Ganglion Cell Complex Values Research Articles

Optical Coherence Tomography Advanced Parameters in Patients With Multiple Sclerosis: Ophthalmological and Neurological Assessments

PurposeTo evaluate ophthalmological, neurological, radiological, and laboratory data in patients with multiple sclerosis (MS) and to identify new ophthalmological factors that could be helpful as biomarkers of the disease, potentially leading to an earlier prediction of disease course and disability progression. DesignRetrospective, cross-sectional-study. MethodsBest-corrected visual acuity (BCVA), ophthalmological biomicroscopy of the anterior segment and fundus, structural optical coherence tomography (OCT) with retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC), and OCT Angiography (OCTA) with vascular density (VD) were performed. The following clinical and neuro-radiological features were assessed: MS phenotype, disease duration, clinical severity, type of treatment, and T2-weighted lesion load plus T1-weighted Gd+-enhancing lesion number on the last brain and spinal cord MRI. ResultsOne hundred and six patients (212 eyes) were analyzed. Sixty-six of them (62.2 %) had MS and 40 (37.8%) were matched healthy controls (HCs). patients with MS showed lower RNFL, GCC, and VD in the radial peripapillary capillary plexus than controls in both eyes (p<0.05). By Performing a logistic regression with a distinct MS outcome for both eyes, we were able to demonstrate that the value that was most predictive of MS was the average GCC thickness (p=0.009). Regression analysis demonstrated that patients with a higher T2-weighted lesions showed a lower RNFL thickness value and reduced GCC and VD values than those with a low lesion load (p<0.01 and p<0.05, respectively). Similarly, relapsing MS patients showed lower RNFL values (p<0.05). ConclusionsSeveral OCT- and OCTA-optic nerve parameters could be useful prognostic biomarkers for the MS disease course in clinical practice. However, it is necessary to do additional research with larger sample sizes in order to validate these findings.

Evaluation of the macular sensitivity and retinal ganglion cell layer in unilateral amblyopia.

To assess macular sensitivity and fixation pattern obtained by microperimetry and ganglion cell complex (GCC) obtained by optical coherence tomography (OCT) in cases with unilateral amblyopia and to compare with control. The study was conducted with 30 patients with amblyopia, aged 5-18 years, and 30 control eyes of healthy children in the same age group. Participants underwent full ophthalmological examination. Macular sensitivity, stabilization, and location of fixation values were measured using microperimetry. The GCC values were obtained by OCT. Measurements were compared between amblyopic eyes, fellow eyes, and controls. Any correlation between GCC, macular sensitivity, and fixation was investigated. P < 0.05 was considered statistically significant. The mean age was 10.13 ± 3.49 years in the amblyopia group and 11.53 ± 2.7 years in the control group. Three groups were formed: amblyopic eyes (Group 1, n = 30), fellow eyes (Group 2, n = 30), and control eyes (Group 3, n = 30). The macular sensitivity values were found highest in the control group (P = 0.007). Bivariate contour ellipse area 1, which is the numerical value of fixation stabilization, was measured to be the lowest in the control group (P < 0.0001). In the analysis among the three groups, no significant difference was observed in terms of the GCC (P = 0.229). In the correlation analyses, a significant correlation was detected between macular sensitivity and GCC values in amblyopic eyes. In amblyopic eyes, the macular sensitivity was significantly lower and the GCC thickness was found to be in a positive correlation with macular sensitivity.

Arterial hemodynamics and its correlation with retinal microarchitecture in pseudoexfoliation glaucoma.

The study aimed to investigate the correlation between arterial hemodynamics measured by color Doppler ultrasonography and retinal microarchitecture parameters determined by spectral-domain optical coherence tomography (SD-OCT) in pseudoexfoliation glaucoma. This prospective study included 82 participants. Peripapillary retinal nerve fiber layer, ganglion cell inner plexiform layer, and ganglion cell complex values were measured. Ophthalmic artery and central retinal artery flows were evaluated with color Doppler ultrasonography, and resistivity index values were calculated. The study included 47 controls and 35 pseudoexfoliation glaucoma cases. In pseudoexfoliation glaucoma group, mean peripapillary retinal nerve fiber layer and ganglion cell complex thickness were statistically significantly lower in all quadrants compared to controls (p<0.001). Resistivity index values of the ophthalmic and central retinal arteries were significantly higher in pseudoexfoliation glaucoma group than in the controls (p<0.001 and r=0.684). Resistivity index values of the ophthalmic and central retinal arteries with ganglion cell complex thickness correlated significantly. On the other hand, no significant relationship for retinal nerve fiber layer thickness was identified. Structural changes (ganglion cell complex and ganglion cell inner plexiform layer) in patients with pseudoexfoliation glaucoma and early glaucomatous loss showed a significant correlation with changes in ocular vascular hemodynamics. In cases where systemic vascular resistance is increased, ganglion cell complex and ganglion cell inner plexiform layer may not exactly reflect glaucoma state. In such cases, thickness changes in the retinal nerve fiber layer may give more realistic results regarding glaucoma. We have seen that pseudoexfoliation glaucoma-induced structural deterioration and increased resistance in ocular hemodynamics correlated with ganglion cell complex, but not retinal nerve fiber layer.

Tat veya Koku Kaybı Gelişen COVID-19 Hastalarında Makula, Retina Sinir Lifi ve Ganglion Hücre Kompleksi Kalınlıklarının Değerlendirilmesi: Kesitsel Çalışma

Objective: To evaluate whether the presence of anosmia or ageusia associates with the thicknesses of the macula, peripapillary retinal nerve fiber layer (pRNFL), and ganglion cell complex (GCC) in patients diagnosed with coronavirus disease-2019 (COVID-19) who had fully recovered. Material and Methods: This study was conducted on 123 eyes of 123 participants. Only the right eyes of all subjects were included in the study. Group 1 consisted of 35 eyes of 35 patients with anosmia or ageusia who had recovered from COVID-19 and Group 2 consisted of 31 eyes of 31 patients without anosmia or ageusia who had recovered from COVID-19. Group 3 consisted of 57 eyes of 57 healthy subjects who were age matched with the study groups. The macula, pRNFL, and GCC thicknesses measured by optical coherence tomography were recorded and compared between groups. One-Way ANOVA test and Independent sample t-test were used to compare examinations between all groups. Results: Inferior pRNFL and average and inferior GCC values in Group 1 were significantly higher than Group 3 (p=0.001, p=0.044, p=0.017, respectively). There was no difference in macula thickness between all groups. Conclusion: In this study, we found that the GCC and pRNFL thicknesses in patients with anosmia or ageusia who had recovered from COVID-19 were significantly higher than those of healthy individuals. Anosmia or ageusia symptoms may be associated with increased pRNFL and GCC thickness in COVID-19 patients.

Effects of Androgens on the Thickness of Retinal Layers in Transgender Men and in Women with Polycystic Ovarian Syndrome.

This study aimed to evaluate the relationship between androgens and the retinal thickness by comparing the macular thickness (MT), retinal nerve fiber layer (RNFL), and ganglion cell complex (GCC) thickness of female-to-male transgender men (TGM), women with polycystic ovary syndrome (PCOS), and cisgender women (CW). Thirty-four eyes of 34 TGM, 34 eyes of 34 women with PCOS, and 45 eyes of 45 CW were evaluated by optical coherence tomography. One-way analysis of variance and body mass index (BMI)-adjusted one-way analysis of covariance were conducted to test the differences between groups for statistical evaluation. The parafoveal MT in TGM was significantly higher than women with PCOS and CW (p<0.001 and p=0.022, respectively). After adjusting for BMI, the perifoveal MT in TGM was significantly higher than women with PCOS and CW (p=0.041 and p=0.021, respectively). The nasal RNFL thickness in TGM was significantly higher than women with PCOS and CW (p=0.021 and p=0.009, respectively). The means of average and inferior RNFL, fovea, and the mean of all GCC values were higher in the TGM group than women with PCOS and CW, but these results were not statistically significant. In this study, there was a significant difference between the TGM group and the CW group for the thickness of the nasal RNFL and parafoveal and perifoveal macular area. Androgens may have the potential to increase retinal thickness in TGM; however, there is a need for validation in larger study groups. Clinical Trial Registration Number: HNEAH-KAEK 2021/4.

Evaluation of ganglion cell complex and retinal nerve fiber layer in children with spina bifida using optical coherence tomography

PurposeSpina bifida (SB) is a congenital disorder caused by the incomplete fusion of the embryonic neural tube during spinal cord development. In this study, we used Spectral Domain Optic Coherence Tomography (SD-OCT) for retinal nerve fibre layer (RNFL) and ganglion cell complex (GCC) analyses and compared the results of healthy children and SB patients in a similar age group. MethodsOur study was planned prospectively and conducted between June 2017 and July 2019. One hundred eyes of 50 participants, consisting of 28 SB patients and 22 healthy children were included. In all cases, RNFL and GCC measurements were undertaken using SD-OCT. The circumpapillary RNFL analysis was conducted by examining the circular area of 3.45 mm in diameter around the centre of the optic disc. GCC parameters were determined with MM7 protocols by taking 15 vertical sections from a 7-mm macular square centred in the fovea. ResultsThe mean GCC thickness of the participants was 91.120 ± 5.224 µm in the control group and 91.696 ± 7.410 µm in the SB group. The difference between the two groups was not statistically significant (p > 0.05). The mean RNFL thickness was 102.499 ± 11.250 µm in the control group and 99.549 ± 15.235 µm in the SB group. The mean RNFL thickness of the patients in the SB group was lower than that of the control group, but the difference was not statistically significant (p > 0.05). ConclusionsIn this study, the lack of a statistically significant difference in the RNFL and GCC values between the SB and control groups can be attributed to successful clinical management.

Effects of menopause on the retinal nerve fiber layer and ganglion cell complex and on intraocular pressure.

To compare the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness and intraocular pressure in reproductive age and postmenopausal women. The study included 94 eyes of 47 reproductive age women (Group 1) and 94 eyes of 47 postmenopausal women (Group 2). In all women, RNFL and GCC thicknesses were measured by optical coherence tomography. Intraocular pressure levels were measured by Goldmann applanation tonometry. Generalized linear mixed models were conducted to test the differences between groups. Age- and body mass index (BMI)-adjusted partial correlation analysis was used to examine the associations between parameters. There was a statistically significant difference in age and BMI between the two groups (P<0.001, P<0.001, respectively). There was no difference in all RNFL and GCC values between the reproductive age and postmenopausal women. The duration of postmenopause versus average, superior hemisphere, and superior values of RNFL and superior and inferior values of GCC were positively correlated with statistical significance in age- and BMI-adjusted partial correlation coefficient tests (r = 0.254, P = 0.017; r = 0.303, P = 0.004; r = 0.317, P = 0.003; r = 0.301, P = 0.004; r = 0.313, P = 0.003; r = 0.271, P = 0.011, with 95% confidence, respectively). In this study, there was no significant difference in all RNFL and GCC values between the reproductive age and postmenopausal women after adjusting for age and BMI. However, we observed that a long postmenopausal period was associated with higher RNFL and GCC values.

Correlation of optical coherence tomography and Doppler ultrasonography findings in pseudoexfoliation syndrome.

We aimed to investigate the correlation between the color Doppler imaging (CDI) results and parameters determined by spectral domain optical coherence tomography (SD-OCT) in cases with pseudoexfoliation syndrome (XFS). 99 participants were included in this prospective study. Retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), optic nerve head (ONH) measurements were recorded. Perfusions of the ophthalmic artery (OA) and central retinal artery (CRA) were determined and resistivity indices (RI) were calculated. No statistically significant differences were determined between the groups regarding the RNFL and ONH parameters. Only the minimum GCC thickness value was determined to be reduced in XFS group (n = 49) when compared to the controls (n = 50) (p = 0.018). The OA-RI and CRA-RI values of XFS group were significantly higher than the control group (p < 0.001 and p = 0.001). In XFSs, negative correlations were present between OA-RI and the minimum, average, inferior and inferotemporal regions of GCC thickness (r = -0.448 p = 0.001, r = -0.275 p = 0.040, r = -0.295 p = 0.027, r = -0.304 p = 0.024, respectively), and also between CRA-RI and minimum GCC values (r = -0.317, p = 0.017). While a significant relationship was present between age and OA-RI and CRA-RI values in controls, no such correlation was present in XFSs. The vascular resistance increased with age in controls, whereas it was independent of age in XFS group. In XFSs, RIs correlated significantly with certain GCC values, but not with RNFL and ONH parameters. It would be beneficial to follow the XFS with CDI as it provides supportive parameters to GCC in order to recognize early changes in XFS.

Optical Coherence Tomography and Optical Coherence Tomography Angiography Findings in Multiple Sclerosis Patients

ABSTRACT In addition to ocular neurodegeneration in multiple sclerosis (MS), accompanying microvascular changes in the retina are thought to occur. In this study we sought to compare retinal neurodegenerative changes using optical coherence tomography (OCT) and microvascular changes using OCT angiography (OCTA) of MS patients and healthy controls. This cross-sectional study included 164 eyes of 83 MS patients and 114 eyes of 57 healthy control subjects. There were significant differences in retinal nerve fibre layer (RNFL), ganglion cell complex (GCC), and radial peripapillary capillary (RPC) vessel density (VD) between the MS group and the control group, but no significant differences in superficial capillary plexus (SCP) VD and deep capillary plexus (DCP) VD, foveal avascular zone (FAZ), non-flow area (NFA), and choriocapillary flow (CCF) values. Comparing the eyes with and without previous optic neuritis showed no significant differences in the OCT and OCTA measurements. A negative correlation was found between the expanded disability status scale score and disease duration and the RNFL and GCC values. A positive correlation was found between the RNFL and GCC values and the SCP VD and RPC VD. In MS patients, RPC VD values decreased in correlation with decreases in RNFL and GCC. This reduction increased as the disease duration and disability criteria increased. OCT and OCTA may be important biomarkers in MS.

Evaluation of the effect of unilateral late blindness on the retina, optic nerve and choroid parameters in the sighted eye

To investigate whether unilateral late blindness alters the peripapillary retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), central macular thickness (CMT) and choroidal thickness (CT). The 17 healthy eyes of 17 monocular patients with late blindness due to isolated eye trauma in one eye and the 19 eyes of 19 healthy individuals were evaluated in this retrospective study. Patients with at least 10years of monocular blindness, a refractive error between + 1.5 and -1.5 D in the sighted eye, a best-corrected visual acuity of at least 20/20 and an axial length (AL) < 25mm were included in the study. Following ophthalmologic examination, the RNFL, GCC, CMT and CT values were measured with spectral domain optic tomography (SD-OCT). Those with ocular, systemic or neurological disease that could influence the measured parameters were excluded from the study. A total of 17 (14 males, 3 females) monocular patients [mean age 41.00 ± 11.95 (24-64)] and 19 (16 males, 3 females) healthy individuals [mean age 39.79 ± 6.74 (30-56)], similar in age and gender (p = 0.949 and p = 0.881), were included in the study. The mean duration of being monocular was 22.76 ± 11.76 (10-49) years. No difference was present between the RNFL, GCC, CMT and CT measurements of the monocular patients and the healthy individuals (p = 0.692, p = 0.294, p = 0.113, p = 0.623, respectively). No significant correlation was found between the duration of monocularity and the retinal and optic nerve parameters. The results of our study indicate no difference in the optic nerve, retina and choroid OCT findings in the sighted eyes of subjects with long-term monocular blindness compared to subjects with bilateral normal eyes. Although functional and volumetric neuroimaging studies suggest the possibility of compensation in these patients, our findings indicate that this is not at the ocular level.

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.

Functional and Structural Changes of the Retinal Nerve Fiber Layer and Ganglion Cell Complex in Heavy Smokers.

PurposeTo assess the functional and structural changes in the retinal nerve fiber layer (RNFL) and the ganglion cell complex (GCC) in heavy smokers using pattern electroretinogram (PERG), photopic negative response(PhNR) and spectral domain optical coherence tomography (SD-OCT).Patients and MethodsSixty eyes of 30 heavy smokers (at least 15 cigarettes/day for 10 years) (study group) and 60 eyes of 30 age and gender-matched healthy non-smoker subjects (control group) were included. After full ophthalmologic examination (PERG), (PhNR) using RETI-port/scan 21 (Roland Consult, Brandenburg, Germany) and (SD-OCT using Topcon 3D OCT model 2000 FA version.8.30) were tested for all participants. Statistical analysis was performed to compare GCC, RNFL thicknesses, PERG and phNR values between groups.ResultsThe mean age was 36.67±4.13 years in the study group and 36.0±4.76 years in the control group. There were no statistical significant differences between the two groups regarding intraocular pressure (p=0.43), axial length (p=0.37), and central corneal thickness (p=0.86). There were significant differences of GCC thickness values between the study group (88.4±6.6 µm) and control group (94.83±5.25 µm) (p<0.001). The mean RNFL values of study and control groups were 97.87±5.88 and 106.43±6.59 µm, respectively (p<0.001). In the study group the superior and inferior quadrants of RNFL were significantly thinner, but there were no significant differences between the two groups in nasal and temporal quadrants. There were no significant differences of PERG-P50 amplitude (p=0.49) and latency (p=0.71); however, PERG-N95 amplitude and latency showed significant differences between the two groups (p<0.001).There were significant differences of phNR amplitude and latency between the two groups (p<0.001). Multiple regression analyses demonstrated that the PhNR, PERG amplitude and latency are the most important determinants for both RNFL and GCC thicknesses.ConclusionIn heavy smokers RNFL thickness was decreased, the PhNR, PERG-N95 amplitudes were diminished and the implicit times were prolonged compared to non-smokers. PhNR and PERG reflect both dysfunction and loss of ganglion cells and their axons.

Optical Coherence Tomography Findings in Obsessive Compulsive Disorder: A preliminary Receiver Operating Characteristic Analysis On Ganglion Cell Layer Volume for Neurodegeneration

Objective: Many theories have been proposed to explain the etiology of obsessive compulsive disorder (OCD), but neuroimaging studies suggest neurodegeneration as a possible cause. Neurodegenerative diseases may cause a reduction in the retinal nerve fiber layer (RNFL) and the ganglion cell complex (GCC), and these changes can be detected by optical coherence tomography (OCT). The aim of this study was to examine the potential relationship between OCT findings and the clinical features of patients with OCD versus the findings for a healthy control (HC) group. Methods: Patients with OCD (n=42) and HC subjects (n=50) completed sociodemographic, Beck Anxiety Inventory, and Beck Depression Inventory forms and underwent OCT. Patients undertook clinical interviews for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (SCID-I) and Yale-Brown Obsessive Compulsive Scale scores, whereas the HC group interviews used the SCID non-patient version. Results: The RNFL and GCC values were significantly lower in the OCD than in the HC group (p

Effect of Obstructive Sleep Apnea Syndrome on Retinal Nerve Fiber Layer and Ganglion Cell Complex

In this study, we aimed to identify the effect of oxygen desaturation due to comparing ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) between patients with obstructive sleep apnea syndrome (OSAS), simple snoring and healthy individuals.132 total patients with OSAS and simple snoring who were diagnosed with polysomnography between 2016 -2018 and 88 healthy individuals were included in the prospective-case control study. The patients were grouped according to the Apnea Hypopnea Index (AHI). Healthy volunteers and the patients with simple snoring (the AHI index value lower than 5) were grouped as respectively Group 1(G1) and Group 2 (G2). Groups 3 to 5 were separated according to the AHI index as mild OSAS (Group 3 (G3); AHI=5-15), moderate OSAS (Group 4(G4);AHI=16-30), and severe OSAS (Group 5(G5); AHI&gt;30). All study participants underwent an examination of both eyes including corrected visual acuity, intraocular pressure measurement, dilated-pupil fundus examination, with RNFL and GCC thickness which were measured with optical coherence tomography (OCT). Of the 132 patients included in the study, 29 had simple snoring, 22 mild, 22 moderate, and 57 severe OSAS. When bilateral mean, superior, inferior, temporal, and nasal RNFL thickness and mean, superior and inferior GCC values were compared among the study groups; no statistically significant difference was found (p&gt;0.005). No significant difference was evaluated between mean RNFL thickness, four quadrants RNFL thicknesses, mean GCC thickness, two quadrants GCC thickness with OCT in the study patients. Indeed, because the patients with diagnosed OSAS could more likely to develop glaucoma, it would be appropriate for these patients to have a regular optic examination.

An investigation of the ocular toxic effects of levetiracetam therapy in children with epilepsy.

To investigate the potential toxic effects of levetiracetam monotherapy on ocular tissues in cases of pediatric epilepsy using optical coherence tomography (OCT). Thirty epileptic children (group 1) receiving levetiracetam monotherapy at a dosage of 20-40mg/kg/day for at least 1year with a first diagnosis of epilepsy and 30 age- and gender-matched healthy children (group 2) were included in the study. In addition to a detailed eye examination, peripapillary retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) thickness, foveal thickness (FT), and central corneal thickness (CCT) were measured in all children by means of spectral domain OCT. The data obtained from the two groups were then subjected to statistical analysis. The mean age of both groups was 12 ± 3.64years [1-12]. The mean duration of levetiracetam in group 1 was 24.07 ± 12.82months. Mean RNFL values in groups 1 and 2 were 106.1 ± 10.42 and 104.98 ± 10.04μm, mean GCC values were 94.72 ± 6.26 and 94.4 ± 6μm, mean FT values were 240.73 ± 17.94 and 240.77 ± 15.97μm, and mean CCT values were 555.1 ± 44.88 and 540.97 ± 32.65μm, respectively. No significant difference was determined between the two groups in terms of any parameter. Best corrected visual acuity values of the subjects in both groups were 10/10, and no color vision or visual field deficit was determined. Levetiracetam monotherapy causes no significant function or morphological change in ocular tissues in pediatric epilepsies.

Effect of Active and Passive Smoking on Retinal Nerve Fibre Layer and Ganglion Cell Complex.

Aim. To evaluate the possible structural and functional changes in the retinal nerve fibre layer (RNFL) and the ganglion cell complex (GCC) of chronic smokers and compare them with those of passive healthy smokers using spectral domain optical coherence tomography (SD-OCT) and pattern electroretinogram (PERG). Materials and Methods. We include 80 active chronic smokers and 80 age- and sex-matched healthy passive smokers. After a full ophthalmological examination, SD-OCT and PERG were tested for all participants. Urinary levels of cotinine and creatinine with subsequent calculation of the cotinine creatinine ratio (CCR). Results. Inferior and superior quadrants of RNFL were thinner in group I, but nasal and temporal quadrants did not show significant difference between the groups. There were no significant differences of GCC values between the two groups. There was no significant difference of PERG-P50 amplitude and latency; however, PERG-N95 showed significant difference between the two groups. Multiple regression analyses demonstrated that the number of cigarettes/day, urinary cotinine, and PERG-N95 amplitude are the most important determinants for both superior and inferior RNFL thicknesses. Conclusion. RNFL thickness decreases in chronic, healthy, heavy cigarette smokers, and this thinning is related to the number of cigarettes/day, urinary cotinine, and PERG-N95 latency and amplitude.

Evaluation of a New Software Version of the RTVue Optical Coherence Tomograph for Image Segmentation and Detection of Glaucoma in High Myopia

To compare the current (6.3) and a novel software version (6.12) of the RTVue-100 optical coherence tomograph (RTVue-OCT) for ganglion cell complex (GCC) and retinal nerve fiber layer thickness (RNFLT) image segmentation and detection of glaucoma in high myopia. RNFLT and GCC scans were acquired with software version 6.3 of the RTVue-OCT on 51 highly myopic eyes (spherical refractive error ≤-6.0 D) of 51 patients, and were analyzed with both the software versions. Twenty-two eyes were nonglaucomatous, 13 were ocular hypertensive and 16 eyes had glaucoma. No difference was seen for any RNFLT, and average GCC parameter between the software versions (paired t test, P≥0.084). Global loss volume was significantly lower (more normal) with version 6.12 than with version 6.3 (Wilcoxon signed-rank test, P<0.001). The percentage agreement (κ) between the clinical (normal and ocular hypertensive vs. glaucoma) and the software-provided classifications (normal and borderline vs. outside normal limits) were 0.3219 and 0.4442 for average RNFLT, and 0.2926 and 0.4977 for average GCC with versions 1 and 2, respectively (McNemar symmetry test, P≥0.289). No difference in average RNFLT and GCC classification (McNemar symmetry test, P≥0.727) and the number of eyes with at least 1 segmentation error (P≥0.109) was found between the software versions, respectively. Although GCC segmentation was improved with software version 6.12 compared with the current version in highly myopic eyes, this did not result in a significant change of the average RNFLT and GCC values, and did not significantly improve the software-provided classification for glaucoma.

Correlation between optical coherence tomography parameters and retinal sensitivity in idiopathic intracranial hypertension

Purpose The aim of this study was to report the findings of optical coherence tomography measurement of retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) in idiopathic intracranial hypertension (IIH) patients and to assess whether the RNFL and GCC correlate with retinal sensitivity determined by automated perimetry in the form of mean deviation (MD) and pattern standard deviation. Patients and methods A prospective observational study was carried out for 30 patients with confirmed IIH (age ≥18 years), BMI below 25, intracranial pressure (ICP) of at least 20 cmH 2 O, and normal neurological examination (except for papilloedema and horizontal diplopia). All patients received a complete neurological examination and most recent lumbar puncture opening pressure (latest ICP) was recorded. Complete ophthalmic evaluation including best-corrected visual acuity, perimetry, RNFL, and GCC thickness within 24 h of performing lumber puncture. Results In IIH patients the initial RNFL thickness was significantly higher, whereas GCC was significantly lower than controls ( P = 0.045 and 0.004, respectively). The value of ICP measured was found to be positively correlated with the stage of papilloedema ( r = 0.494, P = 0.000). The final recordings showed a significant decrease in GCC and RNFL values ( P = 0.000 and 0.002, respectively), and improvement in MD ( P = 0.003). Regression analysis showed that for every 10 μm increase in mean RNFL thickness, there was worsening in MD of 0.56 dB, whereas for every 10 μm decrease in mean GCC thickness, there was worsening in MD of 0.9 dB at the last follow-up. Conclusion GCC and RNFL thickness abnormalities assessed by optical coherence tomography in IIH patients were quantitatively correlated with visual field sensitivity losses and can be definitively useful to quantify optic nerve damage.

Diagnostic value of optical coherence tomography in patients with idiopathic intracranial hypertension

Background Idiopathic intracranial hypertension (IIH) is characterized by raised intracranial pressure in the absence of space-occupying lesions or other known etiology. It mainly affects young obese women, and may cause visual loss due to secondary optic atrophy. Objective The aim of the study was to investigate optical coherence tomography (OCT) and perimetry changes in patients with IIH at admission and 6 months later and highlight the relationship between OCT changes and severity of visual dysfunction measured by automated perimetry. Patients and methods This study included 30 female patients with IIH. Cerebrospinal fluid opening pressure was recorded. Complete ophthalmic evaluation included assessment of best-corrected visual acuity, perimetry, and retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness within 3-4 days of performing the lumbar puncture. Thirty age-matched healthy women underwent a similar ophthalmological evaluation. Results In IIH patients the initial RNFL thickness was significantly higher, whereas GCC was significantly lower than that of controls ( P = 0.045 and 0.004, respectively). The value of intracranial pressure measured was found to be positively correlated with the stage of papilledema ( r = 0.494, P = 0.000). The final recordings showed significant decrease in GCC and RNFL values ( P = 0.000 and 0.002, respectively) and improvement in mean deviation ( P = 0.003). Conclusion GCC and RNFL thickness abnormalities in IIH patients were quantitatively correlated with visual field sensitivity losses. OCT is an effective tool for quantifying parameters of optic nerve damage.