Average Ganglion Cell-inner Plexiform Layer Thickness Research Articles

Association of Spectral-Domain OCT With Long-term Disability Worsening in Multiple Sclerosis

To evaluate whether a retinal spectral-domain optical coherence tomography (SD-OCT) assessment at baseline is associated with long-term disability worsening in people with multiple sclerosis (PwMS), we performed SD-OCT and Expanded Disability Status Scale (EDSS) assessments among 132 PwMS at baseline and at a median of 10 years later. In this prospective, longitudinal study, participants underwent SD-OCT, EDSS, and visual acuity (VA) assessments at baseline and at follow-up. Statistical analyses were performed using generalized linear regression models, adjusted for age, sex, race, multiple sclerosis (MS) subtype, and baseline disability. We defined clinically meaningful EDSS worsening as an increase of ≥2.0 if baseline EDSS score was <6.0 or an increase of ≥1.0 if baseline EDSS score was ≥6.0. A total of 132 PwMS (mean age 43 years; 106 patients with relapsing-remitting MS) were included in analyses. Median duration of follow-up was 10.4 years. In multivariable models excluding eyes with prior optic neuritis, relative to patients with an average baseline ganglion cell + inner plexiform layer (GCIPL) thickness ≥70 µm (the mean GCIPL thickness of all eyes at baseline), an average baseline GCIPL thickness <70 µm was associated with a 4-fold increased odds of meaningful EDSS worsening (adjusted odds ratio [OR] 3.97, 95% confidence interval [CI] 1.24-12.70; p = 0.02) and an almost 3-fold increased odds of low-contrast VA worsening (adjusted OR 2.93, 95% CI 1.40-6.13; p = 0.04). Lower baseline GCIPL thickness on SD-OCT is independently associated with long-term disability worsening in MS. Accordingly, SD-OCT at a single time point may help guide therapeutic decision-making among individual PwMS. This study provides Class I evidence that lower baseline GCIPL thickness on SD-OCT is independently associated with long-term disability worsening in MS.

Effect of myopia and optic disc area on ganglion cell-inner plexiform layer and retinal nerve fiber layer thickness.

Purpose:The aim of this work was to study the impact of myopia and different optic disc areas on ganglion cell-inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL) thickness profiles in myopic patients by spectral-domain optical coherence tomography (SD-OCT).Methods:This was a cross-sectional study of 100 eyes of 50 myopic individuals. All patients underwent complete ophthalmic evaluation and SD-OCT examination. According to spherical equivalent (SE), patients were divided into M1, M2, and M3 (low, moderate, and high myopia group). According to optic disc area values, patients were divided into D1, D2 and D3 (small, medium and large disc groups). Average GCIPL and RNFL thickness recorded globally and separately for all quadrants and also according to 12 clock hours and analyzed with respect to different myopic groups, optic disc area groups, and axial length.Results:Quadrantic RNFL thickness profiles and their average RNFL thickness were significantly thinner in high myopic group compared to low myopic group, except for the temporal quadrant (P < 0.05). Average RNFL and RNFL thickness of all quadrants were significantly thicker in the large disc group than in the small disc group (P < 0.05). Average GCIPL and GCIPL thicknesses of all sectors were significantly thinner in high myopic group compared to low myopic group (P < 0.05). No significant correlation was observed between GCIPL and disc area changes. Average RNFL thickness correlated significantly with SE (3.667 μm/diopter), axial length (–5.3805 μm/mm) and optic disc area (9.4617 μm/mm2). Also, average GCIPL thickness correlated statistically significantly with SE (1.6807 μm/diopter) and axial length (–2.626 μm/mm).Conclusion:Myopia and axial length significantly reduce RNFL and GCIPL thickness profiles but the optic disc area significantly increases RNFL thickness, but not GCIPL thickness.

Retinal and circumpapillary nerve fiber layer thickness and associated factors in children.

To evaluate the distribution of macula and circumpapillary retina nerve fiber layer (cpRNFL) thickness and other associated factors among grade-1 primary school children in Lhasa using spectral-domain optical coherence tomography (SD-OCT). OCT assessment was conducted on 1856 grade-1 students from 7 primary schools in Lhasa, Tibet following a successful random stratified sampling of the students. Each child underwent comprehensive general and ocular examinations as well as an SD-OCT detection (12 × 9 mm, 3D wide scan mode, Topcon 3D OCT-1) to assess the thickness of the macula, ganglion cell-inner plexiform layer (GCIPL), ganglion cell complex (GCC), and cpRNFL. Multivariate and correlation analyses were performed to evaluate the association of the demographic and ocular variables. The average age of the 1762 (94.43%) students who underwent OCT assessment was 6.83 ± 0.46 years. Among them, 984 (53.02%) were boys. The number of students who had macular, cpRNFL, and optic disc scans completed and with adequate image quality were 1412 (82.2%), 1277 (74.4%), and 1243 (72.4%), respectively. The average macula full retinal thickness (FRT), GCIPL, GCC, and cpRNFL thickness of the students was 279.19 ± 10.61 μm, 76.41 ± 4.70 μm, 108.15 ± 6.15 μm, and 112.33 ± 13.5 μm, respectively. Multivariate regression and correlation analysis further revealed that boys and girls had significant differences in their average cpRNFL thickness. Moreover, GCC and GCIPL thickness was negatively correlated with IOP but positively correlated with the body mass index. The thickness of all the layers of the macula and cpRNFL were positively correlated with spherical equivalent. Further to this, the average macular FRT, GCIPL, and GCC thicknesses were positively correlated with cpRNFL global thickness. This study describes the normal distribution of macular retina, cpRNFL, and optic disc parameters in grade-1 Tibetan children in Lhasa. It contributes to the establishment of a normative ophthalmology database of Tibetan children, and advances the ability of OCT in ophthalmic disorder diagnosis during long-term monitoring in plateau.

Age-related Changes of Macular Ganglion Cell-inner Plexiform Layer Thickness in Korean Elderly Subjects.

Purpose We sought to establish normative ranges of the ganglion cell-inner plexiform layer (GCIPL) thickness using spectral-domain optical coherence tomography in Korean elderly individuals and to identify factors that influence GCIPL thickness.Methods We conducted a retrospective, observational study of 114 healthy subjects (75 years old or older) who underwent comprehensive ophthalmic examinations at a single institution. GCIPL thickness was measured with the Cirrus spectral-domain optical coherence tomography system and automatic segmentation. Subjects were divided into two age groups: those younger than 80 years and those 80 years or older, respectively. A cross-sectional analysis was adopted to evaluate associations of GCIPL thickness with sex, age, intraocular pressure, optic disc rim area, axial length, spherical equivalent (SE) refractive errors, astigmatism, and body mass index.Results The average and minimum GCIPL thicknesses were 80.3 ± 5.6 µm and 76.3 ± 5.9 µm, respectively. The GCIPL thickness was significantly lower in the older group than in the younger group in the inferior, inferonasal, and inferotemporal segments (all p < 0.01). A thinner average GCIPL thickness was strongly associated with increasing age (β = -2.87, p = 0.021) and thinner circumpapillary retinal nerve fiber layer thickness (β = 2.87, p < 0.001) in all segments.ConclusionsGCIPL thickness decreased with age globally and in all segments, even after 75 years of age. Thinner GCIPL was associated with older age and thinner circumpapillary retinal nerve fiber layer. Age-related changes should be considered when using GCIPL thickness to assess glaucoma and other optic neuropathies characterized by retinal ganglion cell loss.

Relationship Between Macular Ganglion Cell Thickness and Ocular Elongation as Measured by Axial Length and Retinal Artery Position.

PurposeWe recently reported on the usefulness of retinal artery trajectory in estimating the magnitude of retinal stretch due to myopia. The purpose of the present study was to elucidate the relationship between the peripapillary retinal artery angle (PRAA) and thickness of the macular ganglion cell–inner plexiform layer (GCIPL).MethodsThis r included 138 healthy eyes of 79 subjects older than 20 years of age without any known eye disease. GCIPL thickness was separated into eight sectors according to quadrant and eccentricity from the fovea. The PRAA was calculated as the angle between the superior and inferior retinal arteries. Relationships between whole GCIPL thickness (average and sectorial) and the values of PRAA and axial length (AL) were investigated using a linear mixed model.ResultsAverage GCIPL thickness in the whole scanned area decreased significantly with narrowing of the PRAA with and without adjusting for AL. Sectorized macular GCIPL thickness also decreased significantly, with narrowing of the PRAA in seven out of the eight with the adjustment of AL, the exception being the inferior peripheral temporal sector.ConclusionsMacular GCIPL thickness decreased significantly with narrowing of the PRAA on average and in seven out of eight sectors.

Profile of macular ganglion cell-inner plexiform layer thickness in healthy 6.5\u2009year- old Swedish children

BackgroundThe purpose was to study the macular ganglion cell- inner plexiform layer (GC-IPL) thickness in healthy 6.5 year- old Swedish children using Optical Coherence Tomography (OCT) and to study topography symmetry within eyes and between eye pairs.MethodsA total of 181 eyes of 92 healthy children (39 girls, 53 boys) aged 6.5 and serving as a term-born control group in the Extremely Preterm Infants in Sweden Study (EXPRESS), were examined with Cirrus HD-OCT. Main outcome measures were average and minimum values of GC-IPL thickness of the device’s predefined macular sectors. Single sectors, combined sectors defined as superior and inferior hemispheres and temporal and nasal sectors were evaluated. Intra-individual GC-IPL thickness between eye pairs was analyzed. Visual acuity, refraction and general cognition were assessed and correlated to GC-IPL outcome.ResultsEighty-five children completed the OCT examination and 155 out of 181 scans (86%) were analyzed. The mean average GC-IPL thickness was 85.9 μm (± 5.3; 5th and 95th percentiles were 76.0 and 94.6 μm). The mean minimum GC-IPL thickness was 83.6 μm (± 4.9; 5th and 95th percentiles were 75.4 and 92.3 μm). The difference in thickness between nasal and temporal sectors and between superior and inferior hemisphere sectors were less than 2 μm. The difference between average GC-IPL thickness and minimum GC-IPL thickness was 2.3 μm (± 1.9; 5th and 95th percentiles were 0.0 and 6.0 μm). The difference between the thickest and thinnest sector within eye was 6.4 μm (± 2.2; 5th and 95th percentiles were 3.0 and 10.0 μm). There was a moderate correlation in the difference between the nasal combined and the temporal combined sectors within eye pairs (p < 0.0001, Spearman’s ρ 0.58). The average GC-IPL thickness was weakly positively correlated with SE (spherical equivalent; combined sphere and ½ cylinder) (p = 0.031, Spearman’s ρ 0.23).ConclusionsThis study provides normative GC-IPL thickness values for healthy 6.5 year- old Swedish children. The GC-IPL thickness variations within eyes and within eye pairs are generally small. It could therefore be assumed that larger variations are sensitive markers of focal GC-IPL thinning due to damage to the primary visual pathways in children.

Association of Antihypertensive Medication with Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layer Thickness

To evaluate the association between different classes of antihypertensive medication with retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness in a nonglaucomatous multiethnic Asian population. Population-based, cross-sectional study. A total of 9144 eyes for RNFL analysis (2668 Malays, 3554 Indians, and 2922 Chinese) and 8549 eyes for GC-IPL analysis (2460 Malays, 3230 Indians, and 2859 Chinese) aged 44 to 86 years. Participants underwent standardized systemic and ocular examinations and interviewer-administered questionnaires for collection of data on medication and other variables. Intraocular pressure (IOP) readings were obtained by Goldmann applanation tonometry before pupil dilation for fundoscopy and OCT imaging. Blood pressure (BP) was measured with an automatic BP monitor. Mean arterial pressure (MAP) was defined as diastolic BP plus 1/3 (systolic BP - diastolic BP). Regression models were used to investigate the association of antihypertensive medication with OCT measurements of RNFL and GC-IPL. Average and sectoral RNFL and GC-IPL thickness. After adjusting for age, gender, ethnicity, MAP, IOP, body mass index (BMI), and presence of diabetes, we found that participants taking any type of antihypertensive medication (β=-0.83; 95% confidence interval [CI],-1.46 to-0.02; P= 0.01), specifically angiotensin-converting enzyme inhibitors (ACEIs) (β=-1.66; 95% CI,-2.57 to-0.75; P < 0.001) or diuretics (β=-1.38; 95% CI,-2.59 to-0.17; P < 0.05), had thinner average RNFL in comparison with participants who were not receiving antihypertensive treatment. Use of a greater number of antihypertensive medications was significantly associated with thinner average RNFL (P for trend= 0.001). This association was most evident in the inferior RNFL quadrant in participants using ACEIs (β=-2.44; 95% CI,-3.99 to-0.89; P= 0.002) or diuretics (β=-2.76; 95% CI,-4.76 to-0.76; P= 0.007). A similar trend was noted in our analysis of macular GC-IPL thickness. Use of 2 or more antihypertensive medications, ACEI, and diuretics were associated with a loss of structural markers of retinal ganglion cell health in a multiethnic Asian population.

Evaluation of the association of macular ganglion cell-inner plexiform layer thickness and myopia in Chinese young adults.

To describe the distribution of ganglion cell-inner plexiform layer (GCIPL) thickness among Chinese young adults and report whether the decreased GCIPL thickness is associated with myopia. In this study, we included Chinese young adults who underwent Cirrus spectral domain-optical coherence tomography (SD-OCT). SD-OCT was used to measure average and minimum GCIPL thickness, and GCIPL thickness at all sectors. Subfoveal choroidal thickness (CT), axial length (AL), and spherical equivalents (SE) were also measured. A total of 348 eyes were included in the analysis. Average GCIPL thickness showed a significant difference between myopes and emmetropes, with 87.89 ± 3.65 μm for emmetropic groups and 82.65 ± 4.96 μm for myopic groups. The GCIPL thickness was significantly thinner in myopia than in emmetropia at all locations (P < 0.05), affirming that myopia was associated with thinner GCIPL thickness (P = 0.001). The mean subfoveal CT also showed a significant difference between myopes and emmetropes, with 330.57 ± 9.43 μm for emmetropic groups and 265.98 ± 4.12 μm for myopic groups. GCIPL (OR 0.863, 95% CI, 0.785-0.949), AL (OR 2.499, 95% CI, 1.532-4.075) and intraocular pressure (IOP) (OR 1.250, 95% CI, 1.086-1.438) revealed significant associations with myopia. When adjusting for AL, IOP, and anterior chamber depth (ACD) in the myopia subgroup, the GCIPL thickness remained positively associated. In a specific Chinese young population, myopic eyes have measurably less macular GCIPL thickness than normal eyes. Decreasing GCIPL thickness may be associated with the progression of myopia.

Pattern Electroretinograms in Preperimetric and Perimetric Glaucoma

To investigate whether visual function can be graded in detail using pattern electroretinogram (PERG) in preperimetric to perimetric glaucoma. Cross-sectional observational study. Twenty-six normal subjects, 113 preperimetric glaucoma patients (which included glaucoma suspect patients), and 52 early perimetric glaucoma patients with a mean deviation (MD) >-10 dB were included. Structural and functional measurements were performed using spectral-domain optical coherence tomography and a commercial ERG stimulator, respectively. The average retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thickness were thinnest in the perimetric group, followed by the preperimetric group and the control group (P < .001). PERG N95 amplitude was the largest in the control group, followed by the preperimetric group and the perimetric group (P < .001). Among the preperimetric glaucoma patients, presence of the RNFL defect was associated with lower PERG N95 amplitude (P= .013). The N95 amplitude showed a significant relationship with average RNFL thickness (r= 0.336, P < .001) and GCIPL thickness (r= 0.376, P < .001). In the preperimetric group with the RNFL defect, the N95 amplitude showed larger areas under the receiver operating characteristic curve (0.779) than the MD (0.533, P= .005). PERG N95 amplitudes decreased from the control to preperimetric glaucoma group and were reduced more in perimetric glaucoma. The functional assessment for detecting early glaucomatous damage could be complemented by PERG N95 amplitude. Usefulness of PERG parameters except N95 amplitude seemed to be limited in a clinical setting because of relatively low diagnostic performance in preperimetric glaucoma.

Profiles of Ganglion Cell-Inner Plexiform Layer Thickness in a Multi-Ethnic Asian Population: The Singapore Epidemiology of Eye Diseases Study

To examine the normative profile and determinants of macular ganglion cell-inner plexiform layer (GCIPL) thickness based on spectral-domain OCT (SD-OCT) in a nonglaucoma, multi-ethnic Asian population. Population-based, cross-sectional study. Ethnic Chinese, Malay, and Indian adults aged ≥40 years recruited from the Singapore Epidemiology of Eye Diseases Study. All participants underwent standardized examinations. The GCIPL thickness was measured using Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA). Participants with glaucoma or poor-quality scans were excluded. Eye-specific data were used. Associations of ocular and systemic factors with GCIPL thickness parameters were investigated using multivariable linear regression with generalized estimating equation models to account for correlation between both eyes. GCIPL thickness. A total of 4464 participants (7520 eyes) consisting of 1625 Chinese, 1212 Malay, and 1627 Indian adults contributed to this analysis. Average GCIPL thickness was 82.6±6.1 μm in Chinese, 81.5±6.8 μm in Malays, and 78.0±6.9 μm in Indians (P < 0.001 by analysis of variance). The 5th percentile limit of average GCIPL thickness was 72 μm in Chinese, 70 μm in Malays, and 67 μm in Indians. In multivariable analysis adjusting for age, gender, axial length, presence of cataract, OCT signal strength, disc area, hypertension, diabetes, and hyperlipidemia, eyes of Indians were observed to have 3.43 μm thinner GCIPL on average compared with Chinese (P < 0.001) and 3.36 μm thinner GCIPL compared with Malays (P<0.001). In addition, older age (per decade; β=-2.51), female (β=-1.57), longer axial length (per mm; β=-1.54), and presence of chronic kidney disease (β=-1.49) were significantly associated with thinner average GCIPL (all P ≤ 0.008). Larger optic disc area (per mm2; β= 0.78; P < 0.001) was associated withthicker GCIPL. These factors were consistently observed to be significant for superior and inferior hemisphere GCIPL thickness. GCIPL thickness profiles were significantly thinner in Indians compared with Chinese and Malays. Our findings further highlight the need of a more refined, ethnic-specific normative database for GCIPL thickness, which in turn may improve the detection and diagnosis of glaucoma in Asians.

Diagnosing Glaucoma With Spectral-Domain Optical Coherence Tomography Using Deep Learning Classifier.

The purpose of this study was to assess the performance of a deep learning classifier for the detection of glaucomatous change based on SD-OCT. Three hundred fifty image sets of ganglion cell-inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL) SD-OCT for 86 glaucomatous eyes and 307 SD-OCT image sets of 196 healthy participants were recruited and split into training (197 eyes) and test (85 eyes) datasets based on a patient-wise split. The bottleneck features extracted from the GCIPL thickness map, GCIPL deviation map, RNFL thickness map, and RNFL deviation map were used as predictors for the deep learning classifier. The area under the receiver operating characteristic curve (AUC) was calculated and compared with those of conventional glaucoma diagnostic parameters including SD-OCT thickness profile and standard automated perimetry (SAP) to evaluate the accuracy of discrimination for each algorithm. In the test dataset, this deep learning system achieved an AUC of 0.990 [95% confidence interval (CI), 0.975-1.000] with a sensitivity of 94.7% and a specificity of 100.0%, which was significantly larger than the AUCs with all of the optical coherence tomography and SAP parameters: 0.949 (95% CI, 0.921-0.976) with average GCIPL thickness (P=0.006), 0.938 (95% CI, 0.905-0.971) with average RNFL thickness (P=0.003), and 0.889 (0.844-0.934) with mean deviation of SAP (P<0.001; DeLong test). An SD-OCT-based deep learning system can detect glaucomatous structural change with high sensitivity and specificity.

Comparisons of ganglion cell-inner plexiform layer loss patterns and its diagnostic performance between normal tension glaucoma and primary open angle glaucoma: a detailed, severity-based study.

To evaluate the patterns of macular ganglion cell-inner plexiform layer (GCIPL) loss in normal tension glaucoma (NTG) and primary open angle glaucoma (POAG) in a detailed, disease severity-matched way; and to assess the diagnostic capabilities of GCIPL thickness parameters in discriminating NTG or POAG from normal subjects. A total of 157 eyes of 157 subjects, including 57 normal eyes, 51 eyes with POAG and 49 eyes with NTG were enrolled and strictly matched in age, refraction, and disease severity between POAG and NTG groups. The average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal GCIPL thickness, and the average, superior, temporal, inferior, and nasal retinal nerve fiber layer (RNFL) thickness were obtained by Cirrus optical coherence tomography (OCT). The diagnostic capabilities of OCT parameters were assessed by area under receiver operating characteristic (AUROC) curves. Among all the OCT thickness parameters, no statistical significant difference between NTG group and POAG group was found (all P>0.05). In discriminating NTG or POAG from normal subjects, the average and inferior RNFL thickness, and the minimum GCIPL thickness had better diagnostic capabilities. There was no significant difference in AUROC curve between the best GCIPL thickness parameter (minimum GCIPL) and the best RNFL thickness parameter in discriminating NTG (inferior RNFL; P=0.076) and indiscriminating POAG (average RNFL; P=0.913) from normal eyes. Localized GCIPL loss, especially in the inferior and inferotemporal sectors, is more common in NTG than in POAG. Among all the GCIPL thickness parameters, the minimum GCIPL thickness has the best diagnostic performance in differentiating NTG or POAG from normal subjects, which is comparable to that of the average and inferior RNFL thickness.

Salvage of the retinal ganglion cells in transition phase in Alzheimer's disease with topical coenzyme Q10: is it possible?

The evaluation of the short-term effect of topically applied coenzyme Q10 (CoQ10) on retina and choroid in Alzheimer's disease (AD) was aimed in this study. Randomized controlled study included a total of 93 patients, 62 of whom with AD. Thirty (32.3%) AD patients received treatment (Group 1), 32 (34.4%) AD patients observed without treatment (Group 2), and Group 3 included 31 (33.3%) healthy controls (HC). Neurological and ophthalmological examinations including optical coherence tomography (OCT) were executed. Retinal nerve fiber layer (RNFL) thickness in all quadrants increased following CoQ10 treatment in Group 1; however significant rise yielded in average and temporal quadrant RNFL thickness. Average and superonasal sector ganglion cell-inner plexiform layer (GCIPL) thickness increased significantly following CoQ10 treatment. The correlation analysis between difference in pre- and posttreatment OCT values in Group 1 revealed that rise in average RNFL thickness was inversely correlated with duration of the disease and rise in average GCIPL thickness and superonasal sector thickness was inversely correlated with severity of the disease. Short-term topical CoQ10 resulted in improvement in AD related retinal ganglion cell (RGC) loss which may reflect the salvage of some RGCs in the reversible transitional phase. More bioavailability through intravitreal route of administration and longer duration of effect with sustained release forms may possibly help enhalting the RGC loss, especially incipience of neurodegenerative diseases.

Causes of ganglion cell-inner plexiform layer thinning in myopic eyes.

The present study aimed to determine the main cause of ganglion cell-inner plexiform layer (GCIPL) thinning in long myopic eyes. Optical coherence tomography was performed in 53 subjects with moderate or high myopia (53 eyes; myopia group) and 20 emmetropic subjects (20 eyes; control group). All subjects were over the age of 40 years. Compared groups did not differ in age, sex, and radius of corneal curvature. Spherical equivalent in the myopia group was - 8.2 ± 3.3 D (from - 4.0 to - 22.6 D). A specialized computer program was created to study the effect of the ocular magnification on the average GCIPL thickness. Based on the data of control subjects, a mathematical model was constructed, which showed a very little effect of ocular magnification on GCIPL thickness. It was confirmed by real measurements. After correction by the program, GCIPL thickness in myopes increased only slightly (from 73.9 ± 5.2 to 75.0 ± 5.2 μm, P < 0.000) remaining much lower than in controls (79.7 ± 6.3 μm, P < 0.000). Modeling myopic eye as an ellipsoid showed a significant increase in its surface area compared with emmetropia. Retinal stretching associated with an increase in the surface area of the eyeball explained most of the thinning of GCIPL in myopia. Ocular magnification is responsible for only a minor part of GCIPL thinning in myopia. Stretching of the retina in a long eye is the main cause of the GCIPL thinning. Myopic normative databases should be created to account for the GCIPL thinning in highly myopic eyes.

Ganglion Cell-Inner Plexiform Layer and Retinal Nerve Fiber Layer Changes in Glaucoma Suspects Enable Prediction of Glaucoma Development

To investigate whether progressive macular ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (RNFL) thinning predict development of visual field (VF) defects in glaucoma suspects. Retrospective cohort study. This study included 541 eyes of 357 glaucoma suspects with a mean follow-up of 5.7 years. Progressive GCIPL and RNFL thinning were determined using Guided Progression Analysis (GPA) in optical coherence tomography (OCT). The development of VF defect was defined as the presence of three consecutive abnormal VFs. The risk of developing VF defect was evaluated using Cox proportional hazard models. A total of 74 eyes (13.7%) and 87 eyes (16.1%) showed progressive GCIPL and RNFL thinning by OCT GPA, respectively, and 40 eyes (7.4%) developed VF defects. Eyes with progressive GCIPL (hazard ratio [HR], 7.130; 95% confidence interval [CI], 3.137-16.205) and RNFL (HR, 7.525; 95% CI, 3.272-17.311) thinning showed a significantly higher risk of developing VF defects. The rate of change in the average GCIPL and RNFL thickness was significantly higher in the eyes that developed VF defects (-0.71 and-1.13μm/y, respectively) than the eyes that did not (-0.19 and-0.27 μm/y, respectively; all P < 0.05). Progressive GCIPL (43.1 vs. 63.1 months, respectively; P < 0.001) and RNFL (50.9 vs. 66.7months, respectively; P < 0.001) thinning were detected significantly earlier than the development of VF defects. Monitoring progressive change in GCIPL, as well as RNFL, effectively predicts the development of VF defects in glaucoma suspects.

Characteristics of retinal layer thickness in acute anterior uveitis: an optical coherence tomography study.

To determine the changes in peripapillary retinal nerve fiber layer (pRNFL), macular and ganglion cell-inner plexiform layer (GC-IPL) thicknesses in patients with acute anterior uveitis (AAU). Patients diagnosed with unilateral non-infectious AAU and normal control were enrolled retrospectively. Optical coherence tomography scans were performed during the initial active phase and inactive phase of AAU. Patients were followed for at least 3months after resolution of inflammatory activity. Thirty-seven AAU patients and 40 controls were included. The average RNFL and central macular thickness (CMT) showed significant differences between patients and control groups during active phase (p<0.001 and p=0.022, respectively). The average pRNFL thicknesses of affected eyes and fellow eyes during the active phase were 109.4±12.5μm and 96.5±8.0μm, respectively (p<0.001). During the inactive phase, the average thicknesses were 99.3±8.9μm and 97.0±7.5, respectively; they were not significantly different (p=0.236). The CMTs of affected and fellow eyes during the active phase were 261.6±24.7μm and 251.5±17.3μm, respectively; the difference was significant (p=0.047). The average GC-IPL thicknesses of affected and fellow eyes were not significantly different (p=0.061). The pRNFL and central macula thickened during the active phase of AAU and decreased to a similar degree with fellow eyes during the inactive phase. Additionally, pRNFL thickness showed a sensitive response to the degree of inflammation in AAU. This suggests that pRNFL thickness may be useful in assessing disease activity.

Longitudinal changes in the ganglion cell-inner plexiform layer thickness in high myopia: a prospective observational study

AimTo determine longitudinal changes of the ganglion cell-inner plexiform layer (GC-IPL) thickness in patients with high myopia.MethodsThe subjects were divided into two groups: a high myopia group (axial length ≥26.0...

Pediatric Normative Database of Retinal, Macular and Choroidal Values obtained with Spectral-Domain Optical Coherence Tomography

Purpose: To establish normative values in a Portuguese pediatric population for retinal nerve fiber layer (RNFL), macular, macular ganglion cell-inner plexiform layer (GCIPL) and subfoveal choroidal (SFC) thicknesses Methods: This cross-sectional study enrolled children, 4 to 17 years old, attending the Ophthalmology Department of Hospital de Braga. All subjects underwent comprehensive ophthalmologic examination and were scanned with Cirrus Spectral-Domain Optical Coherence Tomography (SD-OCT). Results: A total of 348 children (9.85±3.49 years) were included. Average RNFL thickness was 97.45±9.78µm and the distribution of RNFL thickness was in agreement with the ISNT rule. Average RNFL thickness showed a positive significant relationship with optic disc (OD) area (p=0.007). A significant positive relationship was also found for OD area (p=0.001 and p=0.04, respectively) and spherical equivalent (SE) (p=0.008 and p=0.004, respectively), in the inferior and nasal quadrants. Average macular thickness was 282.22±11.91µm. Central subfield was the thinnest region, followed by the external ring, while the internal ring was the thickest (p<0.001). Age, SE and gender were the strongest predictors of macular thickness. A negative association was found between the superior external macular thickness and age (p=0.009). A lower thickness in the outer macular region was associated with higher myopic refractive error (p<0.05). Boys had on average a thicker macula (p<0.05). Average GCIPL thickness was 84.97±4.78 µm and average SFC thickness was 374.76±42.51 µm. Conclusion: This study established a SD-OCT normative database for healthy Portuguese children aged 4 to 17 years old, which could improve diagnosis and management of pediatric ophthalmic disorders in children.

Comparison of pattern electroretinograms of glaucoma patients with parafoveal scotoma versus peripheral nasal step

Retinal ganglion cells are distributed disproportionately with retinal eccentricity. Pattern electroretinogram (PERG) stimuli resulted in reduced responses with more eccentric stimuli. Therefore, we investigated whether PERG amplitude is associated with the location of visual field (VF) defect in primary open-angle glaucoma. Data from Twenty-nine glaucoma patients with a parafoveal scotoma (PFS) within the central 10° of fixation, 23 glaucoma patients with a peripheral nasal step (PNS), and 27 normal control subjects were analyzed in this study. Electroretinograms (ERGs) were obtained using a commercial ERG stimulator (Neuro-ERG). The thickness of the ganglion cell-inner plexiform layer (GCIPL) was measured using spectral-domain optical coherence tomography. A lower N95 amplitude was observed in both PFS and PNS compared to the normal control (Both P < 0.001). The N95 amplitude of the PFS group was significantly lower than that of the PNS group (P = 0.034). Average GCIPL thickness correlated positively with N95 amplitude (r = 0.368, P = 0.002), but did not correlate significantly with global mean sensitivity (r = 0.228, P = 0.073) or mean deviation on 24-2 standard automated perimetry (r = 0.173, P = 0.176). In conclusion, parafoveal VF defects were associated with the lower PERG amplitude. Therefore, it is necessary to take into account the location of VF defects in evaluating PERGs of glaucoma patients.

Changes in Peripapillary Microvasculature and Retinal Thickness in the Fellow Eyes of Patients With Unilateral Retinal Vein Occlusion: An OCTA Study.

To evaluate changes in peripapillary microvascular parameters in the fellow eyes of patients with unilateral retinal vein occlusion (RVO) using optical coherence tomography angiography (OCTA) and to determine the relationships between peripapillary microvasculature and retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness. Eighty-three patients with unilateral RVO (50 patients with branch RVO and 33 with central RVO) and 83 normal controls were enrolled. OCTA (Cirrus HD-OCT 5000 with AngioPlex) 6 × 6-mm scans centered on the optic disc were acquired. Peripapillary vessel density (VD) and perfusion density (PD) were automatically calculated. The average RNFL and GC-IPL thicknesses in the fellow eyes of RVO patients were significantly thinner than in normal controls (93.5 vs. 96.6 μm, P = 0.013 and 81.3 vs. 84.1 μm, P = 0.003, respectively). In the fellow eyes of patients with unilateral RVO, the peripapillary VD of the inner ring, outer ring, and full area (17.47, 18.50, and 17.89, respectively) were significantly lower than those of controls (17.87, 18.87, and 18.27, respectively). The peripapillary PD of the inner ring, outer ring, and full area (0.456, 0.467, and 0.456, respectively) were also significantly lower than those of controls (0.468, 0.476, and 0.466, respectively). RNFL and GC-IPL thicknesses were correlated with both peripapillary VD and PD. OCTA revealed that peripapillary microvascular parameters in the fellow eyes of patients with unilateral RVO were decreased, and GC-IPL and RNFL thinning were also observed. The RNFL and GC-IPL thicknesses were positively correlated with both peripapillary VD and PD.