The influence of mild posterior capsular opacification on spectral
domain optical coherence tomography retinal nerve fiber layer thickness
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Abstract
Purpose tau o investigate whether Yag laser capsulotomy, in addition to
restoring ocular media transparency, may also significantly alter
retinal nerve fiber layer (RNFL) thickness analysis and spectral domain
optical coherence tomography (SD OCT) indices and quality parameters,
such as signal strength (SS), in patients with mild, diffuse posterior
capsular opacification (PCO). Methods Prospective interventional case
series study which enrolled 28 patients with mild PCO and good baseline
best-corrected visual acuity (BCVA). All patients underwent a complete
ophthalmologic examination, including SD OCT RNFL thickness measurement
prior to Yag laser capsulotomy. Following laser intervention, all
patients repeated the same complete ophthalmic examination and results
were recorded and analysed. Results Mean RNFL thickness showed a
significant postoperative increase from 89.6 to 94.1 mu m (p = 0.01),
which was also confirmed for superior (p = 0.041), nasal (p = 0.011) and
inferior quadrants (p = 0.032). SS and BCVA were also significantly
increased after laser treatment (p < 0.01). A significant positive
correlation was observed between SS and mean RNFL thickness
postoperatively (p = 0.043) but not preoperatively (p = 0.059).
Similarly, a significant relationship was found between BCVA and average
RNFL thickness after (p = 0.017) but not before (p = 0.457) laser
intervention. Conclusions Our study suggests that the presence of even
mild PCO may alter the sensitivity of SD-OCT acquisition and lead to
inadvertent RNFL thickness underestimation. Clinicians should be alerted
to this contingency and take it into consideration when evaluating
various optic neuropathies with SD OCT, in pseudophakic eyes