Patterns of ganglion cell complex defects and association with functional status in glaucoma patients and suspects

Abstract

Aims/Purpose: To evaluate the frequency and patterns of ganglion cell complex (GCC) defects by spectral‐domain, high‐resolution optical coherence tomography (OCT) in POAG patients and suspects. Secondary endpoint was to analyse and compare the peripapillary retinal nerve fibre layer (RNFL) and GCC thickness as well as the visual field parameters among each GCC defect pattern.Methods: This was a cross‐sectional study and included 220 patients with POAG and suspects. The OCT printouts were analysed by two examiners who carefully searched for GCC defects and in common agreement stratified them into 10 different patterns. GCC thickness, retinal nerve fibre layer (RNFL) thickness were determined for every participant from the exams; mean deviation (MD) and pattern standard deviation (PSD) values were retrieved from automated perimetry exams for every patient. The structural and functional variables were compared among the groups.Results: The sample comprised 91 eyes of 47 patients. The most frequent GCC defect pattern was the minimal (39.1%). It affected more women than man at a rate of 1.4 and was associated with early disease (p < 0.001). The least frequent were inferior and superior confined (2.2% and 1.1% respectively); both were associated with moderate disease (MD = 10.0 dB, p < 0.001). The temporal raphe sign was observed in 5.5% of eyes and was associated with early disease (MD = −5.0 db).Conclusions: In this cohort of Brazilians patients with POAG and suspects, the minimal pattern was the most prevalent GCC defect and was noticed in eyes with early disease. Clinicians should pay special attention to this defect when evaluation eyes with suspicious looking optic disc and POAG patients with early disease.