Abstract
The structural characteristics of the outer retinal layers in primary open angle glaucoma (POAG) are still controversial, and these changes, along with those in the inner retinal layers, could have clinical and/or pathophysiological significance. A custom-built ultra-high resolution optical coherence tomography (UHR-OCT) combined with an automated segmentation algorithm can image and measure the eight intra-retinal layers. The purpose of this study is to determine the thickness characteristics of the macular intra-retinal layers, especially the outer layers, in POAG patients. Thirty-four POAG patients (56 eyes) and 33 normal subjects (63 eyes) were enrolled. Thickness profiles of the eight intra-retinal layers along a 6-mm length centred on the fovea at the horizontal and vertical meridians were obtained and the regional thicknesses were compared between two groups. The associations between the thicknesses of each intra-retinal layer and the macular visual field (VF) sensitivity were then analysed. POAG affected not only the inner retinal layers but also the photoreceptor layers and retinal pigment epithelium of the outer retina. However, the VF loss was correlated mainly with the damage of the inner retinal layers. UHR-OCT with automated algorithm is a useful tool in detecting microstructural changes of macula with respect to the progression of glaucoma.
Highlights
The structural characteristics of the outer retinal layers in primary open angle glaucoma (POAG) are still controversial, and these changes, along with those in the inner retinal layers, could have clinical and/ or pathophysiological significance
We found that the outer retinal layer, including the outer plexiform layer (OPL), photoreceptor layer, and interdigitation zone (IZ) +retinal pigment epithelium (RPE), was slightly but significantly thinner in some regions
Guo et al.[11] found that the ONL was thinner in murine eyes under high intraocular tension, which is consistent with the results of our results reported here and of Lei et al.’s study[23]
Summary
The structural characteristics of the outer retinal layers in primary open angle glaucoma (POAG) are still controversial, and these changes, along with those in the inner retinal layers, could have clinical and/ or pathophysiological significance. A custom-built ultra-high resolution optical coherence tomography (UHR-OCT) combined with an automated segmentation algorithm can image and measure the eight intra-retinal layers. The predominant damage to the retina in primary open angle glaucoma (POAG) is a progressive optic neuropathy characterized by the loss of the retinal ganglion cells and associated axons and dendrites[1]. It is widely accepted that the thicknesses of the inner retinal layers, including the retinal nerve fibre layer (NFL), ganglion cell layer (GCL), and the inner plexiform layer (IPL) are significantly decreased in POAG patients[2,3] These changes are associated with visual field (VF) defects[4,5]. N Number of Subjects (Female/Male) Age, years Spherical Equivalence, D Axial Length, mm Visual Field Mean Deviation, dB Best Corrected Visual Acuity (LogMAR) Intraocular Pressure, mmHg Duration, years Treatment Drug, n Surgery +Drug, n
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