Optical coherence tomography in neuro-ophthalmology

Introduction. - Optical coherence tomography (OCT) is a potential tool for diagnosis and follow-up in diseases of the anterior visual pathway in that it provides a reproducible and reliable quantification of retinal nerve fiber layer (RNFL) thickness. A review of the literature was conducted to define the utility of OCT in neuro-ophthalmology. Materials and methods. - The clinical applications of RNFL thickness measurement by OCT time domain were analyzed. The PubMed search engine enabled us to select the relevant publications, using the following keywords: optic neuropathy, retinal nerve fiber layer thickness, and optical coherence tomography. Publications concerning glaucoma were excluded from this review. Results. - The course of RNFL thickness depends on the underlying disease: (I) progressive reduction toward atrophy (e.g., optic neuritis, chiasmal compression) or (II) initial increase in RNFL thickness followed by a reduction toward (IIa) normalization (papilledema) or (IIb) atrophy (anterior ischemic optic neuropathy, Leber hereditary optic neuropathy). Discussion. - Depending on the type of anterior visual pathway impairment, OCT provides RNFL data relevant for diagnosis, follow-up, and prognosis. As in macular disease, OCT has become an important clinical tool for routine disease assessment in neuro-ophthalmology. (C) 2012 Published by Elsevier Masson SAS.