Microcystic Macular Edema Caused by Non-Glaucomatous Optic Atrophy: A Single-Center, Retrospective, Cohort Study in France

TL;DR

This study found that microcystic macular edema occurs in 15% of non-glaucomatous optic atrophy cases and is linked to retinal layer changes and worse vision.

Contribution

The study reports the prevalence and clinical associations of MME in non-glaucomatous optic atrophy across various etiologies.

Findings

MME occurred in 15% of non-glaucomatous optic atrophy cases.

MME was associated with retinal layer thinning and worse visual acuity.

MME prevalence varied by the underlying cause of optic atrophy.

Abstract

Optic Atrophy (OA) can be associated with the development of microcystic macular edema (MME) in the perifoveal retinal inner nuclear layer (INL). We aimed here to retrospectively determine the prevalence of MME in patients with non-glaucomatous OA in our tertiary ophthalmology department between 2015 and 2020. We then examined how MME affected the thicknesses of the different retinal layers and the differences in demographic and clinical characteristics between those patients who developed MME and those who did not. A total of 643 eyes (429 patients) were included (mean age 45.9 ± 17.8 years, 52% female). MME developed in 95 (15%) eyes and across all etiologies of OA except for toxic/nutritional causes, but the prevalence of MME varied between the different etiologies. The development of MME was associated with thinning of the ganglion cell layer (11.0 vs. 9.6 μm; p = 0.001) and the retinal nerve fiber layer (10.1 vs. 9.15 μm; p = 0.024), with INL thickening in the 3- and 6-mm diameter areas of the central fovea. Patients developing MME had significantly worse distance best-corrected visual acuity than those not developing MME (0.62 vs. 0.38 logMAR; p = 0.002). Overall, the presence of MME in OA cannot be used to guide the diagnostic work-up of OA.

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