Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Tek Taraflı Nonarteritik İskemik Optik Nöropati Geçiren Olguların Sağlıklı Gözlerinin Değerlendirilmesi: Retrospektif Vaka Kontrol Araştırması
Evaluation of the Fellow Eyes in Subjects with Unilateral Nonarteritic Ischemic Optic Neuropathy: Retrospective Case Control Research
Dilek ÖZKAYAa, Umut KARACAa, Gülşah USTAa
aSüleyman Demirel Üniversitesi Tıp Fakültesi, Göz Hastalıkları ABD, Isparta, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2021;30(3):172-7
doi: 10.5336/ophthal.2020-79627
Article Language: TR
Full Text
ÖZET
 Amaç: Tek taraflı Nonarteritik İskemik Optik Nöropati (NAİON) geçiren olguların sağlıklı olan diğer gözlerinde, retina sinir lifi tabakası (RSLT) kalınlığının değerlendirilmesi ve bu değerlerin sağlıklı bireylerle karşılaştırılması. Gereç ve Yöntemler: Bu çalışmada, tek taraflı NAİON tanısı konarak tedavisi yapılıp takip edilen olguların sağlıklı diğer gözleri, çalışma grubunu oluşturdu. Yaş ve cinsiyet uyumlu sağlıklı olguların birer gözleri kontrol grubunu oluşturdu. Ek oküler patolojisi ya da ±3,00 diyoptriden yüksek refraksiyon kusuru olan olgular çalışmaya dâhil edilmedi. Çalışmaya alınan olguların peripapiller RSLT kalınlık ölçümleri optik koherens tomografi cihazı kullanılarak yapıldı. Bulgular: Çalışmada 28 NAİON olgusunun 28 sağlıklı diğer gözü çalışma grubunu, yaş ve cinsiyet uyumlu 30 sağlıklı bireyin 30 gözü ise kontrol grubunu oluşturdu. Peripapiller RSLT kalınlıkları karşılaştırıldığında, ortalama RSLT kalınlığı açısından gruplar arasındaki fark anlamlı bulunmadı (p=0,095). Dört ana kadrandaki RSLT kalınlıkları açısından yapılan karşılaştırmalarda, çalışma grubunda temporal kadran RSLT kalınlığındaki incelme istatistiksel olarak anlamlıydı (p=0,036). Nazal, üst ve alt kadranlardaki farklılıkların anlamlı olmadığı gözlendi (sırasıyla; p=0,603, p=0,210, p=0,127). Ara kadranlarda yapılan karşılaştırmalarda üst temporal kadrandaki RSLT kalınlığının, çalışma grubunda anlamlı olarak daha düşük olduğu izlendi (p=0,033). Diğer ara (üst nazal, alt temporal ve alt nazal) kadranlarda RSLT kalınlıkları açısından gruplar arasındaki fark anlamlı bulunmadı (p=0,547; p=0,322 ve p=0,254). Sonuç: Bu çalışmada, NAİON geçiren olguların sağlıklı gözlerinde tüm kadranlardaki RSLT kalınlığında incelme gözlenmiş olup, bu incelme temporal ve üst temporal kadranlarda anlamlı bulunmuştur. NAİON geçiren olguların sağlıklı gözlerinde optik disk başının ve fizyolojik çukurluğun küçük olması gibi optik diske ait morfolojik değişikliklerle RSLT kalınlığında incelme gibi erken yapısal değişiklikler izlenebilmektedir. Bu amaçla sağlıklı diğer gözde NAİON gelişimini önlemek amacıyla risk faktörleri belirlenmeli ve profilaktik önlemler alınmalıdır.

Anahtar Kelimeler: İskemik optik nöropati; optik koherens tomografisi
ABSTRACT
 Objective: Evaluation of the retinal nerve fiber layer (RNFL) thickness of fellow eyes in subjects with unilateral Nonarteritic Ischemic Optic Neuropathy (NAION) and compare them with healthy subjects. Material and Methods: Fellow eyes of subjects diagnosed, treated and followed for NAION formed study group. One eye of age and gender matched healthy subjects formed control group. Subjects with additional ocular pathologies or refractive errors higher than ±3.00 diopters were excluded from the study. Peripapillary RNFL thickness measurements of cases included in the study were performed by using optical coherence tomography device. Results: Twenty-eight fellow eyes of 28 NAION cases formed study group, age and gender matched 30 eyes of 30 healthy individuals formed control group. When the peripapillary RNFL thicknesses were compared, the difference between the groups in terms of mean RNFL thickness was not significant (p=0.095). The thinning of temporal quadrant RNFL thickness in the study group was statistically significant in the comparison of four main quadrants (p=0.036). It was observed that the differences in nasal, superior and inferior quadrants were not significant (p=0.603, p=0.210 and p=0.127, respectively). When the intermediate quadrants were compared, it was found that the RNFL thickness of superotemporal quadrant significantly decreased in the study group (p=0.033). There was no significant difference between the groups in terms of RNFL thickness for other intermediate (superonasal, inferotemporal, inferonasal) quadrants (p=0.547, p=0.322 and p=0.254). Conclusion: In this study, it has been observed that RNFL thickness in all quadrants decreased in fellow eyes of subjects with NAİON and this thinning was found significant in temporal and superotemporal quadrants. Morphological alterations of optic disc including smaller optic disc and smaller physiological cupping and early structural alterations, such as thinning in RNFL thickness may occur in fellow eyes of patients with NAİON. Therefore, risk factors should be determined and prophylactic precautions should be taken for preventing the development of NAION in fellow eye.

Keywords: Ischemic optic neuropathy; optical coherence tomography
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