Macular Ganglion Cell-inner Plexiform Layer Thickness Research Articles

Evaluation of the association of macular ganglion cell-inner plexiform layer thickness and myopia in Chinese young adults.

To describe the distribution of ganglion cell-inner plexiform layer (GCIPL) thickness among Chinese young adults and report whether the decreased GCIPL thickness is associated with myopia. In this study, we included Chinese young adults who underwent Cirrus spectral domain-optical coherence tomography (SD-OCT). SD-OCT was used to measure average and minimum GCIPL thickness, and GCIPL thickness at all sectors. Subfoveal choroidal thickness (CT), axial length (AL), and spherical equivalents (SE) were also measured. A total of 348 eyes were included in the analysis. Average GCIPL thickness showed a significant difference between myopes and emmetropes, with 87.89 ± 3.65 μm for emmetropic groups and 82.65 ± 4.96 μm for myopic groups. The GCIPL thickness was significantly thinner in myopia than in emmetropia at all locations (P < 0.05), affirming that myopia was associated with thinner GCIPL thickness (P = 0.001). The mean subfoveal CT also showed a significant difference between myopes and emmetropes, with 330.57 ± 9.43 μm for emmetropic groups and 265.98 ± 4.12 μm for myopic groups. GCIPL (OR 0.863, 95% CI, 0.785-0.949), AL (OR 2.499, 95% CI, 1.532-4.075) and intraocular pressure (IOP) (OR 1.250, 95% CI, 1.086-1.438) revealed significant associations with myopia. When adjusting for AL, IOP, and anterior chamber depth (ACD) in the myopia subgroup, the GCIPL thickness remained positively associated. In a specific Chinese young population, myopic eyes have measurably less macular GCIPL thickness than normal eyes. Decreasing GCIPL thickness may be associated with the progression of myopia.

Effect of phenytoin on retinal ganglion cells in acute isolated optic neuritis.

Phenytoin has been shown to reduce the peripapillary retinal nerve fiber layer (pRNFL) loss in optic neuritis (ON). We evaluated the effects of phenytoin on retinal ganglion layers and visual outcomes of newly diagnosed acute ON. A randomized, placebo-controlled trial was conducted in a tertiary referral eye hospital and patients with the first episode of typical demyelinating ON, without any history of multiple sclerosis were randomly assigned to phenytoin or placebo. The thickness of ganglion cell-inner plexiform layer (GCIPL) measured by optical coherence tomography (OCT) was considered as the primary outcome. One patient in the phenytoin group developed severe cutaneous rashes that progressed to Stevens-Johnson syndrome (SJS)/toxic epidermal necrosis (TEN), and further allocation of patients to the phenytoin group was stopped, and finally fifteen participants were included in the phenytoin group. Fifty-one patients were enrolled to the placebo group, from which four were excluded. Both visual acuity and field were not significantly different between the control and phenytoin groups after 1 and 6months. Mean 3- and 6-mm macular GCIPL thicknesses decreased after 6months to 73.6 ± 14.1 and 57.9 ± 7.5μm, respectively, in the phenytoin group and to 71.6 ± 15.7 and 55.6 ± 6.6μm, respectively, in the placebo group with no significant differences between the two groups (P = 0.77 and P = 0.26, respectively, linear multilevel model). Phenytoin is not probably safe and effective as neuroprotection after acute ON. Further investigation with other sodium channel inhibitors could be considered.

Diagnostic ability of vessel density measured by spectral-domain optical coherence tomography angiography for glaucoma in patients with high myopia

Although early glaucoma detection is important to prevent visual loss due to disease progression, its clinical diagnosis in highly myopic eyes is still difficult. Many studies using optical coherence tomography (OCT) angiography (OCTA) reported decreased vessel density (VD) in glaucomatous eyes compared to normal eyes. We evaluated the diagnostic ability of peripapillary VD and macular VD measured by OCTA, comparing them with conventional valuables such as peripapillary retinal nerve fibre layer (RNFL) thickness and macular ganglion cell-inner plexiform layer (GCIPL) thickness measured by OCT. We also calculated the average VD ratio (VDR) (average outer macular VD/average inner macular VD), superior VDR (superior outer macular VD/average inner macular VD), and inferior VDR (inferior outer macular VD/average inner macular VD). Totally, 169 eyes from 169 subjects were enrolled. Among OCTA measurements, the best diagnostic parameters were average VDR (AUROC: 0.852 and 0.909) and inferior VDR (AUROC: 0.820 and 0.941) in nonhighly and highly myopic eyes, respectively. Inferior VDR showed better diagnostic ability than most of the other OCT measurements including peripapillary RNFL thickness and macular GCIPL thickness in highly myopic eyes. Accordingly, OCTA measurements can be useful for diagnosing glaucoma in highly myopic eyes, especially when using calculated indices such as average VDR or inferior VDR.

CHANGES IN GANGLION CELL AND INNER PLEXIFORM LAYERS THICKNESS AND RETINAL MICROVASCULATURE IN DIFFERENT STAGES OF GLAUCOMA

Background: Primary open angle glaucoma (POAG) is an optic neuropathy characterized by progressive degeneration of retinal ganglion cells (RGC) and their axons, which results in characteristic excavation of the neuroretinal rim with corresponding visual field (VF) deficits. Optical coherence tomography angiography (OCTA) is a novel imaging modality that can detect vascular flow of the retina and choroid in great detail. The ability to segment OCT angiograms into the different vascular layers may improve understanding of disease pathogenesis. Objective: To evaluate the correlation between Ganglion Cell and Inner Plexiform Layers thickness using optical coherence tomography (OCT) and the macular microvasculature density in different stages of primary open angle glaucoma using optical coherence tomography angiography (OCTA). Subjects and Methods: The study was performed on 80 eyes of 48 subjects including 20 eyes of 11 controls, and 60 eyes of 37 POAG cases which were divided into 3 groups according to Hodapp,Parish,Anderson (H-P-A) classification; Group1: mild glaucoma (20 eyes), Group 2: moderate glaucoma (20 eyes),Group 3: severe glaucoma (20 eyes). Results: In our study, we found that there was a significant reduction in Ganglion Cell - Inner Plexiform Layer (GCIPL) thickness and macular VD in patients with POAG which increased with increasing glaucoma severity, also we found that OCT and OCTA parametrs were significantly differentiate between normal and POAG cases and also between different stages of POAG. Also we found that an OCTA was an important diagnostic tool in diagnosing mild cases of POAG and to differentiate between mild and moderate cases of POAG,in contrast to OCT in which there was no significant differance between mild and moderate cases of POAG. OCTA seems to be a good candidate for diagnosis and follow-up of glaucoma, complementing the results provided by OCT and visual field testing. Conclusion: Significant differences between eyes with POAG and normal eyes in terms of the macular GCIPL thickness and microvasculature density (VD) suggest that the macular GCIPL thickness and the retinal capillary vessel area density may be reliable indicators of glaucoma severity.

CHANGES IN GANGLION CELL AND INNER PLEXIFORM LAYERS THICKNESS AND RETINAL MICROVASCULATURE IN DIFFERENT STAGES OF GLAUCOMA

Background: Primary open angle glaucoma (POAG) is an optic neuropathy characterized by progressive degeneration of retinal ganglion cells (RGC) and their axons, which results in characteristic excavation of the neuroretinal rim with corresponding visual field (VF) deficits. Optical coherence tomography angiography (OCTA) is a novel imaging modality that can detect vascular flow of the retina and choroid in great detail. The ability to segment OCT angiograms into the different vascular layers may improve understanding of disease pathogenesis. Objective: To evaluate the correlation between Ganglion Cell and Inner Plexiform Layers thickness using optical coherence tomography (OCT) and the macular microvasculature density in different stages of primary open angle glaucoma using optical coherence tomography angiography (OCTA). Subjects and Methods: The study was performed on 80 eyes of 48 subjects including 20 eyes of 11 controls, and 60 eyes of 37 POAG cases which were divided into 3 groups according to Hodapp,Parish,Anderson (H-P-A) classification; Group1: mild glaucoma (20 eyes), Group 2: moderate glaucoma (20 eyes),Group 3: severe glaucoma (20 eyes). Results: In our study, we found that there was a significant reduction in Ganglion Cell - Inner Plexiform Layer (GCIPL) thickness and macular VD in patients with POAG which increased with increasing glaucoma severity, also we found that OCT and OCTA parametrs were significantly differentiate between normal and POAG cases and also between different stages of POAG. Also we found that an OCTA was an important diagnostic tool in diagnosing mild cases of POAG and to differentiate between mild and moderate cases of POAG,in contrast to OCT in which there was no significant differance between mild and moderate cases of POAG. OCTA seems to be a good candidate for diagnosis and follow-up of glaucoma, complementing the results provided by OCT and visual field testing. Conclusion: Significant differences between eyes with POAG and normal eyes in terms of the macular GCIPL thickness and microvasculature density (VD) suggest that the macular GCIPL thickness and the retinal capillary vessel area density may be reliable indicators of glaucoma severity.

Topographic correlation between macular superficial microvessel density and ganglion cell-inner plexiform layer thickness in glaucoma-suspect and early normal-tension glaucoma

Background/AimsTo investigate the topographic relationship between macular superficial microvessel density (SMD) and macular ganglion cell-inner plexiform layer (GCIPL) thickness in eyes with glaucoma-suspect (GS) and early normal-tension glaucoma (NTG).MethodsA total...

Retinal Microvascular and Neurodegenerative Changes in Alzheimer’s Disease and Mild Cognitive Impairment Compared with Control Participants

Evaluate and compare the retinal microvasculature in the superficial capillary plexus (SCP) in Alzheimer's disease (AD), mild cognitive impairment (MCI), and cognitively intact controls using OCT angiography. OCT parameters were also compared. Cross-sectional study. Seventy eyes from 39 AD participants, 72 eyes from 37 MCI participants, and 254 eyes from 133 control participants were enrolled. Participants were imaged using Zeiss Cirrus HD-5000 with AngioPlex (Carl Zeiss Meditec, Dublin, CA) and underwent cognitive evaluation with Mini-Mental State Examination. Vessel density (VD) and perfusion density (PD) in the SCP within the Early Treatment Diabetic Retinopathy Study 6-mm circle, 3-mm circle, and 3-mm ring were compared between groups. Foveal avascular zone (FAZ) area, central subfield thickness (CST), macular ganglion cell-inner plexiform layer (GC-IPL) thickness, and peripapillary retinal nerve fiber layer (RNFL) thickness were also compared. Alzheimer's participants showed significantly decreased SCP VD and PD in the 3-mm ring (P=0.001 and P = 0.002, respectively) and 3-mm circle (P = 0.003 and P = 0.004, respectively) and decreased SCP VD in the 6-mm circle (P = 0.047) compared with MCI and significantly decreased SCP VD and PD in the 3-mm ring (P = 0.008 and P = 0.004, respectively) and 3-mm circle (P = 0.015 and P = 0.009, respectively) and SCP PD in the 6-mm circle (P = 0.033) when compared with cognitively intact controls. There was no difference in SCP VD or PD between MCI and controls (P > 0.05). FAZ area and CST did not differ significantly between groups (P>0.05). Alzheimer's participants showed significantly decreased GC-IPL thickness over the inferior (P = 0.032) and inferonasal (P = 0.025) sectors compared with MCI and significantly decreased GC-IPL thickness over the entire (P = 0.012), superonasal (P = 0.041), inferior (P = 0.004), and inferonasal (P = 0.006) sectors compared to controls. MCI participants showed significantly decreased temporal RNFL thickness (P = 0.04) compared with controls. Alzheimer's participants showed significantly reduced macular VD, PD, and GC-IPL thickness compared with MCI and controls. Changes in the retinal microvasculature may mirror small vessel cerebrovascular changes in AD.

Normative Database and Color-code Agreement of Peripapillary Retinal Nerve Fiber Layer and Macular Ganglion Cell-inner Plexiform Layer Thickness in a Vietnamese Population.

Evaluate the distribution and the color probability codes of the peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) thickness in a healthy Vietnamese population and compare them with the original color-codes provided by the Cirrus spectral domain-optical coherence tomography. This is a cross-sectional study. We recruited nonglaucomatous Vietnamese subjects and constructed a normative database for peripapillary RNFL and macular GCIPL thickness. The probability color-codes for each decade of age were calculated. We evaluated the agreement with κ coefficient between optical coherence tomography color probability codes with Cirrus built-in original normative database and the Vietnamese normative database. In total, 149 eyes of 149 subjects were included. The mean age of enrollees was 60.77 (±11.09) years, with a mean spherical equivalent of +0.65 (±1.58) D and mean axial length of 23.4 (±0.87) mm. Average RNFL thickness was 97.86 (±9.19) µm and average macular GCIPL was 82.49 (±6.09) µm. Agreement between original and adjusted normative database for RNFL was fair for average and inferior quadrant (κ=0.25 and 0.2, respectively); and good for other quadrants (range, κ=0.63 to 0.73). For macular GCIPL κ agreement ranged between 0.39 and 0.69. After adjusting with the normative Vietnamese database, the percent of yellow and red color-codes increased significantly for peripapillary RNFL thickness. Vietnamese population has a thicker RNFL in comparison with Cirrus normative database. This leads to a poor color-code agreement in average and inferior quadrant between the original and adjusted database. These findings should encourage to create a peripapillary RNFL normative database for each ethnicity.

Correlation between macular ganglion cell-inner plexiform layer thickness and visual acuity after resolution of the macular edema secondary to central retinal vein occlusion.

To examine the thickness of the ganglion cell-inner plexiform layer (GCIPL) in eyes with resolved macular edema (ME) in non-ischemic central retinal vein occlusion (CRVO), applying spectral-domain optical coherence tomography (SD-OCT), and its relationship with visual acuity. The retrospective observational case-control study included 30 eyes of non-ischemic CRVO patients with resolved ME (ME eyes) after treatment, and 30 eyes of non-ischemic CRVO patients without ME (non-ME eyes). The macular GCIPL thickness, peripapillary retinal nerve fiber layer (pRNFL) thickness and central macular thickness (CMT) were measured on a SD-OCT scan. Linear regression analyses were performed to determine the correlation between the thickness of each and the visual acuity (VA). No significant difference in average GCIPL thickness, mean pRNFL thickness and CMT were observed between ME group and non-ME group (P=0.296, 0.183, 0.846). But, minimum GCIPL thickness was reduced in ME eyes compared with non-ME eyes (P=0.022). Final VA significantly correlated with the minimum GCIPL thickness in ME eyes (r=-0.482, P=0.007), whereas no correlation was found with average GCIPL thickness, average pRNFL thickness and mean CMT. Minimum GCIPL thickness is reduced in ME eyes compared with non-ME eyes, and correlated with the VA in non-ischemic CRVO. These results propose that inner retinal damage occurring in patients with ME secondary to non-ischemic CRVO may lead to permanent visual defect after treatment.

Segmentation errors in macular ganglion cell analysis as determined by optical coherence tomography in eyes with macular pathology

BackgroundTo evaluate artifacts in macular ganglion cell inner plexiform layer (GCIPL) thickness measurement in eyes with retinal pathology using spectral-domain optical coherence tomography (SD OCT).MethodsRetrospective analysis of color-coded maps, infrared images and 128 horizontal B-scans (acquired in the macular ganglion cell inner plexiform layer scans), using the Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA). The study population included 105 eyes with various macular conditions compared to 30 eyes of 30 age-matched healthy volunteers. The overall frequency of image artifacts and the relative frequency of artifacts were stratified by macular disease.ResultsScan errors and artifacts were found in 55.1% of the 13,440 B-scans in eyes with macular pathology and 26.8% of the 3840 scans in normal eyes. Segmentation errors were the most common scan error in both groups, with more common involvement of both segmentation borders in diseased eyes and anterior segmentation border in normal eyes.ConclusionSegmentation errors and artifacts in SD OCT GCA are common in conditions involving the macula. These findings should be considered when assessing macular GCIPL thickness and careful assessment of scans is suggested.

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.

Macular Ganglion Cell and Retinal Nerve Fiber Layer Thickness in Children With Refractive Errors-An Optical Coherence Tomography Study.

To study the distribution of macular ganglion cell-inner plexiform layer (GC-IPL) thickness and peripapillary retinal nerve fiber layer (RNFL) thickness in children with refractive errors. Two hundred forty-three healthy eyes from 139 children with refractive error ranging from -10.00 to +5.00 D were recruited from the National University Hospital Eye Surgery outpatient clinic. After a comprehensive ocular examination, refraction, and axial length (AL) measurement (IOLMaster), macular GC-IPL and RNFL thickness values were obtained with a spectral domain Cirrus high definition optical coherence tomography system (Carl Zeiss Meditec Inc.). Only scans with signal strength of >6/10 were included. Correlation between variables was calculated using the Pearson correlation coefficient. A multivariate analysis using mixed models was done to adjust for confounders. The mean spherical equivalent refraction was -3.20±3.51 D and mean AL was 24.39±1.72 mm. Average, minimum, superior, and inferior GC-IPL were 82.59±6.29, 77.17±9.65, 83.68±6.96, and 81.64±6.70 μm, respectively. Average, superior, and inferior peripapillary RNFL were 99.00±11.45, 123.20±25.81, and 124.24±22.23 μm, respectively. Average, superior, and inferior GC-IPL were correlated with AL (β=-2.056, P-value 0.000; β=-2.383, P-value 0.000; β=-1.721, P-value 0.000), but minimum GC-IPL was not (β=-1.056, P-value 0.115). None of the RNFL parameters were correlated with AL. This study establishes normative macular GC-IPL and RNFL thickness in children with refractive errors. Our results suggest that high definition optical coherence tomography RNFL parameters and minimum GC-IPL are not affected by AL or myopia in children, and therefore warrants further evaluation in pediatric glaucoma patients.

Ganglion Cell–Inner Plexiform Layer Change Detected by Optical Coherence Tomography Indicates Progression in Advanced Glaucoma

To examine the performance of Guided Progression Analysis (GPA; Carl Zeiss Meditec, Dublin, CA) in spectral-domain optical coherence tomography (OCT) in detecting progressive thinning of ganglion cell-inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL) in glaucoma. Longitudinal, observational study. A total of 196 eyes of 123 primary open-angle glaucoma patients (mean follow-up, 5.0 years). Macular GCIPL and peripapillary RNFL thicknesses were measured by Cirrus HD-OCT (Zeiss, Dublin, CA), and progressive GCIPL and RNFL thinning were assessed by GPA. The reference standard of glaucoma progression was determined by visual field (VF) progression. Glaucomatous eyes were classified into mild (117 eyes) or moderate to advanced (79 eyes) groups based on VF defects. Ganglion cell-inner plexiform layer and RNFL thinning rates were compared between progressors and nonprogressors. Visual field survival estimates in eyes with and without progressive GCIPL and RNFL thinning were evaluated by Kaplan-Meier survival analysis and compared with the log-rank test. Progressive GCIPL and RNFL thinning assessed by OCT GPA. Seventy-six eyes (38.8%) and 43 eyes (21.9%) demonstrated progressive GCIPL and RNFL thinning, respectively, and 48 eyes (24.5%) were classified as progressors by reference standard. The rate of change in the average GCIPL thickness was significantly higher in progressors (-1.05±0.98 μm/year for mild glaucoma and-0.66±0.30 μm/year for moderate to advanced glaucoma) than in nonprogressors (-0.47±0.54 μm/year for mild glaucoma and-0.31±0.50 μm/year for moderate to advanced glaucoma), regardless of glaucoma severity (P < 0.05). Eyes with progressive GCIPL thinning had lower VF survival estimates than eyes without, regardless of glaucoma severity. However, the rate of change in the average RNFL thickness did not differ significantly in moderate to advanced glaucoma (P= 0.765; -0.26±0.55 μm/year for progressors and-0.33±0.92 μm/year for nonprogressors), and VF survival estimates did not differ significantly between eyes with and without progressive RNFL thinning in moderate to advanced glaucoma (P= 0.781). Ganglion cell-inner plexiform layer GPA provides a new approach for evaluating glaucoma progression. It may be more useful for detecting progression in the advanced stages of glaucoma than RNFL GPA.

Measurement of macular structure-function relationships using spectral domain-optical coherence tomography (SD-OCT) and pattern electroretinograms (PERG).

BackgroundRetinal ganglion cell (RGC) death is a common cause of loss of vision during glaucoma. Pattern electroretinogram (PERG) is an objective measure of the central retinal function that correlates with macular GCL thickness. The aim of this study is to determine possible relationships between the N95 amplitude of pattern electroretinogram (PERGamp) and macular ganglion cell/inner plexiform layer thickness (GCIPLT).Methods and findingsThis was a retrospective and comparative study including 74 glaucoma patients (44 early stage and 30 advanced stage cases) and 66 normal control subjects. Macular GCIPLT was measured using Cirrus spectral domain-optical coherence tomography. Standard automated perimetry and pattern ERGs were used in all patient examinations. Three types of regression analysis (broken stick, linear regression, and quadratic regression) were used to evaluate possible relationships between PERGamp and GCIPLT. Correlations between visual field parameters and GCIPLT were evaluated according to glaucoma severity. The best fit model for the relationship between PERGamp and GCIPLT was the linear regression model (r2 = 0.22; P < 0.001). The best-fit model for the relationship between visual field parameters and GCIPLT was the broken stick model. During early glaucoma, macular GCIPLT was positively correlated with PERGamp, but not with visual field loss. In advanced glaucoma, macular GCIPLT was positively correlated with both PERGamp and visual field loss.ConclusionsPERGamp was significantly correlated with macular GCIPT in early glaucoma patients, while visual field performance showed no correlation with GCIPLT. PERGamp can therefore assist clinicians in making an early decision regarding the most suitable treatment plan, especially when GCIPLT is thinning with no change in visual field performance.

Reproducibility of macular ganglion cell\u2013inner plexiform layer thickness in normal eyes determined by two different OCT scanning protocols

BackgroundTo investigate the reproducibility of macular ganglion cell-inner plexiform layer (GCIPL) thickness measurement in normal eyes determined by different operators and two different raster scanning protocols of Cirrus high-definition optical coherence tomography (HD-OCT).MethodsOne hundred and two eyes of 102 normal subjects were scanned three times using Cirrus HD-OCT with Macular Cube 512 × 128 protocol by two operators, respectively. Three extra scans were obtained using Macular Cube 200 × 200 protocol. The average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal GCIPL thickness was measured. The reproducibility of the measurements was evaluated with intraclass correlation coefficients (ICC) and coefficients of variation (CoV).ResultsThe intra-operator ICCs of macular GCIPL thickness were >0.875; and the inter-operator ICCs were 0.882 to 0.991. The intra-protocol ICCs of Macular Cube 512 × 128 and 200 × 200 protocol were 0.953 to 0.987 and 0.953 to 0.991, respectively; and the inter-protocol ICCs were 0.876 to 0.991. All CoVs were <1.5%.ConclusionsCirrus HD-OCT can measure macular GCIPL thickness in normal eyes with excellent reproducibility. The measurements determined by Macular Cube 512 × 128 and 200 × 200 protocol were highly consistent and both protocols were eligible for macular GCIPL thickness measurement.

Comparing the Rates of Retinal Nerve Fiber Layer and Ganglion Cell–Inner Plexiform Layer Loss in Healthy Eyes and in Glaucoma Eyes

To compare the rates of circumpapillary retinal nerve fiber layer (RNFL) and macular retinal ganglion cell-inner plexiform layer (GCIPL) change over time in healthy and glaucoma eyes. Cohort study. The rates of circumpapillary RNFL and macular GCIPL loss in 28 healthy subjects and 97 glaucoma subjects from the Diagnostic Innovations in Glaucoma Study (DIGS) were compared using mixed-effects models. The median follow-up time and number of visits were 1.7 years and 6 visits and 3.2 years and 7 visits for healthy and glaucoma eyes, respectively. Significant rates of loss of both global circumpapillary RNFL and average macular GCIPL thickness were detectable in early and moderate glaucoma eyes; in severe glaucoma eyes, rates of average macular GCIPL loss were significant, but rates of global circumpapillary RNFL loss were not. In glaucoma eyes, mean rates of global circumpapillary RNFL thickness change (-0.98μm/year [95% confidence interval (CI),-1.20 to-0.76]) and normalized global circumpapillary RNFL change (-1.7%/year [95% CI,-2.1 to-1.3]) were significantly faster than average macular GCIPL change (-0.57μm/year [(95% CI,-0.73 to-0.41]) and normalized macular GCIPL change (-1.3%/year [95% CI,-1.7 to-0.9]). The rates of global and inferior RNFL change were weakly correlated with global and inferior macular GCIPL change (r ranges from 0.16 to 0.23, all P < .05). In this cohort, the rate of circumpapillary RNFL thickness change was faster than macular GCIPL change for glaucoma eyes. Global circumpapillary RNFL thickness loss was detectable in early and moderate glaucoma, and average macular GCIPL thickness loss was detectable in early, moderate, and severe glaucoma, suggesting that structural changes can be detected in severe glaucoma.

Ganglion cell‐inner plexiform layer thickness and visual improvement after vitrectomy for rhegmatogenous retinal detachment

PurposeTo evaluate the association of postoperative macular ganglion cell‐inner plexiform layer (GCIPL) thickness with postoperative visual outcomes in patients undergoing vitrectomy for macular–off rhegmatogenous retinal detachment (RRD) using spectral domain optical coherence tomography.MethodsData from 22 eyes with macular‐off RRD who were followed for more 6 months after successful pars plana vitrectomy were analyzed. Macular GCIPL thickness in eyes with RRD was compared with that of the normal contralateral eyes 6 months after surgery. The correlation between the interocular difference in GCIPL thickness and postoperative best corrected visual acuity (BCVA) was evaluated.ResultsPreoperative and postoperative central macular thickness were 538.09 ± 318.42 μm, 230.77 ± 34.69 μm. Mean GCIPL thickness was significantly decreased with time after surgery (3 vs. 6 months, p &lt; 0.01). Mean GCIPL thickness in eyes with RRD 6 months after surgery were 61.04 ± 12.04 μm and in the unaffected contralateral eyes were 73.67 ± 6.73 μm. The interocular difference in macular GCIP thickness was significantly correlated with postoperative BCVA. Among patients with intact photoreceptor layers, a greater decrease in GCIPL thickness was correlated with a worse postoperative BCVA (r = 0.629; p = 0.02). No significant correlation were identified between interocular macular GCIPL thickness difference and age (r = 0.629; p = 0.85), axial length (r = 0.874; p = 0.43).ConclusionsMacular GCIPL thickness decreased after vitrectomy to repair for RRD. The decrease in GCIPL thickness was significantly correlated with postoperative visual outcomes.

Macular Ganglion Cell -Inner Plexiform Layer Thickness Is Associated with Clinical Progression in Mild Cognitive Impairment and Alzheimers Disease.

PurposeWe investigated the association of the macular ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (RNFL) thicknesses with disease progression in mild cognitive impairment (MCI) and Alzheimer’s disease (AD).MethodsWe recruited 42 patients with AD, 26 with MCI, and 66 normal elderly controls. The thicknesses of the RNFL and GCIPL were measured via spectral-domain optic coherent tomography in all participants at baseline. The patients with MCI or AD underwent clinical and neuropsychological tests at baseline and once every year thereafter for 2 years.ResultsThe Clinical Dementia Rating scale-Sum of Boxes (CDR-SB) score exhibited significant negative relationships with the average GCIPL thickness (β = -0.15, p < 0.05) and the GCIPL thickness in the superotemporal, superonasal, and inferonasal sectors. The composite memory score exhibited significant positive associations with the average GCIPL thickness and the GCIPL thickness in the superotemporal, inferonasal, and inferotemporal sectors. The temporal RNFL thickness, the average and minimum GCIPL thicknesses, and the GCIPL thickness in the inferonasal, inferior, and inferotemporal sectors at baseline were significantly reduced in MCI patients who were converted to AD compared to stable MCI patients. The change of CDR-SB from baseline to 2 years exhibited significant negative associations with the average (β = -0.150, p = 0.006) and minimum GCIPL thicknesses as well as GCIPL thickness in the superotemporal, superior, superonasal, and inferonasal sectors at baseline.ConclusionsOur data suggest that macular GCIPL thickness represents a promising biomarker for monitoring the progression of MCI and AD.

In Vivo Evidence of Inner Retinal Neurodegeneration in Retinitis Pigmentosa Using Spectral-Domain Optical Coherence Tomography.

To investigate the topographic changes in macular ganglion cell inner plexiform layer (GCIPL) thickness in eyes with retinitis pigmentosa (RP). Forty-five eyes of 25 subjects with RP who underwent spectral-domain optical coherence tomography (SD-OCT) using the Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA) were analyzed retrospectively. A control group of 67 eyes of 48 age-matched healthy volunteers was also included for comparison. Average, minimum, and sectoral macular GCIPL, as well as retinal nerve fiber layer (RNFL) and outer retinal (OR) thicknesses, were collected and compared between RP and control groups. The average and sectoral macular GCIPL thicknesses were significantly reduced in RP eyes compared with controls (P < .0001). Average macular RNFL thickness was reduced in RP eyes compared with controls (P < .054). In eyes with RP, display reduced GCIPL, RNFL, and OR thickness. The identification of alteration in RNFL, OR, and GCIPL thickness may be useful for future therapeutic implications. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:828-835.].

Retinal Neurodegeneration Associated With Peripheral Nerve Conduction and Autonomic Nerve Function in Diabetic Patients

In this study, we evaluated the correlation of retinal thickness with peripheral nerve conduction and autonomic nerve function in diabetic patients. Cross-sectional study. Medical records of 160 patients (mean age, 63.61 ± 12.52 years) with diabetes without diabetic retinopathy or mild nonproliferative diabetic retinopathy (NPDR) were reviewed. The mean retinal thickness of the parafoveal area and ganglion cell/inner plexiform layer (GC-IPL) thickness in 6 macular regions were measured using optical coherence tomography. Peripheral nerve conduction studies were conducted on peroneal and posterior tibial motor nerves and the sural sensory nerve. Five cardiovascular autonomic function tests were performed. We classified patients into groups by severity of peripheral neuropathy and autonomic dysfunction and analyzed the correlations with mean retinal thickness. The mean retinal thickness of the parafovea was 315.05 ± 12.70μm and mean macular GC-IPL thickness was 79.89 ± 4.70μm. Macular GC-IPL thickness showed significant correlation with peripheral nerve conduction (no peripheral neuropathy vs definite peripheral neuropathy: 82.0 ± 4.8μm vs 75.2 ± 3.8μm, P < .001). GC-IPL thickness decreased with severity of autonomic nerve dysfunction (no/mild dysfunction vs severe dysfunction: 81.2 ± 6.6μm vs 77.6 ± 5.9μm, P= .005). There was no significant correlation between the retinal thickness of the parafovea and electrodiagnostic tests. The decrease of GC-IPL thickness was positively correlated with both peripheral nerve conduction and autonomic nerve function in diabetic patients who presented with no diabetic retinopathy or mild NPDR.