The Relationship Between Cup-to-Disc Ratio and Estimated Number of Retinal Ganglion Cells

Tatham, Andrew J.; Weinreb, Robert N.; Zangwill, Linda M.; Liebmann, Jeffrey M.; Girkin, Christopher A.; Medeiros, Felipe A.

doi:10.1167/iovs.12-11467

Cited by 49 publications

(48 citation statements)

References 44 publications

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“…However, this limitation applies to most measurements obtained in clinical practice from imaging devices and other instruments and the formulas have been validated in multiple external human cohorts. (22–24,44) A further limitation is that although the temporal cpRNFL thickness was used for the structural component of the macular RGC estimate, the exact location of the axons from macular RGCs is not known and may vary between individuals. Furthermore, although the ONH and macular scans were acquired sequentially, and scans were reviewed by the imaging center, there may have been small undetected differences in patient head or eye position that could have influenced measurements.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Ganglion Cell Layer Thickness and Estimated Retinal Ganglion Cell Counts in the Glaucomatous Macula

et al. 2014

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Purpose To investigate the relationship between macular ganglion cell and inner plexiform layer (mGCIPL) thickness and estimated macular retinal ganglion cell (RGC) counts in glaucoma. Design Observational cohort study. Participants A cross-sectional study of 77 healthy, 154 suspect and 159 glaucomatous eyes from the Diagnostic Innovations in Glaucoma Study (DIGS). Methods All eyes had 24-2 Standard Automated Perimetry (SAP) and optic nerve and macular imaging using high definition optical coherence tomography (HDOCT). The total number of RGCs was estimated using a previously described model that utilizes SAP and OCT circumpapillary retinal nerve fiber layer (cpRNFL) measurements. The number of macular RGCs was estimated from the temporal cpRNFL and SAP test points within the central 10 degrees. Main Outcome Measures The correlation between mGCIPL thickness and estimates of macular RGC counts. Results The average estimated macular RGC count in glaucomatous eyes was 306,010 ± 109,449 cells, which was significantly lower than the estimate of 520,678 ± 106,843 cells in healthy eyes (P < 0.001). Glaucomatous eyes had 41% fewer estimated macular RGCs than healthy eyes and suspects 21% fewer. There was strong correlation between estimated macular RGC counts and mGCIPL thickness (R2 = 0.67; P < 0.001). Macular RGC counts performed better than average mGCIPL thickness in discriminating healthy and glaucomatous eyes with receiver operating characteristic (ROC) curve areas of 0.873 and 0.775, respectively (P = 0.015). Conclusions The strong association between estimated macular RGC counts and mGCIPL thickness and the better diagnostic performance of the macular RGC counts compared to mGCIPL thickness provides further evidence that estimates of RGC number from cpRNFL thickness and SAP sensitivity can be used to assess neural losses in glaucoma.

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Section: Discussionmentioning

confidence: 99%

Relationship between Ganglion Cell Layer Thickness and Estimated Retinal Ganglion Cell Counts in the Glaucomatous Macula

et al. 2014

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“…Measurements of the neuroretinal rim area of ONH were done by HRT II and expressed in mm 2 (Fig. 2).…”

Section: Neuroretinal Rim Areamentioning

confidence: 99%

“…POAG is a slowly progressing bilateral chronic optic neuropathy characterized by RGC loss and morphological changes in the optic nerve head (ONH) with thinning of the neuroretinal rim and enlargement of the optic disc cup. Histologic studies have shown the nerve fi bers of greater diameter to decay more rapidly than those with a mean diameter and this loss of large axons is most common in the inferior and superior poles of the optic disc [2][3][4][5] . Studies have demonstrated that mechanical stress could cause physical alterations in the ONH, such as misalignment of the fenestrate in lamina cribrosa, which may lead to axoplasmic fl ow obstruction due to its back bowing.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Optic Nerve Head Morphology in Patients with Primary Open Angle Glaucoma and Non-Arteritic Anterior Ischemic Optic Neuropathy

Jurišić

Lauš

Sesar

et al. 2017

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SUMMARY -Th e aim of this study was to assess damage to retinal ganglion cells (RGC) and morphology of the optic nerve head (ONH) in patients with primary open angle glaucoma (POAG) and non-arteritic anterior ischemic optic neuropathy (NAION). Th e study included three groups of patients, as follows: 40 eyes with POAG, 40 eyes with NAION and 40 eyes with refraction anomaly. All patients underwent standard automated perimetry and analysis of ONH topography by using confocal scanning laser ophthalmoscopy (CSLO)-HRT II. Visual fi eld defects such as decreased retinal sensitivity prevailed in the eyes with POAG, whereas in the eyes with NAION they were mostly manifested as concentrically narrowed visual fi eld and quadrant excesses. Topographic ONH alterations, examined by HRT II, showed the same number of sectors to be aff ected in the eyes with POAG and NAION. A larger number of sectors in the upper part of ONH were aff ected in the eyes with NAION. Optic disc morphology diff ered signifi cantly between the eyes with POAG and NAION by a higher rate of neuroretinal rim thinning and higher mean cup depth in the POAG group.

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“…In assessing the optic nerve, Tatham et al 10 postulated a nonlinear relationship between retinal ganglion cell (RGC) estimate and cup-to-disc ratio. They concluded that cup-to-disc ratio is not sensitive for evaluating progressive neural losses in glaucoma, as small changes can be associated with large losses of RGCs.…”

Section: Optic Nerve Imagingmentioning

confidence: 99%

“…They concluded that cup-to-disc ratio is not sensitive for evaluating progressive neural losses in glaucoma, as small changes can be associated with large losses of RGCs. 10 …”

Section: Optic Nerve Imagingmentioning

confidence: 99%

One Year of Glaucoma Research in Review

Kim¹,

Demetriades²,

Radcliffe³

2014

Asia-Pacific Journal of Ophthalmology

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Purpose The objective of this study was to provide the practicing clinical ophthalmologist with an update of pertinent glaucoma literature published from 2012 to 2013. Design Literature review. Methods The authors conducted a 1-year (July 1, 2012, to September 30, 2013) English-language glaucoma literature search on PubMed using the following terms: glaucoma, automated perimetry, optic nerve imaging, optical coherence tomography, glaucoma structure and function, intraocular pressure, central corneal thickness, glaucoma medical therapy, neuroprotection, glaucoma laser treatment, secondary glaucoma, glaucoma surgery, and miscellaneous topics in glaucoma. Results Of 2659 articles on glaucoma published during our time frame, this review selected original and review articles that reflect novel aspects and updates in the field of glaucoma, while excluding letters to the editor, unpublished works, and abstracts. Preference was given to human research. Conclusions This review focuses on literature that is applicable to ophthalmologists in practice and also highlights studies that may enhance the diagnosis and management of glaucoma.

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The Relationship Between Cup-to-Disc Ratio and Estimated Number of Retinal Ganglion Cells

Cited by 49 publications

References 44 publications

Relationship between Ganglion Cell Layer Thickness and Estimated Retinal Ganglion Cell Counts in the Glaucomatous Macula

Relationship between Ganglion Cell Layer Thickness and Estimated Retinal Ganglion Cell Counts in the Glaucomatous Macula

Comparison of Optic Nerve Head Morphology in Patients with Primary Open Angle Glaucoma and Non-Arteritic Anterior Ischemic Optic Neuropathy

One Year of Glaucoma Research in Review

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