Optic Atrophy From Retrograde Transsynaptic Axonal Degeneration Following Pediatric Brain Injury.

Autor:	Maran JJ; Buchanan Ocular Therapeutics Unit (JJM), Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand; Faculty of Medical and Health Sciences (JJM, CS, HVD-M, SH), University of Auckland, Auckland, New Zealand; Departments of Pediatric Neurology (CS) and Pediatric Radiology (DP), Starship Children's Health, Te Whatu Ora, Health New Zealand, Auckland, New Zealand; and Department of Ophthalmology (HVD-M, SH), Greenlane Clinical Centre, Te Whatu Ora, Health New Zealand, Auckland, New Zealand., Sharpe C, Perry D, Danesh-Meyer HV, Hull S
Jazyk:	angličtina
Zdroj:	Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society [J Neuroophthalmol] 2024 Aug 06. Date of Electronic Publication: 2024 Aug 06.
DOI:	10.1097/WNO.0000000000002228
Abstrakt:	Background: The patterns of optic atrophy due to retrograde transsynaptic degeneration (RTSD) have not been well characterized in children. This study aimed to characterize optic atrophy in pediatric patients with focal intracerebral lesions. Methods: A retrospective review of children with optic atrophy and focal intracerebral lesions was conducted. Ophthalmic data were recorded, including visual acuity, color vision, formal automated visual fields and optical coherence tomography (OCT) of the peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell layer. Results: Six patients (83.33% male) were included. The mean visual acuity (VA) of all eyes was 0.30 logMAR (20/40 Snellen), with no significant difference in the mean logMAR VA in the ipsilateral eye to the location of the lesion compared with the contralateral eye (0.30 vs 0.30, P = 1.000). Color vision (available in 5 patients) was normal in 2, mildly reduced in one and markedly reduced in 2. Bitemporal optic disc pallor was observed in 5 out of 6 patients. OCT data revealed that pRNFL thickness was most significantly diminished in the temporal (95% CI: -44.71 to -14.18 µm, P = 0.0021), inferotemporal (95% CI: -75.06 to -5.17 µm, P = 0.0294), and superotemporal (95% CI: -76.82 to -18.51 µm, P = 0.0055) sectors. Average pRNFL thickness was significantly reduced compared with normative data in both the ipsilateral (95% CI: -40.76 to -11.69 µm, P = 0.0003) and the contralateral eye (95% CI: -38.46 to -5.83 µm, P = 0.0063). When only nasal and temporal data were analyzed, mean pRNFL thickness was still diminished compared with normative data (95% CI: -33.01 to -9.77 µm, P = 0.0012). Conclusions: Children presenting with optic atrophy, particularly with bitemporal optic atrophy, should have neuroimaging to exclude any underlying serious intracranial pathology. Competing Interests: The authors report no conflicts of interest. (Copyright © 2024 by North American Neuro-Ophthalmology Society.)
Databáze:	MEDLINE
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