Abstract
PurposeTo design a mathematical model that can predict the relationship between the ganglion cell complex (GCC) thickness and visual field sensitivity (VFS) in glaucoma patients.DesignRetrospective cross-sectional case series.MethodWithin 3 months from VFS measurements by the Humphrey field analyzer 10-2 program, 83 eyes underwent macular GCC thickness measurements by spectral-domain optical coherence tomography (SD-OCT). Data were used to construct a multiple logistic model that depicted the relationship between the explanatory variables (GCC thickness, age, sex, and spherical equivalent of refractive errors) determined by a regression analysis and the mean VFS corresponding to the SD-OCT scanned area. Analyses were performed in half or 8 segmented local areas as well as in whole scanned areas. A simple logistic model that included GCC thickness as the single explanatory variable was also constructed. The ability of the logistic models to depict the real GCC thickness/VFS in SAP distribution was analyzed by the χ2 test of goodness-of-fit. The significance of the model effect was analyzed by analysis of variance (ANOVA).ResultsScatter plots between the GCC thickness and the mean VFS showed sigmoid curves. The χ2 test of goodness-of-fit revealed that the multiple logistic models showed a good fit for the real GCC thickness/VFS distribution in all areas except the nasal-inferior-outer area. ANOVA revealed that all of the multiple logistic models significantly predicted the VFS based on the explanatory variables. Although simple logistic models also exhibited significant VFS predictability based on the GCC thickness, the model effect was less than that observed for the multiple logistic models.ConclusionsThe currently proposed logistic models are useful methods for depicting relationships between the explanatory variables, including the GCC thickness, and the mean VFS in glaucoma patients.
Highlights
Glaucoma is a neurodegenerative disease associated with the progressive loss of retinal ganglion cells (RGCs)
The x2 test of goodness-of-fit revealed that the multiple logistic models showed a good fit for the real ganglion cell complex (GCC) thickness/visual field sensitivity (VFS) distribution in all areas except the nasal-inferior-outer area
analysis of variance (ANOVA) revealed that all of the multiple logistic models significantly predicted the VFS based on the explanatory variables
Summary
Glaucoma is a neurodegenerative disease associated with the progressive loss of retinal ganglion cells (RGCs). The current structure-function relationship hypothesis states that there is a retinal ganglion cell (RGC) functional reserve or RGC redundancy in early clinical glaucoma. This hypothesis is consistent with the histological finding that as many as half of the RGCs and their axons may be lost before there is detectable visual function loss, as measured by standard automated perimetry (SAP). The loss of RGCs likely leads to the atrophy of the ganglion cell layer (GCL). Upon development of SD-OCT, one of the first areas measured was the thickness of the ganglion cell complex (GCC), which consists of the retinal nerve fiber layer, GCL, and the inner plexiform layer (IPL) [5]
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