Circumpapillary ganglion cell complex thickness to diagnose glaucoma: A pilot study

Abstract

Purpose:The purpose of this study is to evaluate the applicability of a new optical coherence tomography parameter, the circumpapillary ganglion cell complex (cpGCC) thickness for glaucoma diagnostics.Subjects and Methods:The RS-3000 Advance SD-OCT (NIDEK, Aichi, Japan) was used to measure global and sector macular GCC (mGCC) thickness, circumpapillary retinal nerve fiber layer (cpRNFL) thickness, cpGCC, and circumpapillary total retina (cpTR) thickness in 1 eye of 48 preperimetric/early perimetric primary open-angle glaucoma patients and 28 healthy Japanese participants. Area under the receiver-operating characteristic (AUROC) curves were used for between-method comparisons.Results:All global and sector parameters except for the nasal sector differed significantly between the patient groups (P ≤ 0.009). The AUROC for global mGCC (0.917) was significantly higher (P < 0.01) than that for global cpRNFL (0.760), global cpGCC (0.828), and global cpTR (0.812). The AUROC values of global and temporal cpGCC were significantly higher than those of the corresponding cpRNFL parameters (P < 0.05). Correlation between the visual field means deviation and each of the global thickness parameters was similar (r: 0.418–0.473, P < 0.001). At >90% specificity, the cpGCC, cpTR, and cpRNFL were able to detect 4%, 10%, and 0% of glaucoma eyes that were not detected by the mGCC thickness.Conclusions:In Japanese eyes, the diagnostic accuracy of cpGCC is lower than that of mGCC but higher than that of cpRNFL. Our results suggest that the use of cpGCC may not improve glaucoma diagnostics when there is no macular disease but may be of benefit when macular diseases prevent successful mGCC measurements.

Development of a Spatial Model of Age-Related Change in the Macular Ganglion Cell Layer to Predict Function From Structural Changes

“…The 95% prediction intervals describing predicted VF sensitivities were significantly narrower across all cluster-based structure-function models (3.79-4.99 dB) compared with models without clustering applied ( coherence tomography (OCT) technology, high-resolution in vivo visualization of the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) have become possible, providing invaluable information supplementing the clinical examination of glaucoma. 1,2 Although natural changes to the GCL should not be difficult to capture in theory, various biological factors including concurrent changes due to normal aging and inherent, normal interindividual variation confound our ability to differentiate variations of normal from early disease states. [3][4][5] In conjunction with functional considerations such as variable spatial summation characteristics across different macular regions, [6][7][8] these factors have contributed to so-called discordance in the relationship between macular ganglion cell (GC) measurements and visual field (VF) sensitivity.…”

Circumpapillary structure-function relationships with microperimetry and spectral domain optical coherence tomography in glaucoma: a pilot study

“…Our results were not completely unexpected, since cpOR is not influenced by glaucomatous retinal thinning; therefore, no clinically useful correlation was expected from this parameter 13–16. It has also been shown that compared with cpRNFL thickness, the most commonly used parameter for glaucoma investigations,17–19 cpTR thickness is more reproducible, and cpGCC thickness has higher diagnostic accuracy 9,12. For structure-function relationships, in our current investigation cpGCC thickness and cpTR thickness performed better than cpRNFL thickness, both in terms of the number of significantly correlated sectors and the strength of the correlations in the inferotemporal area.…”

“…We found favorable diagnostic performance and strong correlations, particularly in the inferotemporal peripapillary area, which is known to be most severely affected by glaucomatous deterioration. We also found higher diagnostic accuracy for glaucoma using the circumpapillary ganglion cell complex (cpGCC) than with cpRNFL thickness 9. This result suggests that the relationship between cpMP-sensitivity values and cpGCC (a novel parameter) may be stronger than that between cpMP-sensitivity values and cpRNFL thickness (an established parameter).…”

<p>Can We Corroborate Peripapillary RNFL Analysis with Macular GCIPL Analysis? Our 2-Year Experience at a Single-Centre Tertiary Healthcare Hospital Using Two OCT Machines and a Review of Literature</p>

“…Later in Oct 2016, Cennamo et al 26 compared patients with different degrees of glaucoma (pre-perimetric, mild, moderate, severe) using SD-OCT and field parameters and concluded that inferior and mean GCC thickness best discriminated between the groups. In May 2017, Kita et al 27 shifted the focus of study in preperimetric glaucoma patients from macular GCC (mGCC) to circumpapillary GCC (cpGCC) using RS-3000 Advance SD-OCT (NIDEK, Aichi, Japan) as the investigating tool and AUROC as comparison variable. They concluded that mGCC was better than cpGCC with respect to diagnostic accuracy but could not comment on its comparison to pRNFL.…”