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Quantification of retinal ganglion cell loss in patients with homonymous visual field defect due to stroke

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Abstract

Background

To quantify the degree of ganglion cell degeneration through spectral domain optical coherence tomography (SD-OCT) in adult patients with post-stroke homonymous visual field defect.

Methods

Fifty patients with acquired visual field defect due to stroke (mean age = 61 years) and thirty healthy controls (mean age = 58 years) were included. Mean deviation (MD) and pattern standard deviation (PSD), average peripapillary retinal nerve fibre layer thickness (pRNLF-AVG), average ganglion cell complex thickness (GCC-AVG), global loss volume (GLV) and focal loss volume (FLV) were measured. Patients were divided according to the damaged vascular territories (occipital vs. parieto-occipital) and stroke type (ischaemic vs. haemorrhagic). Group analysis was conducted with ANOVA and multiple regressions.

Results

pRNFL-AVG was significantly decreased among patients with lesions in parieto-occipital territories compared to controls and to patients with lesions in occipital territories (p = .04), with no differences with respect to stroke type. GCC-AVG, GLV and FLV differed in stroke patients and controls, regardless of stroke type and involved vascular territories. Age and elapsed time from stroke had a significant effect on pRNFL-AVG and GCC-AVG (p < .01), but not on MD and PSD.

Conclusions

Reduction of SD-OCT parameters occurs following both ischaemic and haemorrhagic occipital stroke, but it is larger when the injury extends to parietal territories and increases as time since stroke increases. The size of visual field defect is unrelated to SD-OCT measurements. Macular GCC thinning appeared to be more sensitive than pRNFL in detecting retrograde retinal ganglion cell degeneration and its retinotopic pattern in stroke.

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Data availability

Data analysed in present study are available on the Open Science Framework (OSF) repository (https://osf.io/4vkwb/).

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Acknowledgements

Research funded by the Italian Ministry of Health to Nadia Bolognini (Grant number: GR-2016-02362497) and Stefania Bianchi Marzoli.

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Authors and Affiliations

  1. Neuro-Ophthalmology Center and Ocular Electrophysiology Laboratory, Scientific Institute Capitanio Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy

    Stefania Bianchi Marzoli, Lisa Melzi & Paola Ciasca

  2. Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Alberto Raggi

  3. Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Anna Bersano

  4. Department of Psychology, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126, Milan, Italy

    Carlotta Casati & Nadia Bolognini

  5. Laboratory of Neuropsychology, IRCCS Istituto Auxologico Italiano, Milan, Italy

    Nadia Bolognini

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  1. Stefania Bianchi Marzoli
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Correspondence to Stefania Bianchi Marzoli or Nadia Bolognini.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Bianchi Marzoli, S., Melzi, L., Ciasca, P. et al. Quantification of retinal ganglion cell loss in patients with homonymous visual field defect due to stroke. Neurol Sci 44, 2811–2819 (2023). https://doi.org/10.1007/s10072-023-06675-2

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