Quantitative Analysis of Retrograde Trans-Synaptic Retinal Degeneration Based on Lesion Topography

Area of Science:

• Neuroscience
• Ophthalmology
• Neurology

Background:

• Retrograde trans-synaptic retinal degeneration (RTSD) is a condition characterized by retinal thinning following injury to the postgeniculate visual pathways.
• The pattern of retinal thinning in RTSD mirrors visual field defects (VFDs), highlighting the topographical organization of the visual pathway.

Purpose of the Study:

• To quantitatively assess the temporal evolution of RTSD in a topographically specific manner.
• To identify factors influencing the progression of RTSD based on lesion location.

Main Methods:

• A longitudinal cohort study involving patients with RTSD due to stroke or tumors.
• Optical coherence tomography (OCT) was used to measure peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) thickness.
• Mixed-effects models analyzed longitudinal changes and associated factors.

Main Results:

• Significant thinning rates were observed in RTSD areas: 6.44 µm/log year for pRNFL and 5.44 µm/log year for mGCIPL.
• Thinning was most rapid in the first 4 years, then slowed. RTSD progression was faster than in non-RTSD areas.
• Older age, male sex, severe VFD, hemorrhagic stroke, and malignant tumors were associated with faster RTSD progression.

Conclusions:

• RTSD significantly affects both pRNFL and mGCIPL, particularly within the first 4 years post-injury.
• The severity of RTSD correlates with the topographical location of the brain lesion.
• While RTSD occurs irrespective of lesion cause, specific factors like age, sex, VFD severity, and lesion type influence its progression rate.