Central retinal vessel trunk exit location: An important factor while evaluating the neuroretinal rim
Purpose: Optic nerve head (ONH) evaluation plays a key role in differentiating normal from glaucomatous disk. Thinning of the inferior neuroretinal rim (NRR) has been noted in early glaucoma. However, NRR thickness in different quadrants appears to depend on various factors including central retinal...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-01-01
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| Series: | Indian Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.ijo.in/article.asp?issn=0301-4738;year=2024;volume=72;issue=2;spage=240;epage=245;aulast=Gandhi |
| _version_ | 1797225808205447168 |
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| author | Monica Gandhi Divya Rajsrinivas Mugdha Jain Shailendra Sabharwal Atanu Majumdar Suneeta Dubey |
| author_facet | Monica Gandhi Divya Rajsrinivas Mugdha Jain Shailendra Sabharwal Atanu Majumdar Suneeta Dubey |
| author_sort | Monica Gandhi |
| collection | DOAJ |
| description | Purpose: Optic nerve head (ONH) evaluation plays a key role in differentiating normal from glaucomatous disk. Thinning of the inferior neuroretinal rim (NRR) has been noted in early glaucoma. However, NRR thickness in different quadrants appears to depend on various factors including central retinal vessel trunk exit (CRVT) position. We evaluated ocular parameters that determined the NRR thickness in the different quadrants of normal eyes. Methods: Retrospective review of demographic and ocular data from 773 eyes of 388 subjects with normal ONH over one year was undertaken. Results: Nearly 54% were males, and the mean age was 43.2 years. The CRVT exit was central in 50% (773). The common site for noncentral CRVT was superotemporal (ST) [37%, 141/384] followed by inferotemporal (IT) [35%, 135/384]. With noncentral CRVT, the probability that the inferior, superior, nasal and temporal (ISNT) rule was not followed was 1.42 times (P < 0.001). The thinnest rim quadrant (TRQ) was mostly ST (69%) irrespective of CRVT location. The TRQ was IT in 40% when CRVT was noncentral and 82% with IT CRVT exit. With noncentral CRVT, round disks favored noncompliance [132 (54.1%), odds ratio (OR) 2.56] with the ISNT rule. The OR of noncompliance with the ISNT rule increases 1.89 times with inferonasal CRVT and 1.22 times with a unit increase in the axial length. Conclusion: TRQ was IT in IT CRVT, and noncompliance with the ISNT rule was observed with large disks, longer axial length, and noncentral CRVT. This implies that despite the ISNT rule being violated these eyes do not have optic nerve pathology and should not be subjected to unnecessary diagnostic tests. |
| first_indexed | 2024-04-24T14:14:54Z |
| format | Article |
| id | doaj.art-3344f14ce58a4ca689975d883825c43d |
| institution | Directory Open Access Journal |
| issn | 0301-4738 1998-3689 |
| language | English |
| last_indexed | 2024-04-24T14:14:54Z |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj.art-3344f14ce58a4ca689975d883825c43d2024-04-03T08:54:29ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892024-01-0172224024510.4103/IJO.IJO_444_23Central retinal vessel trunk exit location: An important factor while evaluating the neuroretinal rimMonica GandhiDivya RajsrinivasMugdha JainShailendra SabharwalAtanu MajumdarSuneeta DubeyPurpose: Optic nerve head (ONH) evaluation plays a key role in differentiating normal from glaucomatous disk. Thinning of the inferior neuroretinal rim (NRR) has been noted in early glaucoma. However, NRR thickness in different quadrants appears to depend on various factors including central retinal vessel trunk exit (CRVT) position. We evaluated ocular parameters that determined the NRR thickness in the different quadrants of normal eyes. Methods: Retrospective review of demographic and ocular data from 773 eyes of 388 subjects with normal ONH over one year was undertaken. Results: Nearly 54% were males, and the mean age was 43.2 years. The CRVT exit was central in 50% (773). The common site for noncentral CRVT was superotemporal (ST) [37%, 141/384] followed by inferotemporal (IT) [35%, 135/384]. With noncentral CRVT, the probability that the inferior, superior, nasal and temporal (ISNT) rule was not followed was 1.42 times (P < 0.001). The thinnest rim quadrant (TRQ) was mostly ST (69%) irrespective of CRVT location. The TRQ was IT in 40% when CRVT was noncentral and 82% with IT CRVT exit. With noncentral CRVT, round disks favored noncompliance [132 (54.1%), odds ratio (OR) 2.56] with the ISNT rule. The OR of noncompliance with the ISNT rule increases 1.89 times with inferonasal CRVT and 1.22 times with a unit increase in the axial length. Conclusion: TRQ was IT in IT CRVT, and noncompliance with the ISNT rule was observed with large disks, longer axial length, and noncentral CRVT. This implies that despite the ISNT rule being violated these eyes do not have optic nerve pathology and should not be subjected to unnecessary diagnostic tests.http://www.ijo.in/article.asp?issn=0301-4738;year=2024;volume=72;issue=2;spage=240;epage=245;aulast=Gandhicentral retinal vessel trunkneuroretinal rimthinnest rim quadrant |
| spellingShingle | Monica Gandhi Divya Rajsrinivas Mugdha Jain Shailendra Sabharwal Atanu Majumdar Suneeta Dubey Central retinal vessel trunk exit location: An important factor while evaluating the neuroretinal rim Indian Journal of Ophthalmology central retinal vessel trunk neuroretinal rim thinnest rim quadrant |
| title | Central retinal vessel trunk exit location: An important factor while evaluating the neuroretinal rim |
| title_full | Central retinal vessel trunk exit location: An important factor while evaluating the neuroretinal rim |
| title_fullStr | Central retinal vessel trunk exit location: An important factor while evaluating the neuroretinal rim |
| title_full_unstemmed | Central retinal vessel trunk exit location: An important factor while evaluating the neuroretinal rim |
| title_short | Central retinal vessel trunk exit location: An important factor while evaluating the neuroretinal rim |
| title_sort | central retinal vessel trunk exit location an important factor while evaluating the neuroretinal rim |
| topic | central retinal vessel trunk neuroretinal rim thinnest rim quadrant |
| url | http://www.ijo.in/article.asp?issn=0301-4738;year=2024;volume=72;issue=2;spage=240;epage=245;aulast=Gandhi |
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