QUANTIFICATION OF RETINAL NERVE FIBER LAYER FOR EARLY DETECTION OF ANTERIOR VISUAL PATHWAY LESIONS

Objective: To assess the role of quantification of retinal nerve fiber layer for early detection of anterior visualpathway lesions. Study Design: Case-control study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jan to Jul 2019. Methodology: A total of 100 cases of anterior visual pathway lesions of varying clinical presentations wereincluded in the study. There were 100 matched controls who were selected from the community without anyophthalmological abnormality using non-probability consecutive sampling technique. Retinal nerve fiber layer(RNFL) thickness was measured with the help of optical coherence tomography in both the cases and controls.Mean retinal nerve fiber layer values were compared in both the groups. Student’s t-test was applied to look forany significant difference between the two groups. Results: Mean age of the patients was 39.14 ± 3.925 years while mean age of the controls was 39.23 ± 2.415 years. Mean retinal nerve fiber layer thickness in the case group was 72.21 ± 9.615 µm while on the control group was 101.34 ± 9.615 µm. A statistically significant difference was observed between cases and controls in terms of mean retinal nerve fiber layer thickness (p<0.001). Subjects with retinal nerve fiber layer thickness <85 µm were more likely to exhibit anterior visual pathway lesions (OR= 15.915 [6.278-40.346]; 95% CI, p<0.001). Conclusion: Decreased retinal nerve fiber layer thickness can serve as a predictor for anterior visual pathwaylesions. Optical coherence tomography should be incorporated for routine screening of high-risk cases in order.........