Comparison of Optic Nerve Head Parameters in Alcoholic Liver Disease Patients With Age-Matched Controls

Alcoholic liver disease (ALD) is associated with systemic neurodegeneration mediated by oxidative stress, mitochondrial dysfunction, and chronic inflammation. As the retina and optic nerve head represent extensions of the central nervous system, they may provide a non-invasive window for detecting alcohol-related neuroretinal damage. This retrospective case-control study compared optic nerve head and peripapillary retinal nerve fiber layer (pRNFL) parameters between 100 patients with ALD and 100 age- and sex-matched healthy controls who underwent comprehensive ophthalmic evaluation and spectral-domain optical coherence tomography imaging. Average and quadrant-wise pRNFL thicknesses were analyzed across predefined age groups using independent samples t-tests. Patients with ALD demonstrated a significantly reduced average pRNFL thickness compared with controls (p < 0.05), with more pronounced thinning observed in younger adults aged 21-40 years. Quadrant-wise analysis revealed predominant involvement of the nasal and temporal quadrants, with relative sparing of the inferior quadrant. An age-related decline in pRNFL thickness was observed in both groups; however, the rate of decline was greater among patients with ALD. These findings suggest that ALD is associated with early and progressive neuroretinal degeneration, distinct from the typical pattern seen in glaucomatous optic neuropathy, and highlight the potential role of spectral-domain optical coherence tomography as a non-invasive tool for detecting subclinical neuroretinal damage in patients with ALD.