Macular Ganglion Cell Layer Thickness Research Articles

The Analysis of Peripapillary RNFL, Macula and Macular Ganglion Cell Layer Thickness in Patients with Monocular Amblyopia Using SD-OCT

Purpose: To determine whether retinal nerve fiber layer (RNFL), macula and macular ganglion cell layer (mGCL)-inner plexiform layer (IPL) thickness differ in the amblyopic and normal fellow eyes of unilateral amblyopic patients using spectral domain optical coherence tomography (SD-OCT). Methods: 80 patients with 160 eyes were included in this study; the distribution of patients was 17 patients with strabismic amblyopia, 17 patients with strabismic non-amblyopia, 23 patients with anisometropic amblyopia, and 23 patients with anisometropic non-amblyopia. Macular, RNFL, and mGCL-IPL thickness were obtained by SD-OCT, and the interocular thickness differences of each group were analyzed. After treatment, the changes of OCT parameters were evaluated in amblyopic patients. Results: Average macular, average RNFL, and average mGCL-IPL thickness of amblyopic eyes were thicker than for normal fellow eyes in amblyopic patients (40 patients total; p < 0.001, p < 0.001, p = 0.002, respectively). In 23 patients with anisometropic amblyopia, average macular, average RNFL, and average mGCL-IPL thickness of amblyopic eyes were thicker than the normal fellow eye (p = 0.008, p < 0.001, p = 0.002). In the 17 patients with strabismic amblyopia, average macular and average RNFL thickness of amblyopic eyes were thicker than the normal fellow eye (p = 0.016, p < 0.006, respectively). No interocular thickness differences were observed in the control groups. Interocular differences between amblyopic and normal eyes remained unchanged after the amblyopic eyes were treated. Conclusions: Average RNFL and average mGCL-IPL thickness of amblyopic eyes were thicker than normal fellow eyes, but no differences were observed for macular in amblyopic patients. There was no change in the OCT parameter in amblyopic eyes after treatment. J Korean Ophthalmol Soc 2016;57(1):98-105

Correlation between Retinal Vessel Calibre and Neurodegeneration in Patients with Type 2 Diabetes Mellitus in the European Consortium for the Early Treatment of Diabetic Retinopathy (EUROCONDOR)

Purpose: To investigate the correlation between retinal vessel calibre and measurements of neurodegeneration in patients with type 2 diabetes (T2D) and no or early diabetic retinopathy (DR). Methods: Baseline data on 440 patients with T2D from the EUROCONDOR clinical trial were used. DR was graded according to the Early Treatment of Diabetic Retinopathy Study (ETDRS) scale, and patients with ETDRS levels 10-35 were included. Retinal vessel diameters were measured by semi-automatic software. Calibres were summarized into central retinal artery and vein equivalents (CRAE and CRVE). Results: Median age and diabetes duration were 64.0 and 10.3 years, respectively. ETDRS levels were 10 (42.3%), 20 (27.5%) and 35 (30.2%). The median CRAE and CRVE were 146.7 and 215.3 µm, respectively. CRAE did not differ according to ETRDS level (p = 0.12), but wider CRVE were found in patients with higher ETDRS levels (p = 0.04). In a multivariable linear regression model, CRAE was associated with macular ganglion cell layer thickness (coefficient 0.27 per micrometre, p < 0.01), and CRVE was correlated with macular retinal thickness (coefficient -0.07 per micrometre, p = 0.04) and retinal nerve fibre layer thickness at the optic disc (coefficient 0.32 per micrometre, p < 0.01). Conclusion: Retinal vessel calibre was independently associated with structural changes of the neuroretina in patients with no or early DR.

Macular Retinal Ganglion Cell Layer Thickness Is Not Reduced in Patients with Obstructive Sleep Apnea

Purpose: To evaluate macular ganglion cell layer (GCL) and ganglion cell-inner plexiform layer (GCIPL) thicknesses in patients with obstructive sleep apnea (OSA) syndrome. Methods: 73 OSA patients and 67 age-matched controls were consecutively and prospectively enrolled. All participants underwent at least one reliable standard automated perimetry (SAP) and were imaged with spectral-domain optical coherence tomography (OCT) using two different devices. The OCT parameters were compared between groups, and Pearson correlations between main indices of SAP and OCT parameters were calculated. Results: The pattern standard deviation of SAP was higher in the OSA group (p = 0.001). Mean GCIPL thickness was 82.99 ± 10.30 and 80.78 ± 12.15 µm in the control and OSA groups, respectively (p = 0.25), and GCL thickness was 44.93 ± 11.42 µm in the control group and 48.81 ± 10.85 µm in OSA individuals (p = 0.47). Pearson correlations between the GCIPL-GCL measurements and the main indices of SAP were not significant. Conclusions: Neither GCIPL nor GCL thickness were reduced in OSA subjects compared with healthy individuals. Retinal sensitivity evaluated with SAP was however decreased in OSA patients.

Retinal Ganglion Cell Atrophy in Homonymous Hemianopia due to Acquired Occipital Lesions Observed Using Cirrus High-Definition-OCT.

Purpose. To report a reduction in macular ganglion cell layer and inner plexiform layer (GCL+IPL) thickness and circumpapillary retinal nerve fiber layer (cpRNFL) thickness using spectral-domain optical coherence tomography in patients with homonymous hemianopia due to posterior cerebral artery (PCA) stroke. Methods. Seven patients with PCA stroke were examined using Cirrus high-definition-OCT. The GCL+IPL thicknesses were divided into the hemianopic and unaffected sides. The relationship between the time after stroke and the GCL+IPL thicknesses in the hemianopic side was evaluated. Results. The average thicknesses of the GCL+IPL were 64.6 and 82.0 μm on the hemianopic and unaffected sides, respectively, and the measurement was significantly thinner on the former side (p = 0.018). A regression analysis revealed a negative linear relationship (R 2 = 0.574, p = 0.049) between the time after stoke and the GCL+IPL thicknesses on the hemianopic side. The supratemporal and inferotemporal cpRNFL thicknesses in the eyes ipsilateral to the stroke showed a significant reduction. Conclusion. Our findings confirmed our previous observations that the degeneration of retinal ganglion cells can occur after PCA stroke. GCL+IPL thinning was demonstrated in the hemiretinae corresponding to the affected hemifields. Also, it is suggested that the retinal changes observed are progressive.

The Analysis of peripapillary retinal nerve fiber layer, macular, macular ganglion cell layer thicknesses in patients with monocular amblyopia using SD-OCT

To determine whether peripapillary retinal nerve fiber layer (PRNFL), macular, macular ganglion cell layer (MGCL) thicknesses differ in the amblyopic and normal eyes of unilateral amblyopic patients using spectral domain optical coherence tomography SD-OCT.

Acute optic neuritis: retinal ganglion cell loss precedes retinal nerve fiber thinning

Optic neuritis (ON) causes axonal loss as reflected by thinning of retinal nerve fiber layer (RNFL) and can be tracked by optical coherence tomography (OCT) about 6 months after ON onset, when swelling of optic nerve head (ONH) has vanished. Changes of macular ganglion cell layer (GCL) thickness provide another window to track the disease process in ON. GCL thinning over time in relation to RNFL change after ON remains elusive. Using OCT, we followed 4 patients with acute unilateral isolated ON for more than 9 months. A diagnosis of multiple sclerosis (MS) was established in all 4 patients. First follow-up was 2-3 weeks after ON onset, and thereafter every 2-3 months. RNFL swelling peaked during first month after acute ON, followed by rapidly reduced swelling (pseudoatrophy) during following 2 months, and thereafter successively vanished 6 months after ON onset. GCL thinning was observed 1-3 months after ON onset, i.e. already during optic disk swelling and before real RNFL thinning. The results imply that quantifying GCL thickness provides opportunities to monitor early axonal loss and ON-to-MS progression, and facilitates distinguishing real atrophy from pseudoatrophy of RNFL after acute ON.

Microcystic macular edema in optic nerve atrophy: case series

AbstractPurpose Microcystic macular edema (MME) is a new entity defined as lacunar areas of hyporeflectivity in the retinal inner nuclear layer after severe optic neuropathy (ON). Initially, MME was fortuitously discovered in optic neuritis.Methods From July 2013, we imaged all patients with ON by SD OCT. Retinal nerve fiber layer thickness (RNFLT), macular cube thickness (MCT) and retinal ganglion cell layer thickness (RGCLT) were assessed. Studied parameters included also the delay between onset of ON and detection of MME and correlation of the visual field defect to the MME topography.Results Sixteeen patients (19 eyes) exhibited MME. Etiologies of ON were compressive (7), degenerative (4), inflammatory (3), ischemic (1), and hereditary (1). There were 9 women and 7 men, mean age at diagnosis being 34.1 years. Visual acuity ranged from NLP to 12/10 (median 4/10). Mean RNFLT was 61.6µm [97+/‐10µm], mean MCT 271.37µm [261+/‐18µm] and mean RGCLT 57.22µm [82+/‐7µm]. The time from diagnosis until MME detection ranged from 4 months to 23 years. A good correlation was found between the zone of retinal atrophy on infrared photography and MME distribution. However, only 4/16 visual field defects correlated to the MME topography.Conclusion MME can occur as early as 4 months after ON (ocular trauma in our series) and can persist as late as 23 years after the onset of ON. MME is not only related to inflammatory ON, as postulated initially, but is a nonspecific manifestation from ON of any etiology. The precise mechanism leading to MME is unknown but trans‐synaptic retrograde degeneration is likely. Why only 10% of patients with ON exhibit MME is unknown, but MME might be a transient phenomenon. Further clinical and experimental studies are needed to answer these questions.

Relation between macular retinal ganglion cell/inner plexiform layer thickness and multifocal electroretinogram measures in experimental glaucoma.

We investigated relations between macular retinal ganglion cell plus inner plexiform layer (RGC+IPL) thickness and macular retinal function revealed by multifocal electroretinonography (mfERG) in a nonhuman primate model of experimental glaucoma. Retinal ganglion cell (RGC) structure and function were followed with spectral-domain optical coherence tomography (SD-OCT) and ERGs in five macaques with unilateral experimental glaucoma. Linear regression was used to study correlations in control (Con) and experimental (Exp) eyes between peripapillary retinal nerve fiber layer (RNFL) thickness, macular RGC+IPL thickness, multifocal photopic negative response (mfPhNR) and high-frequency multifocal oscillatory potentials (mfOP) in slow-sequence mfERG, and low-frequency component (mfLFC) in global-flash mfERG. We used ANOVA and paired t-tests to compare glaucoma-related mfERG changes between superior and inferior hemifields, foveal hexagon, inner three rings, and four quadrants of macula. Average macular RGC+IPL and temporal RNFL thickness were strongly correlated (r(2) = 0.90, P < 0.001). In hexagon-by-hexagon analysis, all three mfERG measures were correlated (P < 0.001) with RGC+IPL thickness for Con (r(2), 0.33-0.51) and Exp eyes (r(2), 0.17-0.35). The RGC structural and functional metrics decreased as eccentricity increased. The reduction in amplitude of mfERG measures in Exp eyes relative to Con eyes was proportionally greater, in general, than the relative thinning of RGC+IPL at the same location for eyes in which structural loss was not evident, or mild to moderate. Although not statistically significant, percent amplitude reduction of mfERG measures was greatest in the inferior temporal quadrant. Macular RGC+IPL thickness and mfERG measures of RGC function can be complementary tools in assessing glaucomatous neuropathy.

Retinal vessel diameters decrease with macular ganglion cell layer thickness in autosomal dominant optic atrophy and in healthy subjects

To investigate retinal trunk vessel diameters in subjects with autosomal dominant optic atrophy (ADOA) and mutation-free healthy relatives. This cross-sectional study included 52 ADOA patients with the optic atrophy 1 (OPA1) exon 28 (c.2826_2836delinsGGATGCTCCA) mutation (age 8.6-83.5 years) (best-corrected visual acuity (BCVA) 8-94 Early Treatment Diabetic Retinopathy Study (ETDRS) letters) and 55 mutation-free first-degree healthy relatives (age 8.9-68.7 years, BCVA 80-99). Analysis of fundus photographs provided integrated magnification-corrected measures of retinal vessel diameters (central retinal artery equivalent, CRAE, and central retinal vein equivalent, CRVE). Statistical analysis was corrected for age, gender, spherical equivalent refraction, axial length and mean arterial blood pressure (MABP) in a mixed model analysis. Retinal arteries and veins were thinner in ADOA than in healthy controls (CRAE (mean ± 2 standard deviations (SD)) 153.9 ± 41.0 μm and CRVE 236.1 ± 42.0 μm in ADOA, CRAE 172.5 ± 25.0 μm (p = 0.0004) and CRVE 254.2 ± 37.6 μm (p = 0.0019) in healthy controls). MABP was comparable in the two groups (p = 0.18), and in both groups, CRAE decreased with increasing MABP (p = 0.01 and p < 0.0001, respectively). In ADOA, CRAE and CRVE decreased with age (p = 0.011 and p = 0.020, respectively) and CRAE decreased with decreasing BCVA (p = 0.011). In patients with ADOA and in healthy controls, CRAE decreased with decreasing average macular ganglion cell-inner plexiform layer (GC-IPL) thickness (p = 0.0017 and p = 0.0057, respectively). Narrow retinal arteries and veins were associated not only with the severity of ADOA but with ganglion cell volume in patients with ADOA and in healthy subjects. This suggests that narrow vessels are a consequence rather than the cause of inner retinal hypoplasia or atrophy, although longitudinal studies are needed to confirm this hypothesis.

Comparison of OCT Parameters between the Dominant and Nondominant Eye

Purpose: To evaluate the anatomical difference between the dominant and nondominant eyes in healthy, young adults by measuring macular, peripapillary retinal nerve fiber layer (PRNFL), and macular ganglion cell layer (MGCL) thicknesses. Methods: Two hundred healthy adults were recruited and assessed for ocular dominance using ‘a hole in the card test’. PRNFL, macular and MGCL thicknesses of both eyes were measured using spectral domain optical coherence tomography (OCT). Results: There were no statistically significant differences for average thicknesses of MGCL in each of the six areas between the dominant and nondominant eyes. No difference was observed between temporal, inferior, average PRNFL thickness and macular thickness in dominant and nondominant eyes. Conclusions: There was no intraocular anatomical difference between the dominant and nondominant eyes in healthy, young adults. J Korean Ophthalmol Soc 2014;55(11):1687-1692

One-year follow-up of macular ganglion cell layer and peripapillary retinal nerve fibre layer thickness changes after panretinal photocoagulation

Background/aimsTo assess the changes of ganglion cell–inner plexiform layer (GCIPL) thickness, retinal nerve fibre layer (RNFL) thickness, and central subfield thickness (CST) after panretinal photocoagulation (PRP) in diabetic retinopathy for...

Pattern electroretinogram in neuromyelitis optica and multiple sclerosis with or without optic neuritis and its correlation with FD-OCT and perimetry

To evaluate the ability of transient pattern electroretinogram (PERG) parameters to differentiate between eyes of patients with neuromyelitis optica (NMO), longitudinally extensive transverse myelitis (LETM), multiple sclerosis with optic neuritis (MS + ON), multiple sclerosis without optic neuritis (MS - ON), and controls, to compare PERG and OCT with regard to discrimination ability, and to assess the correlation between PERG, FD-OCT, and visual field measurements (VFs). Visual field measurements and full-field stimulation PERGs based on both 48- and 14-min checks were obtained from patients with MS (n = 28), NMO (n = 20), LETM (n = 18), and controls (n = 26). In addition, FD-OCT peripapillary retinal nerve fiber layer (RNFL) and segmented macular layer measurements were obtained and their correlation coefficients were determined. Compared to controls, PERG amplitude measurements were significantly reduced in eyes with NMO and MS + ON, but not in eyes with LETM and MS - ON. PERG amplitudes were significantly smaller in NMO and MS + ON eyes than in MS - ON eyes. PERG and OCT performance was similar except in NMO eyes where macular thickness parameters were more efficient at detecting abnormalities. A significant correlation was found between N95 amplitude values and OCT-measured macular ganglion cell layer thickness, total retinal thickness, and temporal peripapillary RNFL thickness. PERG amplitude was also significantly associated with VF sensitivity loss. No statistically significant difference was observed with regard to the best-performing parameters of the two methods. Pattern electroretinogram measurements were able to detect RNFL loss in MS + ON and NMO eyes, with a performance comparable to OCT. PERG amplitude measurements were reasonably well correlated with OCT-measured parameters.

Visual dysfunction in multiple sclerosis correlates better with optical coherence tomography derived estimates of macular ganglion cell layer thickness than peripapillary retinal nerve fiber layer thickness

Background: Post-mortem analyses of multiple sclerosis (MS) eyes demonstrate prominent retinal neuronal ganglion cell layer (GCL) loss, in addition to related axonal retinal nerve fiber layer (RNFL) loss. Despite this, clinical correlations of retinal neuronal layers remain largely unexplored in MS. Objectives: To determine if MS patients exhibit in vivo retinal neuronal GCL loss, deeper retinal neuronal loss, and investigate correlations between retinal layer thicknesses, MS clinical subtype and validated clinical measures. Methods: Cirrus HD-optical coherence tomography (OCT), utilizing automated intra-retinal layer segmentation, was performed in 132 MS patients and 78 healthy controls. MS classification, Expanded Disability Status Scale (EDSS) and visual function were recorded in study subjects. Results: GCL+inner plexiform layer (GCIP) was thinner in relapsing–remitting MS (RRMS; n = 96, 71.6 µm), secondary progressive MS (SPMS; n = 20, 66.4 µm) and primary progressive MS (PPMS; n = 16, 74.1 µm) than in healthy controls (81.8 µm; p < 0.001 for all). GCIP thickness was most decreased in SPMS, and although GCIP thickness correlated significantly with disease duration, after adjusting for this, GCIP thickness remained significantly lower in SPMS than RRMS. GCIP thickness correlated significantly, and better than RNFL thickness, with EDSS, high-contrast, 2.5% low-contrast and 1.25% low-contrast letter acuity in MS. 13.6% of patients also demonstrated inner or outer nuclear layer thinning. Conclusions: OCT segmentation demonstrates in vivo GCIP thinning in all MS subtypes. GCIP thickness demonstrates better structure-function correlations (with vision and disability) in MS than RNFL thickness. In addition to commonly observed RNFL/GCIP thinning, retinal inner and outer nuclear layer thinning occur in MS.