Structure–Function Relationship in Glaucoma Using Ganglion Cell–Inner Plexiform Layer Thickness Measurements

Rao, Harsha L.; Qasim, Muhammad; Hussain, Raza S. M.; Januwada, Manideepak; Pillutla, Lalitha N.; Begum, Viquar U.; Chaitanya, Aditya; Senthil, Sirisha; Garudadri, Chandra S.

doi:10.1167/iovs.15-16943

Cited by 21 publications

(26 citation statements)

References 34 publications

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“…To be fair, there is some evidence that the linear relationship breaks down in the macula and that structural OCT damage may be seen before VF changes (Raza et al, 2011; Rao et al, 2015; Swanson et al, 2004). However, these studies are hard to interpret as various factors contribute to the variability in these data.…”

Section: Understanding Patterns Of Vf Defects Based Upon Cprnfl Damentioning

confidence: 99%

Improving our understanding, and detection, of glaucomatous damage: An approach based upon optical coherence tomography (OCT)

Hood

2017

Progress in Retinal and Eye Research

232

241

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Although ophthalmologists are becoming increasingly reliant upon optical coherence tomography (OCT), clinicians who care for glaucoma patients are not taking full advantage of the potential of this powerful technology. First, we ask, how would one describe the nature of glaucomatous damage if only OCT scans were available? In particular, a schematic model of glaucomatous damage is developed in section 2, and the nature of glaucomatous damage seen on OCT scans described in the context of this model in section 3. In particular, we illustrate that local thinning of the circumpapillary retinal nerve fiber layer (cpRNFL) around the optic disc can vary in location, depth, and/or width, as well as homogeneity of damage. Second, we seek to better understand the relationship between the thinning of the cpRNFL and the various patterns of sensitivity loss seen on visual fields obtained with standard automated perimetry. In sections 4 and 5, we illustrate why one should expect a wide range of visual field patterns, and iilustrate why they should not be placed into discrete categories. Finally, section 6 describes how the clinician can take better advantage of the information in OCT scans. The approach is summarized in a single-page report, which can be generated from a single wide-field scan. The superiority of this approach, as opposed to the typical reliance on summary metrics, is described.

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Section: Understanding Patterns Of Vf Defects Based Upon Cprnfl Damentioning

confidence: 99%

Improving our understanding, and detection, of glaucomatous damage: An approach based upon optical coherence tomography (OCT)

Hood

2017

Progress in Retinal and Eye Research

232

241

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“…Rao et al reported a significant structure–function relationship between GCIPL thickness and 10-2 standard automated perimetry (SAP), though the strength of the coefficient of determination (r 2 ) was rather moderate (range, 0.16–0.60), depending on the thickness parameters and the VF sensitivity scale. Their results demonstrated that, according to the linear model, the best fit was for the inferior and average GCIPL thicknesses 36. In a different study, the structure–function relationship at the temporal parafoveal location was significantly greater than that at the central or nasal parafoveal location, and greater in the inferior hemimacula than in the superior hemimacula 37.…”

Section: Introductionmentioning

confidence: 97%

Macular imaging by optical coherence tomography in the diagnosis and management of glaucoma

Kim

Park

2017

Br J Ophthalmol

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The macular area is important to the detection of glaucomatous retinal ganglion cell (RGC) damage. Macular thickness complementary to peripapillary retinal nerve fibre layer (RNFL) thickness can well reflect glaucomatous damage, given that the macula contains more than 50% of the RGCs in a multilayered pattern and larger RGC bodies compared with their axons. Thus, macular ganglion cell thickness parameters recently have been considered to be an effective glaucoma-diagnostic tool comparable to RNFL thickness parameters. Furthermore, spectral-domain optical coherence tomography ganglion cell-inner plexiform layer thickness and deviation maps can provide additional information essential for distinguishing glaucomatous changes from other, myopia-associated or macular disease-associated changes. Therefore, our aim with this study was to review the clinical application of macular imaging by optical coherence tomography and to provide essential clinical tips for its use in the diagnosis and management of glaucoma.

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“…[9][10][11][12][13][14] More recently, the development of optical coherence tomography (OCT) has allowed large-scale investigations to be conducted by utilizing thickness profile of various retinal structures such as nerve fiber layer and ganglion cell/inner plexiform layer as an in vivo surrogate measure of GC density, [16][17][18][19] including models for estimating the GC counts in vivo from ganglion cell layer (GCL) thickness. 20,21 The white-on-white Goldmann size III stimulus (GIII) is widely accepted as the standard stimulus size for clinical and scientific measurement of differential light sensitivity (DLS).…”

mentioning

confidence: 99%

“…While the choice of this stimulus size is based on historical rather than psychophysical origins, 4,15,22 it has been utilized in numerous structure-function investigations. [10][11][12][13][14]16,17 One such study by Swanson et al 13 modeled structure-function relationships between DLS measured with GIII and histologically derived GC count per stimulus area (GCc; modulated by retinal eccentricity) on a log-log plot as a two-stage linear regression with a distinct ''tipping point. '' The presence of the ''tipping point'' and two different linear regressions is likely a consequence of spatial summation characteristic altering with eccentricity as a result of critical summation area (Ac) enlarging with eccentricity [23][24][25] while the stimulus size remains fixed.…”

mentioning

confidence: 99%

Consistency of Structure-Function Correlation Between Spatially Scaled Visual Field Stimuli and In Vivo OCT Ganglion Cell Counts

Yoshioka

Zangerl

Phu

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate the effect of stimulus size and disease status on the structure-function relationship within the central retina, we correlated the differential light sensitivity (DLS) with Goldmann stimulus size I to V (GI-V) and optical coherence tomography (OCT) derived in vivo ganglion cell count per stimulus area (GCc) within the macular area in normal subjects and patients with early glaucoma.METHODS. Humphrey Field Analyzer 10-2 visual field data with GI through V and Spectralis OCT macular ganglion cell layer (GCL) thickness measurements were collected from normal and early glaucoma cohorts including 25 subjects each. GCc was calculated from GCL thickness data and correlated with DLSs for different stimulus sizes.RESULTS. Correlation coefficients attained with smaller stimulus size were higher compared to larger stimulus sizes in both normal (GI-GII: R 2 ¼ 0.41-0.43, GIII-GV: R 2 ¼ 0.16-0.41) and diseased cohorts (GI-GII: R 2 ¼ 0.33-0.41, GIII-GV: R 2 ¼ 0.19-0.36). Quadratic regression curves for combined GI to V data demonstrated high correlation (R 2 = 0.82-0.90) and differed less than 1 dB of visual sensitivity within the GCc range between cohorts. The established structure-function relationship was compatible with a histologically derived model correlation spanning the range predicted by stimulus sizes GI to GIII.CONCLUSIONS. Stimulus sizes within critical spatial summation area (GI-II) improved structurefunction correlations in the central visual field. The structure-function relationship was identical in both normal and diseased cohort when GI to GV data were combined. Congruency of GI and GII structure-function correlation with those previously derived with GIII from more peripheral locations further suggests that the structure-function relationship is governed by the number of ganglion cell per stimulus area.

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Structure–Function Relationship in Glaucoma Using Ganglion Cell–Inner Plexiform Layer Thickness Measurements

Cited by 21 publications

References 34 publications

Improving our understanding, and detection, of glaucomatous damage: An approach based upon optical coherence tomography (OCT)

Improving our understanding, and detection, of glaucomatous damage: An approach based upon optical coherence tomography (OCT)

Macular imaging by optical coherence tomography in the diagnosis and management of glaucoma

Consistency of Structure-Function Correlation Between Spatially Scaled Visual Field Stimuli and In Vivo OCT Ganglion Cell Counts

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