OCT in toxic and nutritional optic neuropathies

Abstract

Despite the recent developments of OCT in neuro-ophthalmology, its use for diagnosing and monitoring nutritional and toxic optic neuropathies is still limited, due to the lack of powered, longitudinal studies. Small series have suggested that OCT may be useful in various toxic optic neuropathies in the acute stage, disclosing subtle retinal nerve fibre layer thickening, ophthalmoscopically undetectable. At later stages, retinal nerve fibre layer thinning affects the papillomacular bundle, and then, all quadrants, but only rarely before visual loss. Macular volume OCT studies have suggested that in toxic optic neuropathies, the primary site of injury may involve the retinal ganglion cells layers. Retinal nerve fibre layer thinning in the nasal quadrant in patients treated with vigabatrin appears to be predictive of visual field constriction.