Macular Ganglion Cell Complex Research Articles

MP-3 microperimeter in early primary open angle glaucoma with a new pattern.

To investigate macular microperimetry in patients with early primary open angle glaucoma (POAG) using a new custom-made pattern, and analyze the characteristics of macular sensitivity. This case-control study included 38 patients with POAG, who were divided into pre-perimetric glaucoma (18 eyes of 18 patients), early-stage (20 eyes of 20 patients), and control (20 eyes of 20 patients) groups. All subjects underwent standard 24-2 humphrey visual field test. An MP-3 microperimeter with a new custom-made pattern (28 testing points distributed in four quadrants, covering the central 10° of the retina) was used to evaluate macular sensitivity. Ganglion cell complex (GCC) thicknesses were examined using an RS-3000 Advance OCT system. The features of structure and function were analysed per quadrant. The pre-perimetric glaucoma group had significantly lower inferior hemifield macular sensitivity compared to controls (P<0.05). The early-stage POAG group had significantly lower average, inferior hemifield, inferonasal, and inferotemporal mean sensitivities compared to the pre-perimetric glaucoma group (P<0.05), and lower macular sensitivity in all sectors compared to controls (P<0.05). Regarding GCC thickness, all sectors in the early-stage POAG group became thinner compared to those in controls (P<0.05); whereas all sectors in the early-stage POAG group, except the superonasal quadrant, became thinner compared to those in the pre-perimetric glaucoma group (P<0.05). Macular sensitivity and GCC thickness were significantly associated in each sector. The inferotemporal quadrant had the highest correlation coefficients (0.840). The structure-function relationship for the inferonasal and inferotemporal sectors was stronger compared to the corresponding superior sectors. Microperimetry reveals variations in macular sensitivity in patients with early glaucoma earlier than conventional perimetry, particularly in pre-perimetric glaucoma cases in which it might be undetectable by conventional methods. The new custom-made pattern may improve the accuracy of microperimetry by enhancing point arrangement and reducing fatigue effects. Macular sensitivity measured by MP-3 with this pattern shows statistically significant structural and functional associations with the thicknesses of the GCC.

Comparison of diagnostic capability of macular ganglion cell complex vs retinal fiber layer thickness in primary open angle glaucoma patients of Indian origin.

Comparison of diagnostic capability of macular ganglion cell complex thickness vs. retinal nerve fiber layer (RNFL) thickness in patients of primary open-angle glaucoma (POAG). This cross-sectional observational study was carried out between June 2021 and October 2022 at a tertiary care hospital in North India. A total of 118 eyes were included in the study with 30 control and the rest 88 eyes with POAG were divided into three groups based on visual field loss Group 1 (30 eyes): early field loss with mean deviation (MD) < -6 dB; Group 2 (30 eyes): moderate field loss with MD -6 to -12 dB; and Group 3 (28 eyes): severe field loss with MD > -12 dB. Optical coherence tomography (OCT) scans to measure RNFL loss and ganglion cell inferior plexiform layer (GCIPL) loss were taken for each patient. Categorical variables were analyzed using either the Chi-square test or Fisher's exact test. A receiver operating characteristics analysis was calculated to determine optimal cut-off values of superior, inferior, and average GCIPL and RNFL for determining the severity of field loss as compared to controls (30 normal eyes). In the mild field loss group the sensitivity of superior, inferior, and average GCIPL was 86.7, 96.7, and 96.7%, respectively. Similarly, the specificity was 96.7, 93.3, and 100%, respectively. In the same group, the sensitivity of superior, inferior, and average RNFL was 70, 93, and 66%, respectively. Similarly, the specificity was 46.7, 83.3, and 70%, respectively. In the moderate and severe groups, the results were comparable. The sensitivity and specificity of GCIPL loss are significantly better than that of RNFL parameters in the mild field loss group.

Individual vs simultaneous macular and optic disc measurements with spectral domain optical coherence tomography in glaucoma and healthy eyes

We assessed the repeatability and agreement of ganglion cell complex (GCC) in the macular area and the peripapillary retinal nerve fiber layer (ppRNFL) with individual and combined macula and disc scans. The macular GCC and ppRNFL thicknesses from 34 control eyes and 43 eyes with glaucoma were measured with the Canon Optical Coherence Tomography (OCT) HS-100. Two repeated measurements were performed with both scan modes. The repeatability limit (Rlim) and agreement analysis were performed. The individual scan showed better repeatability than the combined scan in both groups. However, the differences in the Rlim for the GCC in most sectors were lower than 3 μm (axial resolution of the OCT), and this was larger than 3 μm for most of the ppRNFL sectors. The mean differences in the thickness between both scan modes for the GCC and ppRNFL measurements were less than 3 and 6 μm, respectively. The interval of the limits of agreement was about 10 μm in some sectors for the GCC, and about 40 and 60 μm in some sectors in controls and glaucoma eyes, respectively. Both scan modes showed good repeatability in both groups. The agreement results suggest that the scan modes cannot be used interchangeably.

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.

Study of the ganglion cell complex of the macula by optical coherence tomography in the diagnosis of glaucoma progression

IntroductionThe aim of this work is to evaluate the usefulness of the study of the ganglion cell complex of the macula using the OCT technique to estimate the progression of glaucoma according to its severity. Material and methodsThis is a retrospective cross-sectional study. It includes 205 eyes of 131 patients with glaucoma or ocular hypertension followed for a mean of 5.7 years. The parameters and rates of three tests have been analyzed using the progression software of each instrument: visual field, optical coherence tomography (OCT) in the ganglion cell complex of the macula and in the nerve fiber layer of the optic nerve. The results of each test, the concordance between them and how they differ according to severity stage have been evaluated. ResultsVisual field classifies more cases of progression in moderate-advanced glaucoma, while in mild glaucoma its capacity is limited. Optic nerve fiber layer OCT classifies more cases of progression in mild glaucoma than in moderate-advanced glaucoma, as it is artifacted by the floor effect. OCT of the macular ganglion cell complex is the test that classifies more cases of progression and has the highest agreement with visual field, regardless of severity. ConclusionIn both mild and moderate-advanced glaucoma, OCT of the macula ganglion cell complex may be a better biomarker of progression than OCT of the macula ganglion cell complex.

A Bayesian Hierarchical Spatial Longitudinal Model Improves Estimation of Local Macular Rates of Change in Glaucomatous Eyes.

Demonstrate that a novel Bayesian hierarchical spatial longitudinal (HSL) model improves estimation of local macular ganglion cell complex (GCC) rates of change compared to simple linear regression (SLR) and a conditional autoregressive (CAR) model. We analyzed GCC thickness measurements within 49 macular superpixels in 111 eyes (111 patients) with four or more macular optical coherence tomography scans and two or more years of follow-up. We compared superpixel-patient-specific estimates and their posterior variances derived from the latest version of a recently developed Bayesian HSL model, CAR, and SLR. We performed a simulation study to compare the accuracy of intercept and slope estimates in individual superpixels. HSL identified a significantly higher proportion of significant negative slopes in 13/49 superpixels and a significantly lower proportion of significant positive slopes in 21/49 superpixels than SLR. In the simulation study, the median (tenth, ninetieth percentile) ratio of mean squared error of SLR [CAR] over HSL for intercepts and slopes were 1.91 (1.23, 2.75) [1.51 (1.05, 2.20)] and 3.25 (1.40, 10.14) [2.36 (1.17, 5.56)], respectively. A novel Bayesian HSL model improves estimation accuracy of patient-specific local GCC rates of change. The proposed model is more than twice as efficient as SLR for estimating superpixel-patient slopes and identifies a higher proportion of deteriorating superpixels than SLR while minimizing false-positive detection rates. The proposed HSL model can be used to model macular structural measurements to detect individual glaucoma progression earlier and more efficiently in clinical and research settings.

The ganglion cell complex thickness and visual function in leber hereditary optic neuropathy

Purpose: To evaluate the ganglion cell complex (GCC) thickness using the Iowa Reference Segmentation Algorithm in individuals with chronic Leber hereditary optic neuropathy (LHON) and to assess its relation to visual acuity, visual field sensitivity, and Estermann score.Methods: In this study, a total of 17 patients (34 eyes) aged 16–72 with chronic LHON were enrolled. Visual acuity, visual fields, and Optic coherence tomography (OCT) were performed. Visual fields was evaluated with Estermann and a custom central 30‐degree test, both performed monocularly with the Octopus 900 Haag‐Streit Diagnostics. OCT imaging was performed using a Canon OCT HS‐100 to measure the retinal ganglion cell complex (GCC) thickness. The raw OCT images were exported to IOWA Reference Algorithm and the GCC segmentation was rechecked and manually recorrected if needed. The thickness obtained from the Iowa Reference Algorithms was analysed and compared against the automated segmentation provided by the OCT's inbuilt segmentation algorithm. The correlation between the GCC thickness from 9 ETDRS sectors and the visual function were analysed.Results: On average the automated segmentation overestimated GCC thickness by 23.8 μm for all sectors. Macular central GCC correlated significantly with both visual field sensitivity and Estermann points missed (r = −0.486 and −0.396 respectively). Macular middle sector GCC thickness correlated significantly with visual acuity and visual field sensitivity (r = −0.586 and −0.396 respectively). GCC thickness in outer macular sector correlated significantly only with visual acuity (r = −0.471).Conclusions: In patients with chronic LHON, GCC thickness in central and middle sectors of macula correlates well with the visual function. OCT imaging and precise ganglion cell thickness evaluations in the macula can provide useful information about the structural damage and level of visual impairment in chronic LHON patients.

Association between functional parameter and structural, and vascular parameters in advanced glaucoma

Aims/Purpose: We aimed to evaluate the function‐vasculature, and function–structure relationships in advanced glaucoma patients.Methods: This cross‐sectional study included 29 eyes of 24 advanced glaucoma patients. Advanced glaucoma was classified as visual fields (VFs) with a mean deviation (MD) below ‐12 dB according to Hodapp‐Parrish‐Anderson classification system. The structural parameters, cup/disc area ratio, cup/disc vertical ratio, cup/disc horizontal ratio, rim area, disc area, cup volume, retinal nerve fibre layer thickness, macular ganglion cell complex (GCC) thickness, were measured using optical coherence tomography (OCT, Optovue, Fremont, CA). The vessel density of superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), outer retina (OR), and choriocapillaris (CC) were analysed by optical coherence tomography angiography (OCTA, DRI OCT Triton Plus, Topcon, Tokyo, Japan). For all layers, the average vessel density of the area between 1 mm and 3 mm diameter circles was calculated, assuming the 1 mm diameter area centered on the fovea as the central region. Relationships between 10–2 VF MD values, and structural and vascular parameters were assessed by Pearson's correlation coefficients. p &lt; 0.05 was considered statistically significant.Results: The mean ± SD age of all patients was 61.9 ± 15.8 years and 75% were male. For structural parameters, there was a positive correlation between the MD and GCC thickness values (p = 0.001, r = 0.617), while none of the parameters of the optic disc were related to the MD value. There were significant positive correlations with the vessel densities of the SRCP and CC layers (p = 0.001, r = 0.593 and p = 0.002, r = 0.541, respectively).Conclusions: Decreased vessel densities of the SRCP and CC were significantly associated with severity of visual field damage. This study showed that OCTA can be a promising method in daily use for monitoring advanced glaucoma.

Association between chromatic sensitivity and peripapillary retinal nerve fibre layer thickness in healthy eyes

Purpose: Knowledge of the retinal structure—chromatic sensitivity relationship of healthy eyes would be important for early detection of retinal neuropathies such as glaucoma. This study investigated the association between colour vision thresholds and the thicknesses of the retina in healthy young eyes.Methods: Measurements were made in 56 healthy eyes of 56 young subjects of mean age 25 ± 2.4 years (range 20–31 years), and distance visual acuity ≤0.1 logMAR. Chromatic sensitivity was measured using the Color Assessment and Diagnosis (CAD) test. The macular thicknesses of the central fovea, parafovea, and macular ganglion cell complex (mGCC), and the thickness of the peripapillary retinal nerve fibre layer (pRNFL) were measured by spectral‐domain optical coherence tomography (SD‐OCT). Relationships between red‐green (RG) and yellow‐blue (YB) thresholds and the retinal thicknesses were examined through Spearman correlation.Results: Significant correlations were detected between pRNFL thickness, in the inferior hemisphere, and the RG and YB‐thresholds (r = −0.30, p = 0.03 and r = −0.31, p = 0.02; respectively). Decreased pRNFL thickness correlated with worse colour thresholds. No significant correlations were found between macular thicknesses and colour thresholds.Conclusions: Greater inferior pRNFL thickness was related to better chromatic sensitivity in healthy eyes of young subjects.

What artificial intelligence can bring us in the diagnosis and progression of glaucoma

Aims/Purpose: Our goal is to focus on the contribution of artificial intelligence in glaucoma from diagnosis to progression.Methods: By a literature review, we will review work using AI in the field of glaucoma, whether for screening, diagnosis or detection of progression.Results: For the diagnosis: Recently, two papers were published reporting results of DL algorithms to diagnose glaucoma from Visual Field data. Several authors have evaluated AI‐based fundus photograph analysis for its utility for detecting glaucoma such as the study of Liu et al which grouped 241 032 images of 68 013 patients with a sensitivity of 96.2% and specificity of 87.2% also for analysing OCT imaging data from peripapillary RNFL thickness maps and the macular ganglion cell complex for discriminating between glaucomatous and normal eyes with AROC values ranging from 0.69 to 0.99. Prediction of IOP trends from previous data and medications would be a useful and plausible use of AI. For the progression of glaucoma: Multiclass support vector machines (SVMs), have been used to simultaneously discriminate between normal, non progressing, and progressing eyes through the analysis of confocal scanning laser ophthalmoscopy (CSLO) images with a correct classification rate of 88% .Conclusions: Many AI strategies have shown promising results for glaucoma detection using fundus photography, optical coherence tomography, or automated perimetry. The combination of these imaging modalities increases the performance of AI algorithms, with results comparable to those of humans. Research in the coming years will need to address unavoidable questions regarding the clinical significance of such results and the explicability of the predictions.

Structure-function relationship and diagnostic value of macular ganglion cell complex measurement using Fourier-domain OCT in glaucoma.

To evaluate the relationship between visual function and macular ganglion cell complex (GCC) thickness measured by Fourier-domain optical coherence tomography (OCT) and evaluate the diagnostic value of GCC measurement compared to retinal nerve fiber layer (RNFL) thickness and macular thickness in detecting early, moderate, and severe glaucomas. Subjects underwent standard automated perimetry (SAP), OCT imaging with optic nerve head mode and GCC mode. The relationship between OCT parameters (mean GCC thickness, mean RNFL thickness, and macular thickness) and perimetry global indices (mean deviation [MD] and pattern standard deviation [PSD]) was evaluated by regression analysis. Diagnostic values of mean RNFL thickness, GCC parameters, and macular thickness were compared with the area under the receiver operating characteristic curves (AUC). A total of 84 eyes, 42 of each normal and primary open-angle glaucoma patients were included in the study. Compared with linear models, second-order polynomial models better described relationships between GCC thickness and MD ( P < 0.001), and between GCC thickness and PSD ( P = 0.00). RNFL parameter, inferior RNFL thickness had the highest AUC for detecting early glaucoma. The AUC of mean GCC thickness for early glaucoma was higher than that of mean RNFL; however, the difference was not significant ( P = 0.09), which was higher than that of macular thickness. The relationship between visual field (VF) sensitivity and GCC thickness is best expressed by the curvilinear function. Macular GCC thickness and RNFL thickness showed similar diagnostic values but were better than macular thickness for detecting early glaucoma but inferior to macular thickness and RNFL thickness for detecting moderate glaucoma.

Utilidad del estudio del complejo de células ganglionares de la mácula mediante tomografía de coherencia óptica en el diagnóstico de progresión del glaucoma

IntroductionThe aim of this work is to evaluate the usefulness of the study of the ganglion cell complex of the macula using optical coherence tomography (OCT) to estimate the progression of glaucoma according to its severity. Material and methodsThis is a retrospective cross-sectional study. It includes 205 eyes of 131 patients with glaucoma or ocular hypertension followed for a mean of 5.7years. The parameters and rates of three tests have been analyzed using the progression software of each instrument: visual field, OCT in the ganglion cell complex of the macula and in the nerve fiber layer of the optic nerve. The results of each test, the concordance between them and how they differ according to severity stage have been evaluated. ResultsVisual field classifies more cases of progression in moderate-advanced glaucoma, while in mild glaucoma its capacity is limited. Optic nerve fiber layer OCT classifies more cases of progression in mild glaucoma than in moderate-advanced glaucoma, as it is artifacted by the floor effect. OCT of the macular ganglion cell complex is the test that classifies more cases of progression and has the highest agreement with visual field, regardless of severity. ConclusionThe study of the macula ganglion cell complex using OCT could be a better biomarker of progression than the study of the optic nerve fiber layer, at any stage of glaucoma.

Central Visual Field Testing in Early Glaucoma: A Report by the American Academy of Ophthalmology

To evaluate the current published literature on the utility of the 10-2 visual field (VF) testing strategy for the evaluation and management of early glaucoma, defined here as mean deviation (MD) better than -6 decibels (dB). A search of the peer-reviewed literature was last conducted in June 2023 in the PubMed database. Abstracts of 986 articles were examined to exclude reviews and non-English-language articles. After inclusion and exclusion criteria were applied, 26 articles were selected, and the panel methodologist rated them for strength of evidence. Thirteen articles were rated level I, and 8 articles were rated level II. The 5 level III articles were excluded. Data from the 21 included articles were abstracted and reviewed. The central 12 locations on the 24-2 VF test grid lie within the central 10 degrees covered by the 10-2 VF test. In early glaucoma, defects detected within the central 10 degrees generally agree between the 2 tests. Defects within the central 10 degrees of the 24-2 VF test can predict defects on the 10-2 VF test, although the 24-2 may miss defects detected on the 10-2 VF test. In addition, results from the 10-2 VF test show better association with findings from OCT scans of the macular ganglion cell complex. Modifications of the 24-2 test that include extra test locations within the central 10 degrees improve detection of central defects found on 10-2 VF testing. Evidence to date does not support routine testing using 10-2 VF for patients with early glaucoma. However, early 10-2 VF testing may provide sufficient additional information for some patients, particularly those with a repeatabledefect within the central 12 locations of the standard 24-2 VF test or who have inner retinal layer thinning on OCT scans of the macula. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

OCT and OCTA in dysthyroid optic neuropathy: a systematic review and meta-analysis

PurposeTo explore the current research about the role of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in dysthyroid optic neuropathy (DON).MethodsStudies in the literature that focused on...

Capacidad diagnóstica de la densidad vascular papilar y macular frente a parámetros estructurales con tomografía de coherencia óptica en el glaucoma seudoexfoliativo

PurposeTo evaluate the diagnostic ability of the vessel density (VD) of the optic nerve head (ONH) and the macula on optical coherence tomography (OCT) angiography and the retinal nerve layer thickness (RNFL) thickness and the macular ganglion cell complex (GCC) thickness on OCT in patients with pseudoexfoliative glaucoma (PXG). MethodsCross-sectional study including PXG patients and healthy controls. Demographic and clinical data were noted for all participants. Optical coherence tomography (OCT) and OCT angiography (OCTA) images of the ONH and macular area were obtained with the RS-3000 Advance OCT (Nidek Co., Gamagori, Japan). The RNFL and GCC thickness of different sectors was provided by the software. Macular VD of the superficial capillary plexus (SCP) and ONH VD of the radial peripapillary capillary plexus (RPCP) were registered. Groups were compared and area under the receiver operating characteristic (AUROC) curves were used to determine the power of discrimination of each parameter. ResultsRNFL and GCC thickness and ONH and macular VD were significantly lower in PXG patients compared with healthy controls (all, P<.05). The best discrimination parameter was the average RNFL thickness (AUROC: 0.928). ONH VD AUROC was better than that of macular VD (AUROC: 0.897 and 0.780, respectively). ONH VD AUROC was comparable to RNFL thickness (P<.001). ConclusionsThe diagnostic ability of ONH vessel density in PXG appears comparable to that of the structural parameters, RNFL and GCC thickness, obtained with OCT, and may be a valuable tool in clinical practice.

Association of macular pigment optical density with retinal layer thicknesses in eyes with and without manifest primary open-angle glaucoma

ObjectiveTo investigate associations between baseline macular pigment optical density (MPOD) and retinal layer thicknesses in eyes with and without manifest primary open-angle glaucoma (POAG) in the Carotenoids in Age-Related Eye...

Diagnostic ability of vessel density of the optic nerve head and macula versus structural parameters with optical coherence tomography in pseudoexfoliative glaucoma

PurposeTo evaluate the diagnostic ability of the vessel density (VD) of the optic nerve head (ONH) and the macula on optical coherence tomography (OCT) angiography and the retinal nerve layer thickness (RNFL) thickness and the macular ganglion cell complex (GCC) thickness on OCT in patients with pseudoexfoliative glaucoma (PXG). MethodsCross-sectional study including PXG patients and healthy controls. Demographic and clinical data were noted for all participants. Optical coherence tomography (OCT) and OCT angiography (OCTA) images of the ONH and macular area were obtained with the RS-3000 Advance OCT (Nidek Co., Gamagori, Japan). The RNFL and GCC thickness of different sectors was provided by the software. Macular VD of the superficial capillary plexus (SCP) and ONH VD of the radial peripapillary capillary plexus (RPCP) were registered. Groups were compared and area under the receiver operating characteristic (AUROC) curves were used to determine the power of discrimination of each parameter. ResultsRNFL and GCC thickness and ONH and macular VD were significantly lower in PXG patients compared with healthy controls (all, p<0.05). The best discrimination parameter was the average RNFL thickness (AUROC: 0.928). ONH VD AUROC was better than that of macular VD (AUROC: 0.897 and 0.780, respectively). ONH VD AUROC was comparable to RNFL thickness (p<0.001). ConclusionsThe diagnostic ability of ONH vessel density in PXG appears comparable to that of the structural parameters, RNFL and GCC thickness, obtained with OCT, and may be a valuable tool in clinical practice.

Retinal functional and structural changes in patients with Parkinson’s disease

BackgroundVisual dysfunction have been well reported as one of the non-motor symptoms in Parkinson’s disease (PD). The aim of this study was to evaluate the functional and structural changes in the retina in patients with PD, and to correlate these changes with disease duration and motor dysfunction.MethodsFor this case–control study, we recruited patients fulfilling the diagnostic criteria for idiopathic PD according to British Brain Bank criteria, aged between 50 and 80 years. Age- and sex-matched healthy controls aged between 50 and 80 years were also recruited. Motor function for PD patients was assessed using Modified Hoehn and Yahr staging scale (H & Y staging) and Unified Parkinson’s Disease Rating Scale (UPDRS). Optical Coherence Tomography (OCT) and full field electroretinogram (ff-ERG) were done to all participants.ResultsData from 50 patients and 50 healthy controls were included in the analysis. Patients with idiopathic Parkinson's had significantly reduced peripapillary retinal nerve fiber layer (RNFL) thickness and macular ganglion cell complex (GCC) thickness compared to healthy controls (P-value < 0.05 in all parameters). They also had significantly delayed latency and reduced amplitude in both dark-adapted rods and the light-adapted cone for both a & b waves compared to healthy controls (P-value < 0.001 in all parameters). There were statistically significant negative correlations between disease duration, and left superior, right inferior and right & left average RNFL thickness [(r) coef. = -0.327, -0.301, -0.275, and -0.285 respectively]. UPDRS total score was negatively correlated with the amplitude of light-adapted of both RT and LT a & b wave and with dark-adapted RT b-wave latency [(r) coef. = -0.311, -0.395, -0.362, -0.419, and -0.342].ConclusionThe retinal structure and function were significantly affected in patients with PD in comparison to healthy controls. There was a significant impact of disease duration on retinal thickness, and there was a significant negative correlation between the degree of motor dysfunction in patients with PD and retinal function.

Sector-Based Regression Strategies to Reduce Refractive Error-Associated Glaucoma Diagnostic Bias When Using OCT and OCT Angiography.

This cross-sectional study aimed to investigate the sectoral variance of optical coherence tomography (OCT) and OCT angiography (OCTA) glaucoma diagnostic parameters across eyes with varying degrees of refractive error. Healthy participants, including individuals with axial ametropia, enrolled in the Hong Kong FAMILY cohort were imaged using the Avanti/AngioVue OCT/OCTA system. The OCT and OCTA parameters obtained include peripapillary nerve fiber layer thickness (NFLT), peripapillary nerve fiber layer plexus capillary density (NFLP-CD), and macular ganglion cell complex thickness (GCCT). Sectoral measurements of NFLT, NFLP-CD, and GCCT were based on sectors and hemispheres. A total of 1339 eyes from 791 participants were stratified based on spherical equivalent refraction: high myopia (<-6 D), low myopia (-6 D to -1 D), emmetropia (-1 D to 1 D), and hyperopia (>1 D). Multivariable broken stick regression models, accounting for age, sex, and signal strength, showed that all NFLT sectors except temporally, the inferior GCCT hemisphere, and half of the NFLP-CD sectors were more affected by ametropia-related covariates than the corresponding global parameters. As expected, the false-positive rates in those sectors were elevated. Finally, sector-specific axial length (AL) and spherical equivalent (SE) adjustments helped reduce the elevated false-positive rates. The effect of optical magnification is even more prominent among sectors than the global parameters. AL- and SE-based adjustments should be individualized to each sector to mitigate this magnification bias effectively. Identifying sectoral differences among diagnostic parameters and adopting these sector-based adjustments into commercial OCT systems will hopefully reduce false-positive rates related to refractive error.

Combining retinal structural and vascular measurements improves discriminative power for multiple sclerosis patients.

Data on how retinal structural and vascular parameters jointly influence the diagnostic performance of detection of multiple sclerosis (MS) patients without optic neuritis (MSNON) are lacking. To investigate the diagnostic performance of structural and vascular changes to detect MSNON from controls, we performed a cross-sectional study of 76 eyes from 51 MS participants and 117 eyes from 71 healthy controls. Retinal macular ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) thicknesses, and capillary densities from the superficial (SCP) and deep capillary plexuses (DCP) were obtained from the Cirrus AngioPlex. The best structural parameter for detecting MS was compensated RNFL from the optic nerve head (AUC = 0.85), followed by GCC from the macula (AUC = 0.79), while the best vascular parameter was the SCP (AUC = 0.66). Combining structural and vascular parameters improved the diagnostic performance for MS detection (AUC = 0.90; p<0.001). Including both structure and vasculature in the joint model considerably improved the discrimination between MSNON and normal controls compared to each parameter separately (p = 0.027). Combining optical coherence tomography (OCT)-derived structural metrics and vascular measurements from optical coherence tomography angiography (OCTA) improved the detection of MSNON. Further studies may be warranted to evaluate the clinical utility of OCT and OCTA parameters in the prediction of disease progression.