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Cohort studyClinical & experimental ophthalmology · 2026

Nasal-Predominant Ganglion Cell-Inner Plexiform Layer Thinning Distinguishes Early-Stage Leber Hereditary Optic Neuropathy From Acute Optic Neuritis.

Yasuyuki Takai, Akiko Yamagami, Kenji Inoue … Keiko Tanaka

OphthalmologyCohort study

Thinner nasal retinal nerve layer helps distinguish Leber optic neuropathy from optic neuritis

Nasal-Predominant Ganglion Cell-Inner Plexiform Layer Thinning Distinguishes Early-Stage Leber Hereditary Optic Neuropathy From Acute Optic Neuritis.

Yasuyuki Takai … Keiko Tanaka

Clinical & experimental ophthalmology · 2026

Background

To compare acute-phase macular ganglion cell-inner plexiform layer (ganglion cell-inner plexiform layer) thickness on optical coherence tomography (optical coherence tomography) between Leber hereditary optic neuropathy (leber hereditary optic neuropathy) and optic neuritis (optic neuritis), and to evaluate the diagnostic performance of nasal ganglion cell-inner plexiform layer thickness.

Methods

In this retrospective single-centre study, optical coherence tomography (CIRRUS HD-optical coherence tomography; Carl Zeiss Meditec, Dublin) acquired within 45 days of symptom onset was analysed.

Results

nasal retina was thinner in Leber's, reliably telling it apart from optic neuritis

-12.1μm

Superonasal difference

-12.4μm

Inferonasal difference

More results

Leber hereditary optic neuropathy showed significantly thinner ganglion cell-inner plexiform layer than optic neuritis in the superonasal (adjusted mean difference -12.1 μm) and inferonasal (-12.4 μm) sectors in the acute phase (FDR-adjusted q = 0.02 and 0.01, respectively).

More results

The nasal ganglion cell-inner plexiform layer difference was evident versus DN-optic neuritis and MOG-optic neuritis, whereas separation from AQP4-optic neuritis was less apparent.

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Conclusion · 1 of 3

Acute-phase optical coherence tomography reveals nasal-predominant ganglion cell-inner plexiform layer thinning in leber hereditary optic neuropathy.

Conclusion · 2 of 3

This pattern differentiates leber hereditary optic neuropathy from DN-optic neuritis and MOG-optic neuritis but is less distinct from AQP4-optic neuritis.

Conclusion · 3 of 3

Nasal ganglion cell-inner plexiform layer thickness, alone or combined with clinical covariates, may aid differential diagnosis in acute presentations.

Post

Nasal-Predominant Ganglion Cell-Inner Plexiform Layer Thinning Distinguishes Early-Stage Leber Hereditary Optic Neuropathy From Acute Optic Neuritis.

Thinner nasal retinal nerve layer helps distinguish Leber optic neuropathy from optic neuritis

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