Ganglion Cell-inner Plexiform Layer Thickness Measurements Research Articles

Exploring the relationship between 24-2 visual field and widefield optical coherence tomography data across healthy, glaucoma suspect and glaucoma eyes.

To utilise ganglion cell-inner plexiform layer (GCIPL) measurements acquired using widefield optical coherence tomography (OCT) scans spanning 55° × 45° to explore the link between co-localised structural parameters and clinical visual field (VF) data. Widefield OCT scans acquired from 311 healthy, 268 glaucoma suspect and 269 glaucoma eyes were segmented to generate GCIPL thickness measurements. Estimated ganglion cell (GC) counts, calculated from GCIPL measurements, were plotted against 24-2 SITA Faster visual field (VF) thresholds, and regression models were computed with data categorised by diagnosis and VF status. Classification of locations as VF defective or non-defective using GCIPL parameters computed across eccentricity- and hemifield-dependent clusters was assessed by analysing areas under receiver operating characteristic curves (AUROCCs). Sensitivities and specificities were calculated per diagnostic category. Segmented linear regression models between GC counts and VF thresholds demonstrated higher variability in VF defective locations relative to non-defective locations (mean absolute error 6.10-9.93 dB and 1.43-1.91 dB, respectively). AUROCCs from cluster-wide GCIPL parameters were similar across methods centrally (p = 0.06-0.84) but significantly greater peripherally, especially when considering classification of more central locations (p < 0.0001). Across diagnoses, cluster-wide GCIPL parameters demonstrated variable sensitivities and specificities (0.36-0.93 and 0.65-0.98, respectively), with the highest specificities observed across healthy eyes (0.73-0.98). Quantitative prediction of VF thresholds from widefield OCT is affected by high variability at VF defective locations. Prediction of VF status based on cluster-wide GCIPL parameters from widefield OCT could become useful to aid clinical decision-making in appropriately targeting VF assessments.

Hybrid deep learning and optimal graph search method for optical coherence tomography layer segmentation in diseases affecting the optic nerve.

Accurate segmentation of retinal layers in optical coherence tomography (OCT) images is critical for assessing diseases that affect the optic nerve, but existing automated algorithms often fail when pathology causes irregular layer topology, such as extreme thinning of the ganglion cell-inner plexiform layer (GCIPL). Deep LOGISMOS, a hybrid approach that combines the strengths of deep learning and 3D graph search to overcome their limitations, was developed to improve the accuracy, robustness and generalizability of retinal layer segmentation. The method was trained on 124 OCT volumes from both eyes of 31 non-arteritic anterior ischemic optic neuropathy (NAION) patients and tested on three cross-sectional datasets with available reference tracings: Test-NAION (40 volumes from both eyes of 20 NAION subjects), Test-G (29 volumes from 29 glaucoma subjects/eyes), and Test-JHU (35 volumes from 21 multiple sclerosis and 14 control subjects/eyes) and one longitudinal dataset without reference tracings: Test-G-L (155 volumes from 15 glaucoma patients/eyes). In the three test datasets with reference tracings (Test-NAION, Test-G, and Test-JHU), Deep LOGISMOS achieved very high Dice similarity coefficients (%) on GCIPL: 89.97±3.59, 90.63±2.56, and 94.06±1.76, respectively. In the same context, Deep LOGISMOS outperformed the Iowa reference algorithms by improving the Dice score by 17.5, 5.4, and 7.5, and also surpassed the deep learning framework nnU-Net with improvements of 4.4, 3.7, and 1.0. For the 15 severe glaucoma eyes with marked GCIPL thinning (Test-G-L), it demonstrated reliable regional GCIPL thickness measurement over five years. The proposed Deep LOGISMOS approach has potential to enhance precise quantification of retinal structures, aiding diagnosis and treatment management of optic nerve diseases.

Evaluation of optic coherence tomography findings in patients with inflammatory bowel disease

BackgroundOcular complications are known to appear in inflammatory bowel disease (IBD). Among these, posterior segment complications can lead to substantial morbidity. The aim of the study is to evaluate the retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL), and macula thickness measurement in patients with IBD. MethodsA total of 118 patients with IBD (42 Crohn's disease (CD), 76 ulcerative colitis (UC)) and 52 healthy subjects were included in the study. RNFL, GCIPL, and macula thickness were measured using spectral-domain optical coherence tomography (SD-OCT). ResultsThe central macular thickness was increased, mean and all superior quadrants of GCIPL thickness measurements were significantly decreased, but RNFL thickness wasn't changed in CD compared to healthy subjects. Although the central macular thickness increased, no change was observed in mean RNFL and GCIPL in UC compared to healthy subjects. Mean RNFL, GCIPL, and macular thickness did not differ during the remission and active phases of the disease in IBD. There was no difference in RNFL, GCIPL, and macular thicknesses in CD patients in terms of the location and behavior of the disease. A significant thickness increase was found in extensive type UC for inferior RNFL value compared to the left side and proctitis. ConclusionsIBD may cause an increase in macular thickness. This finding may be related to the inflammation or ischemia of the retina. The use of SD-OCT in ophthalmologic examination in patients with IBD may enable early detection of retinal changes and alert the clinician to complications of IBD.

Patterns of Optical Coherence Tomography Imaging in Preperimetric Open Angle Glaucoma: A Comparative Study With Young-Age-Onset and Old-Age-Onset Eyes.

Optic coherence tomography imaging in preperimetric open angle glaucoma (OAG) differed between young-age-onset and old-age-onset eyes. Inferior and superior quadrants were thinner in young and old-age-onset eyes, respectively. Understanding the specific patterns of early glaucomatous damage based on age-at-onset may improve glaucoma diagnosis and monitoring. To investigate the patterns of retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thinning in preperimetric OAG by optical coherence tomography based on age at onset ("young-age onset (<40y)" vs. "old-age onset (≥40y)". The RNFL and GCIPL deviation images were acquired by Cirrus HD-optical coherence tomography, and overlaid, thus converted to a "deviation frequency map", respectively. The topographic thinning patterns and parameters of RNFL and GCIPL thickness measurements were compared. A total of 194 eyes of 194 patients with preperimetric OAG and 97 eyes of 97 age-matched normal subjects were analyzed. Young-age-onset eyes of preperimetric OAG mainly had RNFL defects inferotemporally (264-296 degrees) with GCIPL defects in the inferior region (213-357 degrees). Old-age-onset preperimetric OAG eyes had RNFL defects inferotemporally (266-294°) and superotemporally (33-67 degrees), with GCIPL defects in the inferior and superior regions (206-360 degrees, 0-22 degrees). The inferior quadrant of RNFL and GCIPL thicknesses were significantly thinner in young-age-onset eyes compared with old-age-onset eyes ( P =0.012, 0.016), while the superior quadrant of those were significantly thinner in the old-age-onset eyes ( P =0.003, 0.005). Young-age-onset and old-age-onset eyes of preperimetric OAG present different specific patterns of RNFL and GCIPL thinning.

Microperimetry, Humphrey field analyzer, and optical coherence tomography in detecting glaucoma: a comparative performance study

To evaluate and compare the diagnostic performance of microperimetry (MP), visual field (VF) 10-2 and 24-2 tests, and spectral-domain optical coherence tomography (SD-OCT) in primary open-angle glaucoma (POAG). The study consisted of 35 POAG and 42 control eyes were enrolled in this prospective study. Eligible participants were ≥ 50years old. VF assessments were carried out using the Humphrey field analyzer (HFA) and Macular Integrity Assessment. Optic nerve head (ONH), retinal nerve fiber layer thickness (RNFLT), and ganglion cell inner-plexiform-layer thickness (GCIPLT) were measured by SD-OCT. Areas under the receiver operating characteristic curves (AUC) and sensitivities at 95% specificity were calculated for each parameter. HFA 24-2 had the largest AUC value among the functional parameters to differentiate POAG from control eyes [AUC: 0.950 (0.906-0.994), sensitivity at 95%:60]. HFA 24-2 showed a significantly better performance than the 10-2 test (p = 0.036). Among the SD-OCT structural parameters, minimum GCIPLT had the largest AUC value to differentiate POAG from control eyes [AUC: 0.952 (0.905-0.999), sensitivity at 95%:80]. In comparison of the functional and structural parameters, HFA 24-2 showed a significantly better performance than the 10-2 test (p = 0.036). In macular parameters, minimum GCPLT performed significantly better than HFA 10-2 (p = 0.015) in detecting POAG. There was no statistically significant difference between the comparative diagnostic performance of the RNFL, ONH, HFA, and MP (p > 0.05 for all comparisons). The structural and functional test results revealed that GCIPLT measurements had the highest diagnostic performance in detecting POAG. HFA 24-2 test performed better than 10-2 test in distinguishing glaucoma from healthy eyes. MP showed a similar performance with HFA 10-2 and may be considered a complementary diagnostic tool.

Optical Microangiography and Progressive Ganglion Cell–Inner Plexiform Layer Loss in Primary Open-Angle Glaucoma

To evaluate the association between optical microangiography (OMAG) measurements and progressive ganglion cell-inner plexiform layer (GCIPL) loss in patients with primary open-angle glaucoma (POAG). Prospective case series. Sixty-three eyes of 38 patients with POAG were studied for ≥2 years and with ≥ 3 optical coherence tomography examinations. Only those hemifields with mild to moderate functional damage at baseline (106 hemifields) were included in the analysis. OMAG imaging was performed at the baseline visit. The effects of clinical parameters (age, gender, central corneal thickness, presence of disc hemorrhage, and mean and fluctuation of intraocular pressure), baseline mean deviation, retinal nerve fiber layer, and GCIPL thickness and baseline OMAG measurements (peripapillary and macular perfusion density [PD] and vessel density [VD]) on the rate of change of GCIPL thickness were evaluated using linear mixed models. Average (± standard deviation) mean deviation, quadrant retinal nerve fiber layer, and sector GCIPL thickness of the analyzed hemifields respectively at baseline were -5.2 ± 2.8 dB, 94.5 ± 20.0 µm, and 72.4 ± 8.7 µm, respectively. Peripapillary PD and VD in the quadrant were 43.1% ± 7.0% and 17.0 ± 2.6 mm/mm2, respectively. Macular PD and VD in the quadrant were 37.2% ± 6.9% and 15.1 ± 2.6 mm/mm2, respectively. Rate of sector GCIPL change was -0.97 ± 0.15 µm per year. Multivariate mixed models showed that lower peripapillary PD (coefficient 0.04, P=.01) and VD (coefficient 0.09, P=.05) were significantly associated with a faster rate of GCIPL loss. Lower baseline peripapillary OMAG measurements were significantly associated with a faster rate of GCIPL loss in patients with mild to moderate POAG.

Reproducibility of Retinal Nerve Fiber Layer and Macular Ganglion Cell Layer Thickness Measurements by Optical Coherence Tomography in Myopic Eyes.

In myopic eyes, reproducibility of circumpapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer thickness measurement by optical coherence tomography (OCT) showed excellent reproducibility except for the temporal quadrant RNFL thickness measurement. The aim of this study was to evaluate the long-term reproducibility of circumpapillary RNFL and macular ganglion cell-inner plexiform layer (GCIPL) thickness measurements using OCT in myopic eyes. Sixty-five eyes with moderate-to-high myopia (spherical equivalent <-3.0 D, myopia group) and 53 eyes with low-to-no myopia (spherical equivalent ≥-3.0 D, control group) without ocular disorders, such as glaucoma or retinal diseases, were included. Three serial OCT scans recorded at 1-year intervals were analyzed. Reproducibility was evaluated using within-subject SD (Sw), coefficient of variation (CVw), and intraclass correlation coefficient (ICC). Mean±SD refractive error was -0.30±0.80 and -6.26±2.45 D for control and myopia groups, respectively. The myopia group had thinner superior, inferior, and nasal quadrant RNFL, thicker temporal quadrant RNFL, and thinner GCIPL than the control group (P<0.05), except for the minimum and superotemporal GCIPL thicknesses (P>0.05). The myopia group had lower reproducibility in temporal quadrant RNFL thickness (Sw, 2.57 μm; CVw 3.27%; ICC, 0.979) than the control group (Sw, 1.80 μm; CVw 2.59%; ICC, 0.989), whereas in other sectors of RNFL and all GCIPL parameters, comparable reproducibility was observed between the 2 groups. Long-term reproducibility of RNFL and GCIPL thickness measurements in moderate-to-high myopia was comparable to that of low-to-no myopia, except RNFL thickness in the temporal quadrant. These findings should be considered when detecting RNFL and GCIPL changes.

Analysis of the Changes in Retinal Thickness in Eyes Undergoing Vitrectomy with Silicone Oil Tamponade

Purpose: To investigate changes in the retinal layer thickness in rhegmatogenous retinal detachment (RRD) and intraocular foreign body (IOFB) patients undergoing successful pars plana vitrectomy (PPV) with silicone oil tamponade. Methods: This retrospective study included 28 eyes of 28 patients (RRD: 24 patients; IOFB: 4 patients) that were successfully repaired with PPV with silicone oil tamponade. The thickness measurements of the total retina, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GC-IPL) were performed with swept-source optical coherence tomography in nine Early Treatment Diabetic Retinopathy Study subfields, using the wide three-dimensional mode before and after silicone oil tamponade removal. The measurements were compared and differences were analyzed with respect to normal fellow eyes. Results: The RNFL and GC-IPL thickness measurements decreased remarkably as the silicone oil tamponade period progressed, compared with the thickness of the total retinal layer. The average thicknesses of the total retina, RNFL, and GC-IPL were significantly greater in eyes in which the silicone oil had been removed than in those in which the silicone oil remained. Conclusions: Silicone oil tamponade can change the thickness of the retina layer. The longer the silicone oil is tamponaded, the more significant the reduction in thickness of the inner retinal layer.

May ganglion cell complex analysis be a marker for glaucoma susceptibility in unilateral Fuchs' uveitis syndrome?

To compare retinal nerve fiber layer (RNFL) thickness and ganglion cell-inner plexiform layer thickness (GCIPLT) in the affected eyes to fellow unaffected eyes of patients with unilateral Fuchs' uveitis syndrome (FUS) and analyze their change over time. Twenty seven unilateral FUS patients who did not have concomitant systemic or ocular disease were retrospectively enrolled. Central macular thickness (CMT), RNFL thickness, and GCIPLT measurements were evaluated. Data was analyzed using the non-parametric Brunner-Langer model (LD-F2 design) and Wilcoxon signed-rank test. The mean age of the patients was 40.2 ± 10.2years. The median disease duration was 11 (2-62) months. The median best-corrected visual acuity (BCVA) of the affected eyes and the fellow eyes was 0.22 (0.00-2.50) vs. 0.00 (0.0-0.10) logMAR at the initial visit and 0.05 (0.00-2.50) vs. 0.00 (0.0-0.30) logMAR at the final visit. The change in BCVA was found significant in the affected eyes, but not in the fellow eyes (p < 0.001 and p = 0.287, respectively). The median CMT in the affected eyes at the final visit was not statistically different from the value at the initial visit (255 (157-306) vs. 245 (140-310) µm, p = 0.256). The change in RNFL thickness over time in the affected eyes was similar to the fellow unaffected eyes of the patients with unilateral FUS at all quadrants, with non-significant time and group effects (p > 0.05). However, median GCIPLT in all quadrants (except superonasal) in the affected eyes was statistically lower than the fellow eyes at the initial and final visits (p < 0.05). The most affected quadrant of the ganglion cell complex was inferonasal in the involved eyes (79 (42-97) vs. 75 (43-87) µm) at initial and final visits (p = 0.033 for time effect and p < 0.001 for group effect, respectively). Median CMT and RNFL thickness did not change during follow-up in the affected eyes of patients with unilateral FUS. Median GCIPLT in the affected eyes declined over time in all quadrants. Ganglion cell loss was also most prominent in the inferonasal quadrant in the affected eyes. FUS patients should be followed up long-term in terms of ganglion cell loss, especially in the inferonasal quadrant.

Custom extraction of macular ganglion cell-inner plexiform layer thickness more precisely co-localizes structural measurements with visual fields test grids

We aimed to evaluate methods of extracting optical coherence tomography (OCT)-derived macular ganglion cell-inner plexiform layer (GCIPL) thickness measurements over retinal locations corresponding to standard visual field (VF) test grids. A custom algorithm was developed to automatically extract GCIPL thickness measurements from locations corresponding to Humphrey Field Analyser 10-2 and 30-2 test grids over Goldmann II, III and V stimulus sizes from a healthy cohort of 478 participants. Differences between GCIPL thickness measurements based on VF test grids (VF-based paradigms) and the 8 × 8 grid, as per instrument review software, were analyzed, as were impacts of fovea to optic disc tilt and areas over which GCIPL thickness measurements were extracted. Significant differences between the VF-based paradigms and the 8 × 8 grid were observed at up to 55% of locations across the macula, with the greatest deviations at the fovea (median 25.5 μm, 95% CI 25.24–25.72 μm, P < .0001). While significant correlations with fovea to optic disc tilt were noted at up to 33% of locations distributed 6°–8° from the foveal center, there were no marked differences in GCIPL thickness measurements between VF-based paradigms using different stimulus sizes. As such, standard high-density OCT measurement paradigms do not adequately reflect GCIPL measurements at retinal locations tested with standard VF patterns, with the central macular region contributing most to the observed differences and with further correction required for fovea to optic disc tilt. Spatial direction of GCIPL thickness measurements will improve future comparisons of structure and function, thereby improving methods designed to detect pathology affecting the inner retina.

Local Macular Thickness Relationships between 2 OCT Devices

To compare local ganglion cell-inner plexiform layer (GCIPL) thickness measurements between 2 OCT devices and to explore factors that may influence the difference in measurements. Cross-sectional study. Sixty-nine glaucoma eyes (63 patients) with evidence of central damage or mean deviation (MD) of -6.0 dB or worse on a 24-2 visual field (VF). Cirrus and Spectralis OCT macular volume scans were exported, data from the central 20° of both OCT devices were centered and aligned, and 50× 50 arrays of 0.4°× 0.4° superpixels were created. We estimated nonparametric (Spearman's) correlations and used Bland-Altman plots to compare GCIPL thickness measurements between the two OCTs at the superpixel level. Factors that may have influenced the differences between thickness measurements between the two devices were explored with linear mixed models. Pooled and individual-eye Spearman's correlation and agreement between thickness measurements from the two devices. The median 24-2 VF MD was -6.8 dB (interquartile range [IQR], -4.9 to -12.3 dB). The overall pooled Spearman's correlation between the two devices for all superpixels and eyes was 0.97 (P < 0.001). The median within-eye correlation coefficient was 0.72 (IQR, 0.59-0.79). Bland-Altman plots demonstrated a systematic bias in most individual eyes, with Spectralis GCIPL measurements becoming larger than Cirrus measurements with increasing superpixel thickness. The average superpixel thickness and distance to the fovea influenced the thickness difference between the two devices in multivariate models (P < 0.001). Local macular thickness measurements from the Spectralis and Cirrus devices are highly correlated, but not interchangeable. Differences in thickness measurements between the two devices are influenced by the location of superpixels and their thickness.

Comparison of repeatability of swept-source and spectral-domain optical coherence tomography for measuring inner retinal thickness in retinal disease.

PurposeTo compare repeatability between SS-OCT and SD-OCT for measurement of macular, macular retinal nerve fiber (mRNFL), and ganglion cell-inner plexiform layer (GC-IPL) thickness in various retinal diseases.MethodsOne hundred and fourteen eyes of 114 subjects were investigated. Seventy-eight eyes with retinal disease and 36 normal eyes underwent two consecutive measurements of macular, mRNFL, and GC-IPL thickness using SS-OCT and SD-OCT. The data were obtained using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. The eyes with retinal diseases were divided into three subgroups according to central macular thickness (CMT) for analysis. The intraclass correlation coefficient (ICC) was calculated to determine the repeatability of OCT device.ResultsIn normal eyes, both OCT devices showed excellent repeatability of macula, mRNFL, and GC-IPL thickness measurements with high ICCs in all ETDRS subfields. In eyes with retinal disease, although SS-OCT showed better repeatability for inner retinal thickness measurements than SD-OCT, the overall ICCs were lower than those in normal eyes. In subgroup analysis, the ICCs in the low CMT group were lower than those in the normal and high CMT groups, particularly when using SD-OCT.ConclusionsBoth OCT devices had comparable repeatability for retinal thickness measurement in normal eyes and eyes with retinal disease. However, the possibility of measurement error should be considered in eyes with a thin and atrophic retina.

Effects of Measurement Center Shift on Ganglion Cell-inner Plexiform Layer Thickness Measurements.

Our authors studied the effects of measurement center shift on ganglion cell-inner plexiform layer (GCIPL) thickness measurements in Cirrus spectral-domain optical coherence tomography (SD-OCT). The measurement center shift affects the GCIPL thickness measurement depending on the distance of shift. The purpose of this study was to explore changes in macular GCIPL thicknesses measurements after manual shifting of the measurement center using SD-OCT. A prospective study was conducted. A total of 30 normal eyes of 30 subjects were included in the study. An experienced examiner obtained two consecutive measurements of GCIPL thickness using SD-OCT. Coefficients of repeatability were calculated for the average, minimum, and sectoral (superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal) thicknesses. Next, the measurement center was manually shifted from the foveal center. Three measurement centers were horizontally placed at 59-μm intervals from the foveal center, and two further centers were placed 176 μm apart. Also, three measurement centers were vertically placed at 47-μm intervals from the foveal center, and two further centers were placed 142 μm apart. The thickness of GCIPL was measured again at each shift point, and the changes of thickness before and after movement were analyzed. When the measurement centers were shifted to positions 59 μm horizontally or 47 μm vertically from the fovea, no significant changes in GCIPL thicknesses were evident. However, upon more pronounced shifting, the average GCIPL thickness of the direction of the shift region was significantly lower than baseline, whereas the GCIPL of the diametrically opposite sector was thicker than baseline. The impact of changes associated with shifting of the measurement center should be taken into consideration when measuring GCIPL thickness in patients with retinal diseases, glaucoma, or neuro-ophthalmological conditions.

Long-term reproducibility of GC-IPL thickness measurements using spectral domain optical coherence tomography in eyes with high myopia

Although ganglion cell inner plexiform layer (GC-IPL) analysis in the patients with high myopia is useful, there have been few reports to analyze of the reliability for long-term measured GC-IPL thickness. We aimed to analyze the long-term reproducibility of thickness measurements of the GC-IPL using spectral-domain optical coherence tomography (SD-OCT) in patients with high myopia and identify factors that affect such reproducibility. 99 eyes from 99 patients with high myopia without any other ophthalmc disorder such as glaucoma or retinal diseases were included. Two serial SD-OCT (Cirrus-HD) macular scans taken at ≧1 year intervals were analyzed. The intraclass correlation coefficient (ICC), coefficient of variation (CV), and test-retest standard deviation (TRTSD) of GC-IPL thickness measurements were assessed. The ICC, CV, and TRTSD of the mean GC-IPL thicknesses were 0.883, 5.9%, and 2.74, respectively. The ICCs of the six-sector GC-IPL thicknesses ranged from 0.740 to 0.904. The CVs of the minimal and all sectoral GC-IPL thicknesses were <10%. Measurement variances for the mean GC-IPL thicknesses showed significant relationshiups with chorioretinal atrophy and posterior staphyloma. There is high long-term reproducibility in GC-IPL thickness measurements using SD-OCT in high-myopia patients. The factors affecting this reproducibility include chorioretinal atrophy and posterior staphyloma.

Ganglion cell-inner plexiform layer thickness by swept-source optical coherence tomography in healthy Korean children: Normative data and biometric correlations

The purpose of this study was to identify the normative values of ganglion cell-inner plexiform layer (GCIPL) thickness in healthy Korean children using swept-source optical coherence tomography (SS-OCT) and to investigate the correlations of age, refractive error, axial length (AL), retinal nerve fiber layer (RNFL) thickness and cup-to-disc (C/D) ratio with GCIPL thickness. Children aged between 3 and 17 who had visited our pediatric ophthalmology clinic were enrolled. Each subject underwent full ophthalmic examinations including RNFL thickness, C/D ratio and GCIPL thickness measurement by SS-OCT as well as AL measurement by partial-coherence interferometry. A total of 254 eyes of 127 children were included. The mean average GCIPL thickness was 71.5 ± 5.35 μm; the thickest sector was the superonasal and the thinnest the inferior. According to multivariate regression analysis, average GCIPL thickness was significantly associated with spherical equivalent and RNFL thickness (P < 0.0001 for both): the higher the myopia or the thinner the RNFL thickness, the thinner the GCIPL thickness. In conclusion, this study provides an SS-OCT-based pediatric normative database of GCIPL thickness that can serve as a reference for early detection and follow-up of glaucoma and optic nerve diseases in children.

Diagnostic Abilities of the Optical Microangiography Parameters of the 3×3 mm and 6×6 mm Macular Scans in Glaucoma.

To evaluate the diagnostic abilities of macular vessel length and perfusion densities measured with optical microangiography (OMAG) over a 3×3 mm and a 6×6 mm region, and to compare these with macular ganglion cell-inner plexiform layer (GCIPL) thickness in eyes with primary open-angle glaucoma (POAG). In a cross-sectional study, 96 eyes of 57 control subjects and 88 eyes of 57 POAG patients underwent macular imaging with optical coherence tomography. Area under receiver operating characteristic curves (AUC) and sensitivities at 90% specificity of OMAG and GCIPL parameters were evaluated. Most OMAG parameters of the 3×3 mm macular scan and all inner sector parameters of the 6×6 mm scan were similar (P>0.05) in the POAG and control eyes. All outer sector OMAG parameters of the 6×6 mm scan were significantly less (P<0.05) in the POAG eyes. AUC and sensitivity at 90% specificity of the best parameter of the 3×3 mm OMAG scan (inner temporal vessel length density; 0.65% and 26%, respectively) were statistically similar (P>0.05) to that of the 6×6 mm scan (outer inferior vessel length density; 0.72% and 30%, respectively). AUC and sensitivity of the best GCIPL thickness parameter (inferotemporal GCIPL thickness, 0.84% and 67%) were significantly better (P<0.05) than that of the vessel length densities. The outer sector measurements of the 6×6 mm macular OMAG scans seem to be better than the inner sector measurements in diagnosing glaucoma. The GCIPL thickness measurements were significantly better than all macular OMAG parameters in diagnosing glaucoma.

Relationship of Macular Thickness and Function to Optical Microangiography Measurements in Glaucoma.

The purpose of this article was to evaluate the relationship between macular optical microangiography (OMAG), ganglion cell-inner plexiform layer (GCIPL) thickness, and visual sensitivity measurements of different macular sectors in primary open-angle glaucoma. In a cross-sectional study, 39 eyes of 26 primary open-angle glaucoma patients underwent optical coherence tomography imaging and 10-2 visual field examination of the macula in the same session. Linear regression models were used to evaluate the relationships between OMAG, GCIPL thickness, and visual sensitivity measurements in different macular sectors. Strength of relationship was reported as coefficient of determination (R). R values for the associations between OMAG and GCIPL thickness measurements ranged from 0.37 in the temporal sector to 0.56 in the inferior macular sector. R values for the association between OMAG and visual sensitivity measurements ranged from 0.23 in the superior to 0.53 in the inferior macular sector. R values for the association between GCIPL thickness and visual sensitivity measurements ranged from 0.15 in the superior to 0.62 in the temporal sector. The strongest associations between OMAG, GCIPL thickness, and visual sensitivity measurements were found in the inferior macular sector. The association of OMAG with GCIPL thickness measurements was as strong as the association between OMAG and visual sensitivity measurements in the inferior macular sector.

Retinal ganglion cell-inner plexiform and nerve fiber layers in neuromyelitis optica.

To determine the thickness of the retinal ganglion cell-inner plexiform layer (GCIPL) and the retinal nerve fiber layer (RNFL) in patients with neuromyelitis optica (NMO). We conducted a cross-sectional study that included 30 NMO patients with a total of 60 eyes. Based on the presence or absence of optic neuritis (ON), subjects were divided into either the NMO-ON group (30 eyes) or the NMO-ON contra group (10 eyes). A detailed ophthalmologic examination was performed for each group; subsequently, the GCIPL and the RNFL were measured using high-definition optical coherence tomography (OCT). In the NMO-ON group, the mean GCIPL thickness was 69.28±21.12 µm, the minimum GCIPL thickness was 66.02±10.02 µm, and the RNFL thickness were 109.33±11.23, 110.47±3.10, 64.92±12.71 and 71.21±50.22 µm in the superior, inferior, temporal and nasal quadrants, respectively. In the NMO-ON contra group, the mean GCIPL thickness was 85.12±17.09 µm, the minimum GCIPL thickness was 25.39±25.1 µm, and the RNFL thicknesses were 148.33±23.22, 126.36±23.45, 82.21±22.30 and 83.36±31.28 µm in the superior, inferior, temporal and nasal quadrants, respectively. In the control group, the mean GCIPL thickness was 86.98±22.37 µm, the minimum GCIPL thickness was 85.28±10.75 µm, and the RNFL thicknesses were 150.22±22.73, 154.79±60.23, 82.33±7.01 and 85.62±13.81 µm in the superior, inferior, temporal and nasal quadrants, respectively. The GCIPL and RNFL were thinner in the NMO-ON contra group than in the control group (P<0.05); additionally, the RNFL was thinner in the inferior quadrant in the NMO-ON group than in the control group (P<0.05). Significant correlations were observed between the GCIPL and RNFL thickness measurements as well as between thickness measurements and the two visual field parameters of mean deviation (MD) and corrected pattern standard deviation (PSD) in the NMO-ON group (P<0.05). The thickness of the GCIPL and RNFL, as measured using OCT, may indicate optic nerve damage in patients with NMO.

Rate of Macular Ganglion Cell-inner Plexiform Layer Thinning in Glaucomatous Eyes With Vascular Endothelial Growth Factor Inhibition.

To evaluate the rate of progressive macular ganglion cell-inner plexiform layer (GCIPL) thinning in patients with open-angle glaucoma (OAG) who had been treated with intravitreal antivascular endothelial growth factor (VEGF) injection for wet age-related macular degeneration (AMD). This study was a retrospective modified case control study with fellow eye comparison. We enrolled bilateral OAG patients who had been treated with repeated anti-VEGF injections for unilateral wet AMD and followed-up on for a minimum of 24 months by Cirrus high-definition optical coherence tomography. The rate of macular GCIPL thinning was determined by linear regression of serial optical coherence tomography GCIPL thickness measurements over time. We compared the rate of macular GCIPL thinning between anti-VEGF-treated eyes and fellow untreated dry AMD eyes. This study involved 32 OAG eyes of 16 subjects. The total follow-up period was 58.4±25.5 (24 to 98) months, and the mean number of anti-VEGF injections was 10.6±10.4 (3 to 40). The eyes with repeated anti-VEGF treatment differed significantly from their fellow eyes in the rate of GCIPL thinning (-2.95±3.58 vs. -0.77±0.95 µm/y, P=0.015). Also, multivariable regression analyses showed that anti-VEGF injection was significantly associated with the rate of GCIPL thinning (P=0.025). In subjects with bilateral OAG, the rate of GCIPL thinning is significantly faster in eyes treated with anti-VEGF injection for wet AMD than in untreated dry AMD fellow eyes. This finding suggests that in glaucomatous eyes, VEGF inhibition could play a role, at least in part, in progressive change of inner retinal layers.

Macular ganglion cell-inner plexiform layer thickness for detection of early retinal toxicity of hydroxychloroquine.

This study evaluated the macular ganglion cell-inner plexiform layer (GC-IPL) thickness using spectral-domain (SD) optical coherence tomography (OCT) in patients with chronic exposure to hydroxychloroquine (HCQ). A total of 90 patients (90 eyes) treated with HCQ for at least 5years and normal controls were included in the study. A fundus examination, automated threshold perimetry, and GC-IPL thickness measurements using the Cirrus high-definition OCT ganglion cell analysis algorithm were performed in all patients treated with HCQ. Average, minimum, and sectorial macular GC-IPL thicknesses were compared between the patients and controls. There was no statistically significant difference in age or sex between the groups. The anterior segment and fundoscopy were normal in all patients and controls. Visual field (VF) testing was normal in all patients. The average, minimum, and sectorial macular GC-IPL thicknesses were significantly lower in patients than those in control subjects. There was significant thinning of the macular GC-IPL in the absence of clinically evident HCQ-related retinopathy and VF abnormalities. Measurements of the macular GC-IPL thickness using SD-OCT may therefore be useful in the early diagnosis and in monitoring the progression of retinal changes in patients receiving long-term HCQ therapy.