Discriminating Between Compressive Optic Neuropathy With Glaucoma-Like Cupping and Glaucomatous Optic Neuropathy...

Area of Science:

• Ophthalmology
• Neuro-ophthalmology
• Medical Imaging

Background:

• Differentiating compressive optic neuropathy with glaucoma-like cupping (GL-CON) from glaucomatous optic neuropathy (GON) is clinically significant.
• Both conditions can present with similar optic disc cupping, posing diagnostic challenges.

Purpose of the Study:

• To compare peripapillary retinal nerve fiber layer (pRNFL) thickness and retinal microvasculature between GL-CON and GON.
• To identify imaging biomarkers using optical coherence tomography (OCT) and OCT angiography (OCTA) for distinguishing these conditions.

Main Methods:

• Retrospective cross-sectional study analyzing OCT and OCTA scans from GL-CON, GON, and control eyes.
• Measurements included pRNFL thickness, ganglion cell complex thickness, cup/disc ratio, and peripapillary/macular vessel density.
• Statistical analysis utilized analysis of covariance and area under the curve calculations.

Main Results:

• Glaucomatous optic neuropathy (GON) eyes exhibited thinner inferior pRNFL and larger vertical cup/disc ratios compared to GL-CON eyes.
• Vessel density in radial peripapillary and superficial macular areas was significantly lower in GON eyes, particularly in specific sectors.
• Superficial macular vessel density in the peritemporal sector was the most effective discriminator between GL-CON and GON.

Conclusions:

• Compressive optic neuropathy with glaucoma-like cupping (GL-CON) demonstrates distinct pRNFL and retinal microvascular changes.
• OCT and OCTA are effective tools for distinguishing GL-CON from GON based on these detected alterations.