Optical coherence tomography shows early loss of the inferior temporal quadrant retinal nerve fiber layer in autosomal dominant optic atrophy.

PURPOSE: The aim of the study was to evaluate the relationship between visual function and retinal nerve fiber layer thickness (RNFLT) determined using Stratus optical coherence tomography (OCT) in patients with autosomal dominant optic atrophy (ADOA).

METHODS

The study was a retrospective, institutional, and comparative case series. Thirty-six consecutive patients with ADOA and 72 age-matched normal controls were compared with regard to RNFLT, best-corrected visual acuity (BCVA), and visual field.

RESULTS

The relative reduction of RNFLT of ADOA patients was most evident in the temporal quadrant (56.8%), followed by the inferior (35.5%), superior (27.2%), and nasal quadrants (26.4%). In ADOA patients, BCVA decreased with RNFL thinning (p < 0.001), and was not related to age (p = 0.210). Papillomacular bundle RNFLT decreased with age throughout the study period of 3.7 ± 2.3 years (-3.83 ± 9.96 μm, p = 0.017). The presence of a superotemporal central scotoma (61.1%) was related to decreased inferotemporal RNFLT (7 and 8 o'clock, p = 0.016 and p = 0.036, respectively).

CONCLUSIONS

The papillomacular bundle RNFL of ADOA is most vulnerable and progressively damaged with age, despite early temporal RNFL loss. Early loss of inferior temporal RNFL in ADOA is related to superotemporal central scotoma.