A Novel Method to Detect Local Ganglion Cell Loss in Early Glaucoma Using Spectral-Domain Optical Coherence Tomography

Abstract

PURPOSE.To test the glaucoma-discriminating ability of a new method for detecting local ganglion cell loss using spectraldomain optical coherence tomography (OCT).METHODS. This study included 58 glaucomatous and 48 healthy eyes from Japanese subjects. Combined thickness of the ganglion cell layer and inner plexus layer (GCIPL) was measured on a macular cube scan in Cirrus HD-OCT. Average GCIPL thickness within a macular elliptical annulus and minimum GCIPL thickness on 360 spokes extending from the inner to the outer radius of the elliptical annulus were calculated. Area under the receiver operating characteristic curve (AROC) to discriminate between healthy eyes and early (mean deviation [MD], ‡À6 dB)/advanced (MD, <À6 dB) glaucomatous were compared between parameters.RESULTS. Forty-three were normal-tension glaucoma, and 15 were high-tension glaucoma. The mean minimum GCIPL thickness was 77.0 lm in healthy eyes and 60.6 lm in glaucomatous eyes (P < 0.001). For the intersession repeatability, the coefficients of variation for average GCIPL and minimum GCIPL were 0.98 and 1.85 in glaucomatous eyes, and 0.89 and 1.85 in healthy eyes, respectively. Minimum GCIPL thickness AROC (0.896) was significantly higher (P ¼ 0.0062) than average GCIPL thickness (0.821) for early glaucoma, whereas minimum GCIPL AROC (0.991) was comparable (P ¼ 0.103) to average GCIPL (0.964) for advanced glaucoma. The minimum GCIPL thickness AROC was comparable (P ¼ 0.861) to average circumpapillary retinal nerve fiber layer (cpRNFL) thickness (0.890) for early glaucoma.CONCLUSIONS. In Japanese patients with 74.1% of normal-tension glaucoma, the minimum GCIPL on spokes may be useful for detecting early glaucoma. (Invest Ophthalmol Vis Sci. 2012; 53:6904-6913)

Correlation Between En Face Optical Coherence Tomography Defects of the Inner Retinal Layers and Ganglion Cell Inner Plexiform Layer Analysis After Internal Limiting Membrane Peeling for Idiopathic Full-Thickness Macular Hole

“…Previous studies using optical coherence tomography (OCT) have focused mainly on the predictive factors for MH surgery. [14][15][16][17][18][19][20][21][22] Also, studies have correlated the surgical outcome with integrity of the outer retinal layers, especially the photoreceptors. [23][24][25] The advancement of spectral-domain OCT (SD-OCT) combined with the development of intraretinal boundary segmentation algorithm has enabled more selective assessment of different layers of the macula.…”

Retinal nerve fibre layer and ganglion cell complex thickness in patients with keratoconus

“…Evaluation of the GCC is important as it has good sensitivity in differentiating between healthy and glaucomatous eyes which may be a consequence of GCC changes occurring early in glaucoma. 62,63 Thus, it is proposed that evaluation of the GCC in addition to the RNFL may be more important especially in individuals with keratoconus where other clinical tests (tonometry, optic nerve head assessment and visual fields) necessary for evaluation of glaucoma may be unreliable. The study concludes that keratoconus is associated with RNFL and GCC thickness changes that are not clinically significant.…”

Strategies to improve early diagnosis in glaucoma

“…Care should therefore be taken when interpreting the results of studies where OCT has been evaluated outside of this context. In fact, most studies examining the diagnostic ability of OCT in glaucoma have included patients with established visual field defects and relatively few have examined the utility of imaging specifically in early disease (Begum et al, 2014;Jeoung et al, 2014;Lisboa et al, 2012Lisboa et al, , 2013bSung et al, 2012;Takayama et al, 2012;Wu et al, 2012).…”

“…A growing number of other studies have examined the diagnostic ability of macular measures in early glaucoma, including in eyes without defects on conventional perimetry (Begum et al, 2014;Jeoung et al, 2013;Lisboa et al, 2013b;Takayama et al, 2012). Begum and colleagues compared 53 healthy eyes to 83 glaucomatous eyes, including 21 with preperimetric glaucoma (Begum et al, 2014).…”

“…In other words using this standard, one would expect circumpapillary and optic nerve head measures to perform better than macular parameters. Further studies examining macula changes in early glaucoma are therefore warranted, particularly, as other macular parameters such as minimum mGCIPL thickness may have better diagnostic ability than average thicknesses ( Jeoung et al, 2014;Takayama et al, 2012). Minimum mGCIPL thickness is calculated from a radial line macula scan by sampling 360 spokes of measurements extending from the center of the fovea and selecting the spoke with the lowest average thickness (Mwanza et al, 2012).…”