Ganglion Cell-inner Plexiform Layer Thickness Research Articles

Dynamics of retinal changes in early-stage Parkinson’s disease

Parkinson’s disease (PD) is a neurodegenerative disorder primarily characterized by motor symptoms, with emerging evidence suggesting retinal pathology, particularly in the ganglion cell-inner plexiform layer (GCIPL), detectable via optical coherence tomography (OCT). This study aimed to characterize early retinal dynamics in PD using OCT. We conducted a prospective one-year longitudinal multicenter study involving 53 early-stage PD patients with a disease duration of 5 years or less and 52 controls. The participants underwent retinal spectral-domain OCT, primary visual function and cognitive examinations. We examined baseline retinal measures and short-term longitudinal differences between groups via linear mixed effects models. In PD patients, the baseline GCIPL thickness in central regions was increased by up to 4 μm, and the rate of thinning in the parafoveal GCIPL was − 0.61 [0.29] µm/year faster over a one-year follow-up period than in controls in the 2- to 3-mm ring (p = 0.039). In PD patients, greater central GCIPL thickness was associated with poorer contrast sensitivity and reduced performance on the Farnsworth D15 color vision test. It also predicted subsequent thinning in both the GCIPL (2- to 3-mm ring) and the inner nuclear layer (2- to 5-mm rings). However, this increased thickness was not linked to prevalent or progressive motor or cognitive manifestations. In conclusion, this study provides the first detailed topographical description of early retinal dynamics in PD patients, revealing increased central GCIPL thickness and accelerated parafoveal GCIPL thinning in PD. However, the macular region shows complex and variable dynamics among PD patients, but these changes precede detectable progression in clinical scales.

Longitudinal Changes of Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layer in Highly Myopic Glaucoma: A 3-year Cohort Study.

To describe the longitudinal changes in peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGC-IPL) thicknesses in highly myopic eyes with and without glaucoma, and to investigate the effects of high myopia (HM) on the sectoral patterns of pRNFL and mGC-IPL thinning. Longitudinal cohort study. A total of 243 eyes from 243 individuals with 3-year follow-up were included in this study: 109 eyes in the HM group, 64 eyes in the open-angle glaucoma (OAG) group and 70 eyes in the highly myopic glaucoma (HMG) group. Based on visual field assessment, 19 OAG eyes and 21 HMG eyes were determined to be progressive. Mean and sectoral pRNFL and mGC-IPL thicknesses were obtained using swept-source optical coherence tomography. A linear mixed-effects model was used to compare the thinning rates and percentages between groups. Mean and sectoral thinning rates and percentages of pRNFL and mGC-IPL in HM, OAG, and HMG eyes. The mean age of the participants was 37.2 ± 11.2 years, and the mean follow-up duration was 3.2 ± 0.3 years. The mean pRNFL thickness changed at rates of -0.44, -0.63 and -1.17 μm/year in the HM, OAG, and HMG group, respectively (P < 0.001), while the mean mGC-IPL thickness changed at rates of -0.10, -0.32 and -0.41 μm/year in the three groups, respectively (P < 0.001). Temporal pRNFL thinning was faster in HMG compared to OAG (-1.24 μm/year vs -0.45 μm/year, P = 0.002). The mGC-IPL thinning rate in each sector was not significantly different between HMG and OAG group (all Ps > 0.05). In contrast to OAG, HMG eyes showed greater percentage thinning rates of pRNFL in the inferior and temporal sectors, with a greater mGC-IPL thinning in the inferonasal sector. The patterns of pRNFL and mGC-IPL thinning differ between HMG and OAG. In particular, faster temporal pRNFL thinning may serve as a distinguishing feature for identifying glaucoma in HM eyes. These findings may also enhance the understanding of the mechanisms of damage in HMG.

In vivo imaging of mitochondrial function in normal, glaucoma suspect, and glaucoma eyes.

To investigate macula and optic nerve head (ONH) mitochondrial metabolic activity using flavoprotein fluorescence (FPF) in normal, glaucoma suspect (GS), and open-angle glaucoma (OAG) eyes we performed a cross-sectional, observational study of FPF in normal, GS, and OAG eyes. The macula and ONH of each eye was scanned and analyzed with a commercially available FPF measuring device (OcuMet Beacon, OcuSciences Inc., Ann Arbor, MI). One-way analysis of variance was used to compare macula and ONH FPF scores between groups. Linear regression models investigated the correlation between FPF scores and structural and functional parameters. We included 25 normal, 16 GS, and 54 OAG eyes. The average age in years ± SD for normal, GS, and OAG groups was 60.6 ±17.4, 67.8 ± 10.3, and 67.9 ± 11.6, respectively (P = 0.064). There was no significant difference in gender, race/ethnicity, visual acuity, and intraocular pressure between groups. OAG eyes had larger cup-to-disc ratio, thinner retinal nerve fiber and macula thicknesses, and worse visual field indices compared to normal and GS eyes (P ≤ 0.018). There was no significant difference in any FPF metric between the study groups in either the macula or the ONH, despite normalizing FPF data for structural differences between groups (e.g. retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness). In conclusion, no significant differences in metabolic activity as measured by FPF were found in macula and ONH FPF scores using the integrated clinician report generator between normal, GS, and OAG eyes. Further research is needed to evaluate the role of mitochondrial metabolic activity measurements in glaucoma.

How to diagnose glaucoma in myopic eyes by detecting structural changes?

Myopia is rapidly escalating globally, especially in East and Southeast Asia, where its prevalence among younger populations reaches alarming levels of 80 to 90%. This surge contributes to a myopia epidemic linked to several ocular complications, including glaucoma. As myopic individuals age, the risk of developing glaucoma increases, and an additional concern arises from the growing frequency of refractive surgeries among younger individuals, making precise optic nerve assessments critical before surgery. Evaluating the optic nerve head (ONH) in myopic eyes is challenging, as structural changes due to myopia often resemble glaucomatous alterations. Techniques such as optical coherence tomography (OCT) have improved the examination of ONH microstructures, but interpreting results remains complex due to potential false-positive findings. Myopic eyes exhibit unique changes, such as peripapillary atrophy and altered neuroretinal rim configurations, making it crucial to distinguish these from true glaucomatous signs. Recent advancements in OCT technology and the establishment of myopia-specific normative databases have enhanced diagnostic accuracy. Parameters such as minimum rim width, ganglion cell-inner plexiform layer thickness and temporal raphe sign show promise in differentiating between glaucomatous and nonglaucomatous changes. Ultimately, a comprehensive approach incorporating multiple OCT metrics is essential for accurately diagnosing glaucoma in myopic patients. By integrating various structural evaluations and leveraging advanced imaging techniques, clinicians can better navigate the complexities of glaucoma diagnosis amidst the challenges posed by myopia. This review highlights the need for increased attention and tailored strategies in managing glaucoma risk within this increasingly affected population.

Changes of retinal ganglion cell–inner plexiform layer thickness and visual acuity in patients with diabetic macular edema treated with Aflibercept

Background Anti-vascular endothelial growth factor agents have now become the first line of treatment for diabetic macular edema (DME). Changes in the thickness of the individual retinal layers including the ganglion cell–inner plexiform layer (GC–IPL) might serve as a biomarker for the response to treatment. Aim The aim of this study was to evaluate the effect of intravitreal injections of Aflibercept on the average thicknesses of the GC–IPL in naïve eyes and on the visual acuity in patients with DME. Patients and methods This is a retrospective observational study that included 224 naïve eyes of 224 patients having DME. It compared the changes in the GC–IPL thickness at baseline and after receiving three loading doses of Aflibercept followed by as needed protocol for 12 months. All patients had optical coherence tomography imaging at baseline (with GC–IPL thickness measurement) and at the 12-month visit. The change in GC–IPL thickness was measured and was correlated with best-corrected visual acuity. Results During the study duration, a median of five injections of Aflibercept were given. There was a statistically significant decrease in the posttreatment values of the GC–IPL thickness from 89±13 to 84±14.7 µm (P=0.029). Moreover, a statistically significant association was found between the thickness reduction of the GC–IPL in the central macular area and the best-corrected visual acuity (r=0.9, P=0.005, Pearson coefficient=0.26). Conclusion The results of this study suggest that the reduction in the GC–IPL thickness can be used as a prognostic tool for the response to Aflibercept as it was associated with improved visual acuity.

The relationship between optical coherence tomography and magnetic resonance imaging measurements in people with multiple sclerosis: A systematic review and meta-analysis.

Several studies show that optical coherence tomography (OCT) metrics e with cognition, disability, and brain structure in people with multiple sclerosis (PwMS). This review the correlation between OCT parameters and magnetic resonance imaging (MRI) measurements in PwMS. A comprehensive search of PubMed/MEDLINE, Embase, Scopus, and Web of Science was performed, including studies published in English up to November 29, 2024 to identify studies reporting quantitative data on the correlation between baseline OCT parameters and MRI measurements in PwMS. The meta-analysis was performed using R software version 4.4.0. From 4931 studies, 68 studies on 6168 PwMS (67.4% female) were included. The most significant correlations were found between peripapillary retinal nerve fiber layer (pRNFL) thickness and lower T1 lesion volume r=-0.42 (95% CI: -0.52 to -0.31, p-value <0.001, I2=24%), greater thalamic volume r=0.39 (95% CI: 0.17 to 0.61, p-value <0.001, I2=81%), and lower T2 lesion volume r=-0.37 (95% CI: -0.54 to -0.21, p-value <0.001, I2=85%), respectively. Additionally, lower macular ganglion cell-inner plexiform layer (mGCIPL) thickness showed the most significant correlations with positive and lower thalamic volume r=0.37 (95% CI: 0.1 to 0.64, p-value=0.008, I2=88%), and positive and lower grey matter volume (GMV) 0.33 (95% CI: 0.15 to 0.52, p-value <0.001, I2=81%), respectively. pRNFL and mGCIPL thickness are correlated with MRI measurements, suggesting that OCT can serve as a non-invasive, cost-effective, and complementary tool to MRI for enhancing the exploring of brain structural changes in PwMS.

Macular patterns of neuronal and visual field loss in recovered optic neuritis identified by machine learning

We used machine learning to investigate the residual visual field (VF) deficits and macula retinal ganglion cell (RGC) thickness loss patterns in recovered optic neuritis (ON). We applied archetypal analysis (AA) to 377 same-day pairings of 10-2 VF and optical coherence tomography (OCT) macula images from 93 ON eyes and 70 normal fellow eyes ≥ 90 days after acute ON. We correlated archetype (AT) weights (total weight = 100%) of VFs and total retinal thickness (TRT), inner retinal thickness (IRT), and macular ganglion cell-inner plexiform layer (GCIPL) thickness. AA showed most ON eyes had a 10-2 VF pattern like the normal fellow eye VF, despite having markedly thinner GCIPL patterns. AA identified 7 VF and 11 retinal thickness ATs for each OCT model. The normal VF AT constituted 80% of ON eyes and 90% of normal fellow eyes. The most common GCIPL AT consisted of diffuse thinning. We identified significant correlations for the normal AT weights using OCT AT weights of five GCIPL ATs (r = 0.45), four TRT ATs (0.53) and two IRT ATs (0.42). Following acute ON, most eyes had complete 10-2 VF recovery despite significant GCIPL thinning, suggesting compensatory mechanisms for vision.

Comparison of peripapillary and macular Optical Coherence Tomography parameters between children and young adults.

To compare the retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer thickness, central subfield thickness (CSFT), and parafoveal and perifoveal thickness in children of different age groups with young adult controls by using spectral-domain optical coherence tomography. This cross-sectional study included children aged 6-17 years and adult controls (18-22 years) - group 1: 6-9 years (57 eyes), group 2: 10-13 years (116 eyes), group 3: 14-17 years (66 eyes), and group 4 (controls): 18-22 years (61 eyes). A mixed-effects model was used to compare the OCT parameters among the groups, along with multivariable analysis. Analysis of 300 eyes of 152 patients was done. Group 2 (99.7 ± 1.1 μm, P = 0.03) and group 3 (100.4 ± 1.5 μm, P = 0.03) had thicker RNFL on average as compared to group 4 (95.6 ± 1.6 μm) on multivariable analysis. In pairwise comparison, group 2 (129.8 ± 2.5 μm, P = 0.02) and group 3 (132.6 ± 2.4 μm, P = 0.004) had thicker inferior RNFL compared to adult controls (122.4 ± 2.5 μm); superior RNFL was thicker in group 2 (129.6 ± 2.0 μm, P = 0.01) and group 3 (131.2 ± 2.6 μm, P = 0.008) compared to group 1 (120.9 ± 2.8 μm). On multivariable analysis, adult controls had thicker CSFT (236.5 ± 2.6 μm) than group 1 (222.7 ± 3.1 μm) and group 2 (229.6 ± 2.3 μm). Similarly, on pairwise comparison, adult controls had thicker parafoveal superior quadrants (320.5 ± 2.5 μm) and inferior quadrants (317.5 ± 2.3 μm) when compared with groups 1 and 2. RNFL thickness seems to increase up to 17 years and then starts reducing, unlike CSFT, which increases with age from 6 to 22 years. A differential growth occurs in the different quadrants of RNFL and macula with age with some quadrants increasing in thickness as compared to the others.

Optical coherence tomography in secondary progressive multiple sclerosis: cross-sectional and longitudinal exploratory analysis from the MS-SMART randomised controlled trial

BackgroundOptical coherence tomography (OCT) inner retinal metrics reflect neurodegeneration in multiple sclerosis (MS). We explored OCT measures as biomarkers of disease severity in secondary progressive MS (SPMS).MethodsWe investigated people with...

Clinical efficacy of optical coherence tomography parameters to predict the visual field outcome following pituitary adenoma surgery.

To investigate the factors affecting visual field recovery in patients with pituitary adenoma following surgical removal, both eyes of 35 patients with pituitary adenoma who had been followed up for > six months post-surgery were retrospectively analyzed. Pre- and post-operative visual acuity, visual field test, retinal nerve fiber layer (RNFL), and ganglion cell inner plexiform layer (GCIPL) thickness were investigated. The average age of the 35 patients was 58.3 ± 11.5 years. Preoperatively, 30 eyes (mean average RNFL thickness, 99.73 ± 5.89 μm) and 40 eyes (mean average RNFL thickness, 77.55 ± 8.35 μm) were included in the thick (≥ 90 μm) and thin RNFL group (< 90 μm), respectively. In the thick RNFL group, pre- and post-operative mean deviation (MD) and pattern standard deviation (PSD) were favorable (all p < 0.001), and the proportion of eyes of postoperative MD change which were stable or improved was greater than in the thin RNFL group (p = 0.042). Preoperative MD, RNFL (except nasal quadrant) and GCIPL thickness were positively correlated to postoperative MD values (all, p < 0.05). Preoperative MD and temporal RNFL thickness were significantly correlated with postoperative MD change rate (p = 0.03 and 0.04, respectively). Preoperative GC IPL thickness and postoperative MD change rate were not significantly correlated (p = 0.61). Using univariate regression analysis, preoperative best corrected visual acuity (Odds ratio [OR], 0.050; p < 0.001), tumor volume (OR, 1.110, p = 0.002), higher preoperative MD values (OR, 0.858; p < 0.001), lower preoperative PSD values (OR, 1.169, p = 0.002), thick RNFL (OR, 0.215; p = 0.003) and thick GCIPL (OR, 0.305, p = 0.018) were significantly associated with a good visual field outcome following surgery. According to multivariate analysis, any other parameters were not significant. In patients with thick RNFL, postoperative MD values were better than in the thin RNFL group. Eyes with preoperative higher MD and thick temporal RNFL showed more improvement in their visual fields postoperative. Preoperative thick RNFL could be a potential predictor of visual field recovery following TSA-TR, while macular GCIPL thickness does not appear to be a reliable predictor.

Examination of optical coherence tomography findings in patients with pregabalin use disorder.

Pregabalin abuse is a rapidly growing health problem worldwide, and little is known about the effects of prolonged high-dose use in patients with pregabalin use disorder. In this study, the effects of pregabalin abuse on retinal layers were investigated in patients with pregabalin use disorder (PGUD). This study included 35 controls and 34 patients with PGUD, according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria. Optic coherence tomography (OCT) measurements including the retinal nerve fiber layer (RNFL), ganglion cell layer-inner plexiform layer (GCL-IPL) and ganglion cell complex (GCC) were performed. RNFL thickness was evaluated in four quadrants (inferior, superior, nasal, temporal). GCL-IPL and GCC thickness were evaluated in six sectors (superior, superonasal, inferonasal, inferior, inferotemporal, superotemporal). GCC inferonasal (p = 0.040, r = 0.354), GCC inferior (p = 0.018, r = 0.402) GCL-IPL inferior (p = 0.031, r = 0.370) and GCL-IPL inferotemporal (p = 0.029, r = 0.376) thickness were positively correlated with the duration of pregabalin use. There was no significant sector or quadrant-wise difference between groups (p > 0.05). Our findings emphasized the drug's potential neuroprotective effect. It should be taken into consideration that neurodegenerative changes due to substance use disorder occur with long-term. Longitudinal prospective studies investigating dose-duration relationship are needed.

Angioarchitectural alterations in the retina and choroid in frontotemporal dementia.

Frontotemporal dementia (FTD) is a progressive neurodegenerative disorder that affects the frontal and temporal lobes of the brain, leading to cognitive decline and personality changes. The objective of this cross-sectional study was to characterize angioarchitectural changes in the retina and choroid of individuals with FTD compared to cognitively normal controls using optical coherence tomography (OCT) and OCT angiography (OCTA). Cross-sectional comparison of patients with FTD and controls with normal cognition. All participants underwent Mini-Mental State Examination (MMSE) at the time of imaging. Outcome measures included OCT parameters: retinal nerve fiber layer (RNFL) thickness, ganglion cell layer-inner plexiform layer (GC-IPL) thickness, central subfield thickness (CST), subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI); and OCTA superficial capillary plexus parameters: foveal avascular zone (FAZ) area, 3x3mm and 6x6mm macular perfusion density (PD) and vessel density (VD), 4.5x4.5mm peripapillary capillary perfusion density (CPD) and capillary flux index (CFI). Generalized estimating equation analysis was used to account for the inclusion of 2 eyes from the same participant. 29 eyes of 19 patients with FTD and 85 eyes of 48 controls were analyzed. In FTD, 3x3mm macular PD (p = 0.02) and VD (p = 0.02) and CFI (p = 0.01) were reduced compared to controls. There was no difference in average 4.5x4.5mm CPD, RNFL thickness, GC-IPL thickness, CST, SFCT, CVI, FAZ, or 6x6mm VD or PD between FTD and controls (all p > 0.05); however, there was a trend toward lower macular 6x6mm PD and VD in patients with FTD. Decline of peripapillary and macular OCT and OCTA parameters merit further investigation as potential biomarkers for FTD detection. Noninvasive retinal and choroidal imaging may hold promise for earlier detection, and future longitudinal studies will clarify their role in monitoring of FTD.

Total retinal thickness is an important factor in evaluating diabetic retinal neurodegeneration

ObjectiveMacular retinal nerve fibre layer (mRNFL) and ganglion cell-inner plexiform layer thickness (GC-IPL) measurements are important markers of diabetic retinal neurodegeneration (DRN). In this cross-sectional study, we aimed to quantify...

Discriminating Diseases Mimicking Normal-Tension Glaucoma (NTG) from NTG.

Background/Objectives: The aim of this study was to identify the most reliable ocular exam and establish a threshold for deciding whether to perform neuroimaging in order to screen for diverse diseases other than normal-tension glaucoma (NTG). A retrospective, observational, comparative study was used. Methods: In total, 106 individuals with atypical features of NTG who underwent glaucoma assessments and contrast-enhanced MRI of the brain or orbit were included. The criteria for atypical NTG included the following: (1) unilateral normal-tension glaucoma, (2) visual field (VF) damage inconsistent with optic disc appearance, (3) fast VF progression, (4) worsening of visual acuity, (5) optic disc pallor, (6) scotoma restricted by a vertical line, and (7) central scotoma. Glaucoma evaluations included measurements of visual acuity, intraocular pressure, central corneal thickness, axial length, cup-disc ratio, retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GCIPL) thickness, mean deviation (MD), and visual field index (VFI). Statistical analyses involved independent t-tests, receiver operating characteristic (ROC) curves, and area under the curve (AUC) in order to differentiate neuro-ophthalmological conditions from NTG, compare the diagnostic power of each factor, and determine the cut-off value. Results: Relatively fewer diagnoses of non-glaucomatous diseases were associated with unilateral NTG, the worsening of VA, and central scotoma. Factors such as rapid visual field progression, optic disc pallor, and scotoma restricted by a vertical line had a relatively higher diagnostic rate of non-glaucomatous diseases. There were significant differences in average RNFL and GCIPL thicknesses at the nasal quadrant between NTG and NTG-mimicking conditions. Only the GCIPL thickness at the nasal quadrant had reliable power for discriminating between neuro-ophthalmological disease and NTG. For the GCIPL thickness at the nasal quadrant, the AUC was 0.659, and the cut-off value was 65.75. Conclusions: When deciding whether to proceed with imaging, such as carrying out an MRI test, for NTG patients with atypical NTG characteristics, it would be advisable to consider the nasal sector cut-off value of GCIPL thickness.

Correlations Between Disability Score, Optical Coherence Tomography and Microperimetry in Patients with Multiple Sclerosis.

To characterize ocular motility disturbances through Microperimetry (MP) in patients with Multiple Sclerosis (MS) trying to detect those capable of influencing the disability to improve the accuracy of assessing visual impact in EDSS scale. MP results were compare with some structural parameters obtained by OCT. Cross-sectional analytical and correlational case-control study approved by Ethical Committee. A total of 82 eyes (41 patients) and 30healthy eyes (15 subjects) were enrolled after informed consent. All participants underwent ophthalmological evaluation with MP and OCT. Variables included MS disease duration, Expanded Disability Status Scale (EDSS) score; in OCT: central macular thickness (CMT), ganglion cell-inner plexiform layer thickness (GCIPL), and peripapillary retinal nerve fiber layer thickness (pRNFL); and in MP: test duration, reaction time, average macular threshold (AT), and 4 fixation stability indexes (P1, P2, BCEA63, BCEA95). MS group showed a significant decrease in GCIPL (p < 0.001) and pRNFL thickness (p < 0.001) compared to the control group. Furthermore, patients demonstrated a longer examination (p < 0.001) and reaction (p < 0.001) times, reduced AT (p < 0.001), more unstable fixation indexes (P1 p <0.004, P2 p = 0.018, BCEA63 p = 0.005 and BCEA95 p = 0.007), measured by MP. In addition, patients with a history of ON (n=16) demonstrated longer examination times in MP (p = 0.049) compared to MS patients without ON, but they were not correlations with OCT measurements, EDSS score correlated with the CMT (p = 0.023, r = -0.25), MP duration (p = 0.043, r = 0.22), and fixation indexes (P1 p = 0.049, r = -0.22, BCEA63 p = 0.041, r = 0.23, BCEA95 p = 0.049, r = 0.22). Our study emphasizes the complementary utility of MP and OCT in assessing MS patients. Additionally, it highlights that using MP for objective measurements of oculomotor dysfunction could improves accuracy in disability assessment on the EDSS scale.

Comparison of ganglion cell-inner plexiform layer thickness among patients with intermittent exotropia according to fixation preference: a retrospective observational study.

This study was performed to compare the thickness of the ganglion cell-inner plexiform layer (GCIPL) depending on the presence or absence of fixation preference in patients with intermittent exotropia (IXT) with refractive values close to emmetropia and with no amblyopia. The study recruited pediatric patients diagnosed with IXT with a spherical equivalent within ±1.25 diopter and no amblyopia. The patients were categorized into two groups: a monocular exotropia group with fixation preference and an alternating exotropia group without fixation preference. GCIPL thickness was measured using spectral domain optical coherence tomography, and the macula was divided into nine sectors according to the Early Treatment Diabetic Retinopathy Study (ETDRS). GCIPL thickness in each sector was compared between the monocular and alternating exotropia groups. In the monocular exotropia group, GCIPL thickness was significantly thinner in the dominant eye than in the nondominant eye in the S1 sector (91.2±7.4 μm vs. 93.3±5.2 μm, p=0.019). However, in the alternating exotropia group, there were no significant differences between the eyes across all ETDRS sectors. When comparing the interocular differences in GCIPL thickness between the two groups, the monocular exotropia group (absolute value of the dominant eye minus the nondominant eye) exhibited significantly greater differences in several ETDRS sectors than the alternating exotropia group (absolute value of the right eye minus the left eye). The significant interocular difference in GCIPL thickness in the monocular exotropia group suggests that fixation preference may influence the anatomical structure of the macula in patients with IXT.

A Novel Approach To Predict Glaucomatous Impairment in the Central 10° Visual Field, Excluding the Effect of Cataract.

Our previous study predicted genuine glaucomatous visual field (VF) impairment in the central 10° VF, excluding the effect of cataract, using visual acuity (VA) and global indexes of VF more accurately than pattern deviation (PD). This study aimed to improve the accuracy by using pointwise total deviation (TD) values with the machine-learning method of random forest model (RFM) and to investigate whether incorporating optical coherence tomography-measured ganglion cell-inner plexiform layer (GCIPL) thickness is useful. This retrospective study included 89 eyes with open-angle glaucoma that underwent successful cataract surgery (with or without iStent implantation or ab interno trabeculotomy). Postoperative TD in each of the 68 VF points was predicted using preoperative (1) PD, (2) VA and VF with a linear regression model (LM), and (3) VA and VF with RFM, and averaged as predicted mean TD (mTDpost). Further prediction was made by incorporating the preoperative GCIPL into the best model. The mean absolute error (MAE) between the actual and predicted mTDpost with RFM (1.25 ± 1.03 dB) was significantly smaller than that with PD (3.20 ± 4.06 dB, p < 0.01) and LM (1.42 ± 1.06 dB, p < 0.05). The MAEs with the model incorporating GCIPL into RFM (1.24 ± 1.04 dB) and RFM were not significantly different. Accurate prediction of genuine glaucomatous VF impairment was achieved using pointwise TD with RFM. No merit was observed by incorporating the GCIPL into this model. This pointwise RFM could clinically reduce cataract effect on VF.

Macular exudate in idiopathic intracranial hypertension affects outer retina and visual acuity

BackgroundOptical coherence tomography (OCT) is suggested as a potential tool for retinal biomarkers in idiopathic intracranial hypertension (IIH). We explored how macular exudate (ME) affects retinal structure in IIH and...

Inter-eye asymmetry of microvascular density in patients on hydroxychloroquine therapy by optical coherence tomography angiography

AimsTo explore the inter-eye retinal microvascular density asymmetry of patients on hydroxychloroquine (HCQ) therapy through optical coherence tomography angiography (OCTA). Methods40 subjects were enrolled in this cross-sectional study, including 20 systemic lupus erythematasus patients currently treated with HCQ (40 eyes) and 20 age- and sex-matched normal controls (NCs, 40 eyes). OCTA images were obtained to measure macular and peripapillary mircrovasculatures and microstructures, including vessel density, retinal nerver fiber layer thickness, and peripapillary ganglion cell-inner plexiform layer thickness. The absolute values of the difference between right and left eyes were taken as a measure of inter-eye asymmetry. ResultsMacular whole image vessel density (wiVD-M) and perifoveal vessel density (pfVD) of superficial capillary plexus (SCP) were notably reduced in both the right and left eyes of the HCQ treatment group compared with NCs. Specifically, SLE patients treated with HCQ have higher inter-eye asymmetry of wiVD-M of SCP (2.28 ± 1.03 vs 1.27 ± 0.79, p < 0.01) and pfVD of SCP (2.55 ± 1.26 vs 1.78 ± 1.06, p = 0.04) compared with NCs. There were no significant differences in inter-eye asymmetry of structure parameters. Inter-eye asymmetry of wiVD-M of SCP (AUC = 0.80, p < 0.01) and pfVD of SCP (AUC = 0.71, p = 0.02) exhibited greater discrimination power. ConclusionSLE Patients treated with HCQ exhibited a notably higher inter-eye vessel density asymmetry compared to that of NCs. Thus, inter-eye vessel density asymmetry could be used to screen for HCQ retinal toxicity.

Inner retinal layer thickness alterations in adult and pediatric patients with neurofibromatosis 1

This study compared the thickness of each intraretinal layer in patients with neurofibromatosis 1 (NF1) and controls to analyze the association between intraretinal layer thickness and visual function. The macular spectral-domain optical coherence tomography volumetric dataset obtained from 68 eyes (25 adult eyes, 43 pediatric eyes) with NF1 without optic glioma and 143 control eyes (100 adult eyes, 43 pediatric eyes) was used for image auto-segmentation. The intraretinal layers segmented from the volumetric data included the macular retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL), inner nuclear layer, outer plexiform layer, outer nuclear layer, and photoreceptor layer. Cases and controls were compared after adjusting for age, sex, refractive error, and binocular use. The association between retinal layer thickness and visual acuity was also analyzed. The GCIPL was significantly thinner in both adult and pediatric patients with NF1 compared with healthy controls. Average RNFL and GCIPL thicknesses were associated with visual acuity in adult patients with NF1. In pediatric patients, average GCIPL thickness was associated with visual acuity. These results suggest that changes in the inner retinal layer could be a biomarker of the structural and functional status of patients with NF1.