Retinal nerve fiber layer

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Retinal nerve fiber layer
Section of retina. (Stratum opticum labeled at right, second from the top.)
Plan of retinal neurons. (Stratum opticum labeled at left, second from the top.)
Details
Identifiers
Latinstratum neurofibrarum retinae
TA98A15.2.04.017
FMA58688
Anatomical terminology

The retinal nerve fiber layer (RNFL) or nerve fiber layer, stratum opticum, is part of the anatomy of the eye.

Physical structure[edit]

The RNFL formed by the expansion of the fibers of the optic nerve; it is thickest near the optic disc, gradually diminishing toward the ora serrata.

As the nerve fibers pass through the lamina cribrosa sclerae they lose their medullary sheaths and are continued onward through the choroid and retina as simple axis-cylinders.

When they reach the internal surface of the retina they radiate from their point of entrance over this surface grouped in bundles, and in many places arranged in plexuses.

Most of the fibers are centripetal, and are the direct continuations of the axis-cylinder processes of the cells of the ganglionic layer, but a few of them are centrifugal and ramify in the inner plexiform and inner nuclear layers, where they end in enlarged extremities.

Relation with diseases[edit]

Retinitis pigmentosa[edit]

Patients with retinitis pigmentosa have abnormal thinning of the RNFL which correlates with the severity of the disease.[1] However the thickness of the RNFL also decreases with age and not visual acuity.[2] The sparing of this layer is important in the treatment of the disease as it is the basis for connecting retinal prostheses to the optic nerve, or implanting stem cells that could regenerate the lost photoreceptors.

Optic neuritis[edit]

Asymmetry between the eyes in thickness of RNFL has been proposed as a strong indicator of optic neuritis.[3][4][5] Optic neuritis is often associated with multiple sclerosis, and RNFL data may indicate the pace of future development of the MS.[6][7]

Correlation with ethnicity[edit]

RNFL is a sensitive structure which may vary based on ethnicity.[8]

Other factors affecting RNFL[edit]

Some process can excites its natural apoptosis. Harmful situation can make some damage on RNFL such as high intraocular pressure, high fluctuation on phase of intraocular pressure, inflammation, vascular disease and any kind of hypoxia. Gede Pardianto (2009) reported 6 cases of RNFL thickness change after the procedures of phacoemulsification.[9] Sudden intraocular fluctuation in any kind of intraocular surgeries maybe harmful to RNFL in accordance with mechanical stress on sudden compression and also ischemic effect of micro emboly as the result of the sudden decompression that may generate micro bubble that can clog micro vessels.[10] Glaucoma is the lead cause of irreversible blindness in contemporary times. Furthermore, greater research in the RNFL and even optic nerve head (ONH) abnormalities, can pave the way for early detection and diagnosis of glaucoma[1]

Pattern of retinal nerve fibers

References[edit]

  1. ^ a b Desissaire S, Pollreisz A, Sedova A, Hajdu D, Datlinger F, Steiner S, et al. (October 2020). "Analysis of retinal nerve fiber layer birefringence in patients with glaucoma and diabetic retinopathy by polarization sensitive OCT". Biomedical Optics Express. 11 (10): 5488–5505. doi:10.1364/BOE.402475. PMC 7587266. PMID 33149966.
  2. ^ Oishi A, Otani A, Sasahara M, Kurimoto M, Nakamura H, Kojima H, et al. (March 2009). "Retinal nerve fiber layer thickness in patients with retinitis pigmentosa". Eye (London, England). 23 (3): 561–6. doi:10.1038/eye.2008.63. PMID 18344951.
  3. ^ "An intereye difference of 5–6 μm in RNFL thickness is a robust structural threshold for identifying the presence of a unilateral optic nerve lesion in MS." Nolan RC, Galetta SL, Frohman TC, Frohman EM, Calabresi PA, Castrillo-Viguera C, et al. (December 2018). "Optimal Intereye Difference Thresholds in Retinal Nerve Fiber Layer Thickness for Predicting a Unilateral Optic Nerve Lesion in Multiple Sclerosis". Journal of Neuro-Ophthalmology. 38 (4): 451–458. doi:10.1097/WNO.0000000000000629. PMC 8845082. PMID 29384802.
  4. ^ Jiang H, Delgado S, Wang J (2021). "Advances in ophthalmic structural and functional measures in multiple sclerosis: do the potential ocular biomarkers meet the unmet needs? - PMC". Current Opinion in Neurology. 34 (1): 97–107. doi:10.1097/WCO.0000000000000897. PMC 7856092. PMID 33278142.
  5. ^ Nij Bijvank J, Uitdehaag BM, Petzold A (2021). "Short report: Retinal inter-eye difference and atrophy progression in multiple sclerosis diagnostics - PMC". Journal of Neurology, Neurosurgery, and Psychiatry. 93 (2): 216–219. doi:10.1136/jnnp-2021-327468. PMC 8785044. PMID 34764152.
  6. ^ Bsteh G, Hegen H, Altmann P, Auer M, Berek K, Pauli FD, et al. (October 19, 2020). "Retinal layer thinning is reflecting disability progression independent of relapse activity in multiple sclerosis". Multiple Sclerosis Journal - Experimental, Translational and Clinical. 6 (4): 2055217320966344. doi:10.1177/2055217320966344. PMC 7604994. PMID 33194221.
  7. ^ Martinez-Lapiscina EH, Arnow S, Wilson JA, Saidha S, Preiningerova JL, Oberwahrenbrock T, et al. (May 2016). "Retinal thickness measured with optical coherence tomography and risk of disability worsening in multiple sclerosis: a cohort study". The Lancet. Neurology. 15 (6): 574–584. doi:10.1016/S1474-4422(16)00068-5. PMID 27011339.
  8. ^ Heidary F, Gharebaghi R, Wan Hitam WH, Shatriah I (September 2010). "Nerve fiber layer thickness". Ophthalmology. 117 (9): 1861–1862. doi:10.1016/j.ophtha.2010.05.024. PMID 20816254.
  9. ^ Pardianto G (2009). "Mastering phacoemulsification in Mimbar Ilmiah". Oftalmologi Indonesia. 10: 26.
  10. ^ Pardianto G, Moeloek N, Reveny J, Wage S, Satari I, Sembiring R, et al. (2013). "Retinal thickness changes after phacoemulsification". Clinical Ophthalmology. 7. Auckland, N.Z.: 2207–14. doi:10.2147/OPTH.S53223. PMC 3821754. PMID 24235812.

Public domain This article incorporates text in the public domain from page 1015 of the 20th edition of Gray's Anatomy (1918)

External links[edit]

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