Using the Thickness Map from Macular Ganglion Cell Analysis to Differentiate Retinal Vein Occlusion from Glaucoma.

Nam Ho Lee,Kee Sup Park,Kyoung Nam Kim,Jung Yeul Kim,Han Min Lee,Chang-Sik Kim

doi:10.3390/jcm9103294

Nam Ho Lee, Kee Sup Park + Show 4 more

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https://doi.org/10.3390/jcm9103294

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Abstract

Purpose: We hypothesized that the thickness map from macular ganglion cell analysis (GCA) acquired from spectral-domain optical coherence tomography can be used to differentiate retinal vein occlusion (RVO) from glaucoma. Methods: In this retrospective case control study, 37 patients with resolved RVO and 74 patients with primary open-angle glaucoma (POAG) were enrolled. Two independent examiners diagnosed patients with RVO or POAG based on the topographic pattern in the GCA thickness map. Inter-observer agreement for a decision between RVO and POAG was assessed using kappa statistics. Diagnostic specificity and accuracy were calculated. Results: Inter-observer agreement was good, with a kappa value of 0.765 (95% confidence interval, 0.634–0.896, p < 0.001). The diagnostic specificity of RVO from POAG using the GCA thickness map was 93.2% and diagnosis accuracy was 80.4%. Conclusions: An irregular GCA thickness map represents a simple and convenient differential diagnostic clue to distinguish RVO from POAG.

Highlights

Retinal vein occlusion (RVO) is the second most frequent vascular disease of the retina [1]
This study investigated the usefulness of the ganglion cell analysis (GCA) thickness map for differentiation of RVO from primary open-angle glaucoma (POAG)
Based on consistent readings from independent examiners, the diagnostic specificity of RVO using the GCA thickness map was relatively good (93.2%) and the diagnostic accuracy was 80.4%

Summary

Introduction

Retinal vein occlusion (RVO) is the second most frequent vascular disease of the retina [1]. Flame-shaped retinal hemorrhage, hard exudate, and edema are observed, commonly accompanied by a patient’s complaints of an acute reduction in visual acuity with fovea involvement. After resolution of the acute phase, differential diagnosis from other diseases, such as glaucoma, may be difficult in cases without subjective symptoms of deceased visual acuity and objective finding of abnormally tortuous or collateral vessels. Many other diseases involve RNFL thinning, such as compressive optic neuropathy, ischemic optic neuropathy, and hypertensive retinopathy [2,3,4,5,6,7,8]. RVO is one of them [9]

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