Jiang Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha , Hunan Province, China; Hunan Clinical Research Center of Ophthalmic Disease, Changsha , Hunan Province, China
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Abstract:
      AIM: To assess the differences in average and sectoral peripapillary retinal nerve fiber layer (pRNFL) thickness using spectral domain optical coherence tomography (SD-OCT) in patients with non-arteritic anterior ischemic neuropathy (NAION) compared with those with primary open angle glaucoma (POAG).

    METHODS: A comprehensive literature search of the PubMed, Cochrane Library, and Embase databases were performed prior to October, 2021. Studies that compared the pRNFL thickness in NAION eyes with that in POAG eyes with matched mean deviation of the visual fields were included. The weighted mean difference (WMD) with 95% confidence interval (CI) was used to pool continuous outcomes.

    RESULTS: Ten cross-sectional studies (11 datasets) comprising a total of 625 eyes (278 NAION eyes, 347 POAG eyes) were included in the qualitative and quantitative analyses. The pooled results demonstrated that the superior pRNFL was significantly thinner in NAION eyes than in POAG eyes (WMD=-6.40, 95%CI: -12.22 to -0.58, P=0.031), whereas the inferior pRNFL was significant thinner in POAG eyes than in NAION eyes (WMD=11.10, 95%CI: 7.06 to 15.14, P≤0.001). No difference was noted concerning the average, nasal, and temporal pRNFL thickness (average: WMD=1.45, 95%CI: -0.75 to 3.66, P=0.196; nasal: WMD= -2.12, 95%CI: -4.43 to 0.19, P=0.072; temporal: WMD= -1.24, 95%CI: -3.96 to 1.47, P=0.370).

    CONCLUSION: SD-OCT based evaluation of inferior and superior pRNFL thickness can be potentially utilized to differentiate NAION from POAG, and help to understand the different pathophysiological mechanisms between these two diseases. Further longitudinal studies and studies using eight-quadrant or clock-hour classification method are required to validate the obtained findings.

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