Optic nerve cupping in patients with retrograde trans-synaptic degeneration

Retrograde trans-synaptic degeneration (RTSD) refers to the atrophy of retinal ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) following injury to corresponding post-geniculate neurons. RTSD in adults has recently been demonstrated using optical coherence tomography (OCT), but corresponding morphological changes in the optic disc have not yet been demonstrated. Optic disc cupping has been associated with periventricular leukomalacia in children and attributed to RTSD. We investigated the amplitude of RTSD in relation to latency since post-geniculate injury, and assessed cup size in patients with adult-onset RTSD.