Comparison between retinal nerve fiber layer and macular thickness measured with OCT detecting progressive axonal loss following traumatic optic neuropathy.

PURPOSE To compare the optical coherence tomography retinal nerve fiber layer and macular thickness measurements for detection of progressive axonal loss following acute traumatic optic neuropathy in a longitudinal study. METHODS Three patients with unilateral traumatic optic neuropathy were evaluated sequentially after trauma. Macular and retinal nerve fiber layer thickness measurements were obtained using optical coherence tomography weekly for five weeks and around the twelfth week after trauma. RESULTS All patients showed progressive macular and retinal nerve fiber layer thickness reduction. The mean retinal nerve fiber layer thickness on the first week was 114 microm and reduced sequentially over the first five weeks and was 46 microm on the twelfth week. For macular parameters, the mean average thickness on the first week was 248 microm and also reduced over the first five weeks and was 218 microm on the twelfth week. When compared to the initial measurement, macular thickness average reduction rate at the 12th week was 14% while peripapillary retinal nerve fiber layer thickness average reduction rate was 59%. CONCLUSIONS Although both measurements reduce significantly after trauma, retinal nerve fiber layer thickness measurements show greater and faster retinal neural reduction if compared to macular thickness measurements in traumatic optic neuropathy.