Diagnostic ability of OCT parameters and retinal ganglion cells count in identification of glaucoma in myopic preperimetric eyes

Abstract

Background The aim of the study is to evaluate the diagnostic ability of OCT parameters and retinal ganglion cells (RGCs) count in identify glaucomatous disease in myopic preperimetric eyes. Methods This was a cross-sectional observational study. The study group consisted of 154 eyes: 36 controls, 64 preperimetric (PPG), and 54 primary openangle glaucoma (POAG) eyes. Each group was divided into three subgroups based on axial length: emmetropic, myopic with axial length (AL) < 25 mm, and myopic with AL > 25 mm, to analyze the effect of myopia. The RGCs count was obtained using a model described later. As regard the influence of myopia on OCT parameters and RGC count, we performed Pearson’s correlation. The Area Under Receiver Operator Characteristics Curves (AUROC curves) evaluated which parameter had the best sensitivity and specificity in identifying glaucoma in myopic eyes. Results In Pearson’s test, all Ganglion Cell Complex (GCC) thicknesses showed the weakest and less significant correlation with AL in all groups. All the AUROCs were statistically significant, and above 0.5. Inferior GCC and Global Loss Volume (GLV) showed the highest AUCs in all myopic group and the best diagnostic ability in distinguishing control from glaucomatous eyes. RGCcount showed good AUROC in all groups, with sensitivities of about 83% in myopic eyes, and specificity over 91% in all groups. Conclusions GCC is the parameter less influenced by the AL, and the inferior GCC and the GLV have the best diagnostic performance. The RGCcount has good sensitivity and specificity, so it can be used as a complementary test in the diagnosis of glaucoma in myopic preperimetric eyes.

Update on the Utility of Optical Coherence Tomography in the Analysis of the Optic Nerve Head in Highly Myopic Eyes with and without Glaucoma

“…Seo et al showed that the best RNFL sectors for diagnosing glaucoma in patients with high myopia were the temporal-inferior sector and the inferior quadrant (AUROC were 0.974 and 0.951, respectively) [ 64 ]. Similarly, Rolle et al, using Fourier-Domain-OCT (FD-OCT RTVue-100; Optovue, Fremont, CA, USA), found that the average RNFL yielded the best diagnostic ability for the diagnosis of glaucoma in patients with AXL > 25 mm, followed by the superior and inferior RNFL, reaching AUROC of 0.883, 0.858, and 0.872, respectively [ 73 ]. As the macular parameters are not significantly affected by high myopia, recent studies have established that the macular ganglion cells’ layer thickness has higher diagnostic power and progression analysis than the peripapillary RNFL thickness in high myopia [ 74 , 75 , 76 ], the inferotemporal macular GCIPL thickness being the best parameter for myopic glaucoma discrimination [ 74 ].…”

“…Best diagnostic ability of glaucoma in patients with AXL > 25 mm [ 73 ] Average RNFL: AUROC of 0.883 Superior RNFL: AUROC of 0.858 Inferior RNFL: AUROC 0.872 …”

Evaluation of Blood Flow Parameters of the Macular Area and Optic Disc in Patients with Combination of Glaucoma and Axial Myopia

“…При этом для выявления наиболее чувствительных анатомических критериев глаукомы при близорукости многими авторами проводилась оценка томографических параметров глаукомы при осевой миопии и у близоруких пациентов без глаукомы. Так, было показано, что толщина комплекса ганглиозных клеток с внутренним плексиформным слоем при миопии снижена незначительно, что делает данный показатель особенно ценным для диагностики глаукомы при миопии [9], что и было подтверждено в исследовании диагностической чувствительности для глаукомы таких параметров, как показатель общего объема потерь КГК и толщина комплекса ганглиозных клеток в нижнем секторе макулярной зоны [10,11].…”

The Diagnostic Value of Optical Coherence Tomography for Detecting Glaucoma in High Myopia

“…Glaucoma is the leading cause of visual loss in the world 2. More than 100 million people currently suffer from irreversible visual impairment and blindness due to glaucoma, and the number is estimated to affect 111 million people in 2040, resulting in heavy social health burdens 3,4. However, medical and surgical treatment nowadays could not reverse glaucomatous damage to visual system.…”

“…suffer from irreversible visual impairment and blindness due to glaucoma, and the number is estimated to affect 111 million people in 2040, resulting in heavy social health burdens. 3,4 However, medical and surgical treatment nowadays could not reverse glaucomatous damage to visual system. Lowing the intraocular pressure (IOP) was the only proved effective way to slow the progression of glaucomatous damages.…”