Ganglion Cell Complex Changes Research Articles

Delayed Surgical Reversal of Optic Nerve Compression Leads to Exponential Degeneration of Optic Nerve Fibers and Selective Sparing of the Small Fibers.

To evaluate the effectiveness of surgical reversal of experimental optic nerve compression in treating persistent compressive optic neuropathy and to explore the relationship between surgical outcomes and the timing of the procedure. Surgical reversal procedures (decompression surgery) were conducted at five time intervals: 1, 3, and 7 days and 2 and 3 weeks following optic nerve compression in a rabbit model. The groups were labeled as DC-1d, DC-3d, DC-7d, DC-2w, and DC-3w, respectively. The study investigated changes in ganglion cell complex (GCC) thickness using spectral-domain optical coherence tomography and the percentage of surviving retinal ganglion cells (RGCs) through immunofluorescence staining and optic nerve axons stained with p-phenylenediamine at 4 weeks after decompression. Additionally, the area distribution of surviving axons was analyzed. The decline in GCC thickness was halted following decompression. The remaining thickness of the GCC in group DC-1d was found to be statistically significantly higher at 2, 3, and 4 weeks postonset compared to the no-decompression group. Similarly, GCC thickness in group DC-3d was significantly higher at 3 and 4 weeks postonset. The percentage of surviving RGCs and axons at 4 weeks postonset exhibited an exponential correlation with the onset time of decompression, with R2 values of 0.72 and 0.78, respectively. The surviving axon area declined following delayed decompression. Persistent substantial compression on the optic nerve leads to exponential degeneration of the optic nerve, initially affecting larger optic nerve fibers. Early intervention aimed at relieving the compression on the optic nerve may offer potential benefits in mitigating the degenerative effects and conserving visual function.

Optic Nerve Head, Retinal Nerve Fiber Layer and Ganglion Cell Complex Changes after Successful Subscleral Trabeculectomy

Optic Nerve Head, Retinal Nerve Fiber Layer and Ganglion Cell Complex Changes after Successful Subscleral Trabeculectomy

Ganglion cell complex changes in wet AMD patients treated with anti-VEGF intravitreal injections according to a treat-and-extend protocol

ObjectifAnalyser la variation de l’épaisseur du complexe des cellules ganglionnaires (GCC) dans la dégénérescence maculaire liée à l’âge (DMLA) humide chez des patients qui reçoivent des injections intravitréennes. NatureÉtude de cohorte rétrospective portant sur 46 yeux dans une seule clinique d'ophtalmologie de soins tertiaires. ParticipantsLe groupe « injection » était formé de patients qui présentaient une DMLA humide et qui ont reçu des injections intravitréennes pendant au moins 3 ans dans le cadre d'un régime « traitement-et-extension » : 22 patients ont reçu le ranibizumab et 1 patient, l'aflibercept. Le groupe témoin était formé de patients atteints de DMLA sèche sous seule observation, qui n'ont reçu aucun traitement pendant la même période. L’épaisseur du GCC et l'acuité visuelle ont été notées au départ de même que lors des visites de suivi à 1, à 2 et à 3 ans. RésultatsDans le groupe injection, on a enregistré une tendance non significative vers une diminution de l’épaisseur du GCC au cours des 3 années de suivi (–4,09 ± 8,47 µm; p = 0,09). Toujours dans le groupe injection, l'analyse de corrélation entre le nombre d'injections intravitréennes et l’épaisseur du GCC a mis au jour une tendance non significative vers l'apparition d'un lien direct : un plus grand nombre d'injections était en corrélation avec un GCC relativement plus épais après 3 ans. On n'a pas noté de différence significative au chapitre de l’épaisseur du GCC entre la visite initiale et le suivi à 3 ans dans le groupe témoin. ConclusionsD'après les résultats de notre étude, il ne se produit pas d'amincissement significatif du GCC chez les patients atteints de DMLA humide après un régime « traitement-et-extension » de 3 ans.

A Comparative Study of Ganglion Cell Complex Thickness Changes in Diabetic Macular Edema and Central Retinal Vein Occlusion Macular Edema: An Optical Coherence Tomography Study.

Aim This studyaims to compare the ganglion cell complex changes in diabetic macular edema (DME) and central retinal vein occlusion (CRVO) macular edema using optical coherence tomography (OCT). Methods This was a hospital-based cross-sectional study conducted for six months. All patients having DME and CRVO macular edema presenting to the Ophthalmology Department at Acharya Vinobha Bhave Rural Hospital were included in the study. A detailed and comprehensive ophthalmic examination was performed, and OCT was done for each patient. Results The incidence of both DME and CRVO macular edema were both found to be maximum in the age group of 61-69 years. DME is more common in males (62.86%) than females (37.14%); the same was observed in CRVO group: 54.29% were males and 45.71% were females. Macular edema showed a mean value of 370.11 in DME and 428.71 in CRVO. Thus, the CRVO group showed more macular edema than the DME group. The ganglion cell complex thickness showed a mean value of 58.47 in DME and 66.77 in the CRVO group, implying that the thickness reduced significantly in the DME group. Conclusion OCT provides quantitative measurement of the ganglion cell complex thickness, which helps monitor the course of macular edema secondary to CRVO and diabetes Mellitus and thereby provides an assessment of the prognosis of the disease as these two diseases in particular are major causes of blindness worldwide, and timely care and management can help in altering its course.

Ganglion cell complex analysis in thalassemia major patients measured by optical coherence tomography

To analyze the changes in ganglion cell complex (GCC), peripapillary retinal nerve fiber layer (RNFL) thickness and central macular thickness (CMT) on spectral domain optical coherence tomography (OCT) in patients with thalassemia major. Forty one eyes of 41 patients with thalassemia major and 41 eyes of 41 healthy subjects were included in this prospective and comparative study. Peripapillary RNFL thickness, CMT and macular GCC thickness were evaluated with OCT (Cirrus HD-OCT 5000Carl Zeiss Meditec, Inc, Dublin, CA, USA) in all patients and healthy controls. Additionally, disease duration, serum ferritin level, hemoglobin concentration, the dosage and duration of chelation therapy, count of transfusion, patient’s weight were analyzed in thalassemia major group. RNFL thickness values were lower in the thalassemia patients but the difference was not statistically significant (except superior quadrant) and there was no significant differences in the mean CMT measurements. GCC thickness was thinner in all areas ( average, superior, inferior, superior-temporal, inferior-temporal, superior-nasal, inferior-nasal) but only the thinning in the inferior-temporal was statistically significant. GCC and RNFL thickness changes occur earlier than CMT changes in β-thalassemia major patients. GCC thickness measurements can be used for follow-up in combination with other diagnostic methods.

Macular ganglion cell complex changes in eyes treated with aflibercept for neovascular age-related macular degeneration

BackgroundTo evaluate the effect of intravitreal aflibercept injection on macular ganglion cell complex (GCC) in patients with neovascular age-related macular degeneration (nAMD). MethodsIn total, 36 eyes of 36 treatment-naïve patients with nAMD (18 female and 18 male) and 36 eyes of 36 healthy subjects (20 female and 16 male) as controls were included in this retrospective study. Spectral-domain optical coherence tomography images were evaluated after each injection for 3 months and at 12 months. Mean GCC thickness of the center, inner ring, and outer ring of the ETDRS grid was automatically quantified. ResultsMean foveal thickness was statistically significantly decreased at 3 months and at 12 months compared with baseline in the patient group. Ganglion cell layer thickness in the center was statistically significantly decreased in eyes with nAMD at baseline. There was a statistically significant decrease for mean retinal nerve fiber layer, ganglion cell layer, and inner plexiform layer thickness at 12 months compared with baseline. ConclusionsMacular GCC thickness was decreased after intravitreal aflibercept injection in patients with nAMD, in particular at 12 months.

Changes in the Ganglion Cell Complex after Inner Limiting Membrane Peeling for Epiretinal Membrane in Glaucoma Patients.

Epiretinal membrane (ERM) is a disease that affects the vitreoretinal interface and causes metamorphopsia, anorthopia, and decreased visual acuity. In this study, ERM patients who underwent internal limiting membrane (ILM) peeling were classified as those with glaucoma (Group G) and a control group (Group C). Changes in ganglion cell complex (GCC) thickness were compared between these groups to investigate whether such changes had an effect on progression of glaucoma from structural change. This was a retrospective, observational study that included 27 eyes of 27 patients. Group C included 22 eyes, and Group G included 5 eyes. Patients underwent ILM peeling, and cataract surgery was combined with vitrectomy for 16 phakic eyes; 2 phakic eyes and 9 aphakic eyes were treated only with vitrectomy. GCC thickness was measured preoperatively and at 2 weeks and 1, 3, and 6 months postoperatively, and these values and the rates of thinning were compared between the two groups. The mean age of patients was 66.7±12.8 years (range 30-84 years). There was no significant difference between groups in the thickness of the GCC or its rate of thinning after ILM peeling. The present results suggest that this procedure does not cause structural exacerbation of glaucoma in glaucoma patients. Although further studies of the functional effects of ILM peeling are required, the present results suggest that there is no significant difference between the two groups.

Changes in Ganglion Cell Complex and Peripapillary Retinal Nerve Fiber Layer after Femtosecond Laser-Assisted Cataract Surgery Compared to Manual Phacoemulsification in Patients Receiving a Trifocal Intraocular Lens.

Introduction During femtosecond laser-assisted cataract surgery (FLACS), there is a significant increase in intraocular pressure, which might lead to ganglion cell damage. We aimed to determine whether there were differences in the changes produced in the ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (pRNFL) thickness, as evaluated with optical coherence tomography (OCT), between phacoemulsification and FLACS, after implantation of a trifocal intraocular lens (IOL). Methods Patients with no coexistent pathologies undergoing cataract surgery with implantation of a PanOptix IOL were explored with the Cirrus-OCT before and three months after surgery. GCC values were obtained from the built-in software. The differences between pre- and postoperative GCC and pRNFL thicknesses after phacoemulsification were compared to differences after FLACS. Results A total of 171 eyes were included, 74 undergoing FLACS and 97 phacoemulsification. For both groups, there was a statistically significant increase in GCC values after cataract surgery, except for the inferior and inferonasal sectors. There were no statistically significant differences between FLACS and phacoemulsification. Mean change in average GCC and minimum GCC were 1.08 ± 1.40 µm (range −1 to +6 µm) and 1.69 ± 2.54 µm (range −3 to +11 µm) after FLACS and 0.99 ± 1.67 µm (range −5 to +6 µm) and 2.02 ± 3.54 µm (−6 to +18 µm) after phacoemulsification. These values are similar to those previously reported after phacoemulsification with monofocal IOL implantation. No significant changes after surgery were detected for the pRNFL, with no differences between groups. Discussion. There were no differences in the changes produced by FLACS and phacoemulsification in either GCC or pRNFL values. Although mean change was small, the range of variation was wide. Therefore, it is necessary to establish a new baseline for GCC and pRNFL thicknesses after cataract surgery in order to monitor any subsequent changes.

Changes in the ganglion cell complex thickness after anti-VEGF treatment for diabetic macular edema.

To assess tomographic ganglion cell complex changes in patients with diabetic macular edema treated with intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF). We analyzed data from 35 eyes of 35 previously untreated patients in whom diabetic macular edema improved after three loading doses of anti-VEGF injection and who did not receive repeated injections. We recorded spectral domain-optical coherence tomography assessments of ganglion cell complex and central macular thickness at baseline and monthly for three months, and on the sixth and ninth month after treatment. We compared the results with those of the unaffected eyes in the same patients and with those in a control group of patients with diabetic macular edema who were untreated. The mean age of the patients in the treatment group was 60 ± 4.38 years. The foveal thicknesses measured using optical coherence tomography decreased significantly from baseline to the third month post-injection (p<0.05). The mean ganglion cell complex thickness was 115.08 ± 16.72 µm before the first injection and 101.05 ± 12.67 µm after the third injection (p<0.05). The mean ganglion cell complex was 110.04 ± 15.07 µm on the sixth month (p>0.05) and 113.12 ± 11.15 µm on the ninth month (p>0.05). We found a significant difference between the patients and the control group in terms of mean ganglion cell complex thickness on the second- and third-months post-injection (p<0.05). Our study showed that the ganglion cell complex thickness in patients with diabetic macular edema decreased after the anti-VEGF injections. We cannot ascertain whether the ganglion cell complex thickness decreases were due to effects of the anti-VEGF agents or to the natural disease course.

Retinal Ganglion Cell Complex Changes after Intravitreal Bevacizumab for Diabetic Macular Edema.

To measure the changes in ganglion cell complex as measured on optical coherence tomography (OCT) after intravitreal injection of bevacizumab (Avastin). Quasi-experimental study. Department of Ophthalmology, Lahore General Hospital, Lahore, from March 2017 to April 2018. Patients presenting to the Eye OPD were assessed for diabetic macula edema requiring intravitreal injection of anti-VEGF. Patients having any coexisting ocular pathology hindering the OCT measurement, i.e. corneal opacity, vitreous hemorrhage, retinal detachment or having macular edema secondary to other cases were excluded. Retinal ganglion cell complex thickness and signal strength was measured in superior, inferior, supero-nasal, superotemporal, infero-nasal and infero-temporal quadrants on OCT. Pre-injection, visual acuity was measured, OCT performed and the findings were recorded on a designed proforma. Post-injection, the patients were called for follow-up after one month at which time same measurements were evaluated. All the injections were administered by a single surgeon. The thickness of ganglion cell complex increased significantly (p <0.001) one month after Intravitreal injection of bevacizumab. Intravitreal administration of bevacizumab in diabetic macular edema affects the measurement of retinal ganglion cell complex thickness on OCT.

OPTICAL COHERENCE TOMOGRAPHY;

ABSTRACT:&#x0D; PURPOSE: &#x0D; To study the changes in Ganglion Cell Complex as measured on OCT after&#x0D; phacoemulsification with intra ocular lens implantation.&#x0D; STUDY DESIGN:&#x0D; Quasi experimental study&#x0D; PLACE AND DURATION OF STUDY:&#x0D; Department of Ophthalmology, Lahore General Hospital, Lahore from 1-3-2017 to 30-4-2018&#x0D; MATERIALS AND METHODS:&#x0D; Ethical approval of the study was obtained from ‘’Ethical Review Committee’’ of Lahore General&#x0D; Hospital, Lahore. Patients presenting to the Eye OPD Lahore General Hospital were assessed for&#x0D; inclusion and exclusion criteria. All patients (n=64) diagnosed with cataract requiring surgery&#x0D; were included in study. Patients having any coexisting ocular pathology hindering the OCT&#x0D; measurement i.e. Corneal opacity, Vitreous hemorrhage, Retinal detachment were excluded&#x0D; from study. Retinal Ganglion Cell Complex thickness was measured in Superior, Inferior,&#x0D; Supero-Nasal, Supero-Temporal, Infero-Nasal and Infero-Temporal quadrants. Besides that&#x0D; Signal Strength on OCT was also documented. Pre-Operatively, Visual acuity was measured and&#x0D; OCT performed and the findings were recorded on a designed proforma. Post-Operatively, the&#x0D; patients were called for follow-up after one month at which time Visual acuity was again&#x0D; measured and OCT performed and findings recorded in the proforma. All the surgeries were&#x0D; performed by single surgeon.&#x0D; RESULTS: &#x0D; The thickness of Ganglion Cell Complex increased significantly (p&lt;0.001) one month after&#x0D; cataract surgery.&#x0D; CONCLUSION:&#x0D; Cataract surgery does affect the measurement of Retinal Ganglion Cell Complex thickness on&#x0D; OCT.

Peculiarities of the retinal ganglion cell complex changes in patients with diabetes mellitus depending on the scleral lamina cribrosa thickness

Peculiarities of the retinal ganglion cell complex changes in patients with diabetes mellitus depending on the scleral lamina cribrosa thickness

Inner retinal thickening in newly diagnosed choroidal neovascularization.

Automated segmentation of retinal layers by spectral-domain optical coherence tomography (SD-OCT) is usually erroneous in the presence of retinal diseases. The purpose of this study is to report the changes in ganglion cell complex (GCC) comprising retina nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) in neovascular age-related macular degeneration (AMD) patients by manually correcting the automated segmentation errors. Thirty eyes of 30 patients with new-onset choroidal neovascularization secondary to neovascular AMD and 30 eyes of 30 healthy subjects were included. The inner retinal thicknesses were measured using early treatment diabetic retinopathy circle in the central 1mm (fovea) and surrounding 3mm diameter (parafovea) after checking the accuracy of automated segmentation lines. Manual segmentation was done to ensure the accurate segmentation, when needed. Neovascular AMD patients had thicker mean RNFL, GCL, IPL, and GCC thicknesses within the fovea compared to healthy eyes (p = 0.04, p = 0.001, p = 0.032, and p = 0.005, respectively). In the parafoveal area, among the thickness-related measurements, the only significant difference was a thicker mean RNFL (p = 0.002). Diffuse thickening of inner retinal layers in neovascular AMD may overestimate actual GCC thickness within fovea. This pseudo-increase in GCC thickness and inner retinal layers in general likely does not reflect more cells or tissue, but rather diffuse edema which leads to a falsely increased reading of layer thickness. Such false readings may also make the assessment of other conditions that lead to reduced inner retinal layer thickness such as glaucoma, optic nerve disease, or retinovascular occlusions more difficult.

Клінічна оцінка змін комплексу гангліонарних клітин сітківки при діабетичній полінейропатії в залежності від тяжкості захворювання

Клінічна оцінка змін комплексу гангліонарних клітин сітківки при діабетичній полінейропатії в залежності від тяжкості захворювання

Ganglion cell complex changes with long-standing diabetic macular oedema among Egyptian diabetic patients: an optical coherence tomography study

Introduction Optical coherence tomography (OCT) is a valuable tool for imaging retinal thickness and structure as well as performing good evaluation for the ganglion cell complex (GCC) parameters, reflecting the status of retinal nerve fiber layer, the ganglion cell layer and the inner-plexiform layers. In this study, these parameters were evaluated in eyes with long-standing diabetic macular oedema, thus emphasising the importance of seriously treating macular oedema. Patients and methods Sixty eyes of 38 patients were included in the study. There were 38 eyes of 25 male patients and 22 eyes of 13 female patients. These 60 eyes were divided into two groups: group A (30 eyes) included eyes of patients with long-standing diabetic macular oedema (>1 year duration) and group B (30 eyes) included eyes of patients without apparent ocular pathology as a control. The age range was 23–73 years (mean 56.57±11.42) in group A and 30–74 years (mean 53.33±12.10) in group B. The duration of diabetes ranged from 1 to 25 years (mean 15.2±5.97) in group A. The patients were examined by an ocular response analyser (OCT-Optovue) that performs different GCC studies in addition to macular map analysis (EMM5). Best-corrected visual acuity in Snellen lines was also reported. Collected data were arranged and subjected to analysis using suitable statistical methods. Results In this study, a highly significant difference (P 0.05) with the other studied GCC parameters. Compared with normative data, FLV% was abnormal in 70% of eyes, borderline in 6.67% of eyes and normal in 23.33% of eyes in diabetic macular oedema group compared with the control group, which showed values of 0, 6.67 and 93.33% for abnormal, borderline and normal values respectively, with χ2-test showing a highly significant difference (χ2=30.718 P Conclusion Compared with normal group, patients with long-standing diabetic macular oedema showed higher mean values for all GCC parameters, which were strongly correlated with the central macular thickness. The FLV% values in particular was abnormal in ∼70% of eyes with diabetic macular oedema in comparison with normative data, and it correlated strongly with the duration of diabetes, so we recommend considering this parameter (FLV%) for seriously treating diabetic macular oedema before permanent GCC damage occurs.

EFFECT OF INTRAVITREAL RANIBIZUMAB ON GANGLION CELL COMPLEX AND PERIPAPILLARY RETINAL NERVE FIBER LAYER IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION USING SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY.

To analyze the changes in ganglion cell complex and peripapillary retinal nerve fiber layer thickness, in central macular thickness and choroidal thickness on spectral domain optical coherence tomography in patients with neovascular age-related macular degeneration treated with intravitreal ranibizumab injections. All consecutive patients with untreated neovascular age-related macular degeneration received loading phase of three monthly intravitreal ranibizumab, followed by retreatments on a pro re nata protocol for 12 months. changes in ganglion cell complex and retinal nerve fiber layer at the end of follow-up. Secondary outcome: changes in best-corrected visual acuity, central macular thickness, and choroidal thickness at the end of follow-up. Choroidal thickness was measured at 500 μm, 1000 μm, and 1,500 μm intervals nasally, temporally, superiorly, and inferiorly to the fovea, respectively, on horizontal and vertical line scans centered on the fovea. Twenty-four eyes were included. Ganglion cell complex and peripapillary retinal nerve fiber layer thickness did not show statistically significant changes through 12 months (55.6 ± 18.5 and 81.9 ± 9.9 μm at baseline, 52.7 ± 19.3 and 84.6 ± 15.5 μm at month 12, P > 0.05). Central macular thickness showed progressive decrease from baseline to month 12, with maximum reduction at month 3 (P < 0.001). Statistically significant reduction in choroidal thickness was registered in the nasal 500, 1000, and 1,500 μm from the fovea, corresponding to the papillomacular region (from 169.6 ± 45.3 to 153.9 ± 46.9, P < 0.001). Intravitreal ranibizumab injections did not affect retinal nerve fiber layer and ganglion cell complex thickness in 1-year follow-up. Choroidal thickness in papillomacular area and central macular thickness was significantly reduced at the end of treatment. Further studies, with larger sample, longer follow-up, and greater number of injections, are warranted.

Résultats anatomiques et fonctionnels de la chirurgie du trou maculaire avec pelage de membrane limitante interne après suivi de 10 ans

To evaluate the anatomical and functional results of macular hole surgery with internal limiting membrane (ILM) peeling after 10years follow-up. Monocentric retrospective study of patients who had undergone macular hole surgery between 2003and 2005in the Nancy University Medical Center and still followed in the department in 2014. All patients underwent pars plana vitrectomy and ILM peeling without staining. Clinical examination at ten years including determination of best-corrected visual acuity (BCVA), evaluation of quality of life and spectral domain optical coherence tomography was performed. Four men and six women with mean age of 64±8years were included. The mean diameter of the MH was 395±133μm. The mean best corrected visual acuity improved significantly from 0.90±0.22logMAR to 0.14±0.14logMAR after 10years with a satisfactory quality of life in 90% of patients. The integrity of the IS/OS layer was preserved in 9eyes. Inner retinal dimples located in the temporal quadrant related to ILM peeling initiation were observed in 8eyes. No significant RNFL or ganglion cell complex changes were found compared to the contralateral eye. Macular hole surgery with ILM peeling in this series resulted in a visual acuity gain of 8ETDRS lines and persistent improvement in quality of life after a 10-year follow-up.

Влияние версии программного обеспечения ОКТ на обнаружение изменений в комплексе ганглионарных клеток сетчатки при экстракции катаракты

Влияние версии программного обеспечения ОКТ на обнаружение изменений в комплексе ганглионарных клеток сетчатки при экстракции катаракты

Macular Ganglion Cell Complex and Retinal Nerve Fiber Layer Comparison in Different Stages of Age-Related Macular Degeneration

To employ optical coherence tomography (OCT) to analyze the morphologic changes in the inner retina in different categories of age-related macular degeneration (AMD). Observational cross-sectional study. Single-center study. Inclusion criteria were age over 50, diagnosis of Age-Related Eye Disease Study (AREDS) category 2 and 3, naïve neovascular AMD, and atrophic AMD. Healthy patients of similar age acted as a control group. Primary outcome measures were the changes in ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL). Secondary outcomes included modifications of rim area and cup-to-disc ratio. One hundred and thirty eyes of 130 patients were recruited: 26 eyes for AREDS category 2, 26 for AREDS category 3, 26 for neovascular AMD, 26 with atrophic AMD, and 26 controls. Mean peripapillary RNFL thickness was significantly lower in neovascular AMD, compared to controls (P= .004); peripapillary RNFL did not significantly vary among AREDS category 2 and 3 and atrophic AMD groups, compared to controls. Mean GCC thickness was higher in the control group, becoming progressively thinner up to neovascular and atrophic AMD groups (P < .0001). Rim area was significantly thinner in the neovascular AMD group compared with controls (P= .047); cup-to-disc ratio was higher in the neovascular AMD group compared with the control group (P= .047). This study demonstrates that eyes with neovascular AMD display reduced RNFL and GCC thickness. RNFL is partially spared in atrophic advanced AMD. The identification of alteration in RNFL and GCC thickness may reveal useful for future therapeutic implications.

Changes in ganglion cell complex thickness in patients treated with intravitreal anti‐vascular endothelial growth factor therapy

AbstractPurpose To evaluate the effect of repeated intravitreal injections of anti‐vascular endothelial growth factor(VEGF) on the thickness of the ganglion cell complex(GCC) in patients with retinal diseases.Methods This is a retrospective study of 91 patient with injections for age‐related macular degeneration(AMD), diabetic retinopathy(DMR), or retinal vein occlusion(RVO), who received more than three anti‐VEGF injections. For this study, Ganglion cell complex thickness was measured by SD‐OCT. The measurements of GCC thickness were made at the fovea and at 3 points nasal and 3 points temporal to the fovea, each separated by a distance of 500 microns. We also evaluated the correlation between changes in ganglion cell complex and other factors including intraocular pressure (IOP), injection times, and the type of disease.Results After multiple intravitreal anti‐VEGF treatments, ganglion cell complex thickness decreased from the initial GCC thickness. Changes of GCC thickness(final GCC thickness ‐ initial GCC thickness) were ‐7.47 ± 22.81, ‐4.93 ± 21.93, ‐3.60 ± 33.39, ‐1.19 ± 9.38, ‐9.10 ± 32.89, ‐0.93 ± 24.44 and ‐2.57 ± 24.78 at T 1500, T 1000, T 500, the fovea, N 500, N 1000 and N 1500, respectively. And mean GCC thickness was changed from 98.56 ± 17.04 to 94.30 ± 14.49 (p= 0.15). When classified by disease, the decrease in GCC thickness was statistically significant in RVO patients. The number of injections was found to have no correlation with changes in GCC thickness.Conclusion Multiple intravitreal injections of anti‐VEGF lead to a significant change in GCC thickness. But, the number of injections did not appear to adversely affect GCC thickness.