Purpose: Toxic and nutritional optic neuropathy is a well-recognised condition characterised by chronic and excessive use of tobacco and alcohol, often combined with the nocuous effect of poor nutrition. The arrival of newer technologies such as optical coherence tomography (OCT) in routine clinical use has allowed clinicians to examine the structural changes of the optic disc more closely, although published reports on its role in this condition has been scarce. Previously described changes include retinal nerve fibre layer (RNFL) thickening in the acute phase, followed by thinning later in time. RNFL damage has also been described to favour certain quadrants in the optic nerve head. Here we described common findings of retinal nerve fibre layer analysis in patients with toxic and nutritional optic neuropathy.

Methods: This is a single centre, retrospective cross-sectional study of retinal nerve fibre layer analysis of 27 patients with suspected toxic nutritional optic neuropathy over 5 years (May 2012–May 2017), referred for electrophysiology testing. Diagnosis was provided by clinicians based on history, examination, visual fields and bloods tests. All patients had reports electrophysiological tests which supports the diagnosis, and had the retinal nerve fibre layer analysis performed by the Heidelberg Spectralis OCT.

Results: 27 patients met the inclusion criteria and were included in the study. Of these, 17 were male and 10 female, with a mean age of 53 (range 38–71).