Mean Ganglion Cell-inner Plexiform Layer Thickness Research Articles

Retinal neurodegeneration in diabetic retinopathy with systemic hypertension.

To identify the impact of hypertension (HTN) on inner retinal layer thickness in patients with diabetic retinopathy (DR). In this retrospective cross-sectional study, participants were divided into three groups: type 2 diabetes patients without DR (DM group), patients with DR (DR group), and patients with both DR and HTN (DR+HTN group). The peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell-inner plexiform layer (GC-IPL) thicknesses, measured using optical coherence tomography, were compared among the groups. A total of 470 eyes were enrolled: 224 eyes in the DM group, 131 eyes in the DR group, and 115 eyes in the DR+HTN group. The mean RNFL thicknesses were 95.0 ± 7.7, 92.5 ± 10.1, and 89.2 ± 11.2μm, and the mean GC-IPL thicknesses were 84.0 ± 5.7, 82.0 ± 7.6, and 79.2 ± 8.1μm in each group, respectively (all P < 0.001). In the DR+HTN group, the DR stage showed a significant association with pRNFL (B = - 5.38, P = 0.014) and GC-IPL (B = - 5.18, P = 0.001) thicknesses in multivariate analyses. Subgroup analyses revealed that pRNFL (P = 0.007) and GC-IPL (P = 0.005) thicknesses decreased significantly as DR progressed only in the DR+HTN group. Patients with both DR and HTN exhibited much thinner pRNFL and GC-IPL, compared with patients with DR only. These results may have been related to the amplified diabetic retinal neurodegeneration and synergistic impact of ischemia in DR patients with concurrent HTN. Additionally, the progression of DR resulted in more severe inner retinal damage when combined with HTN.

Optical coherence tomography of the macular ganglion cell layer in children with neurofibromatosis type 1 is a useful tool in the assessment for optic pathway gliomas.

Optic pathway glioma (OPG) is a feared complication to neurofibromatosis type 1 (NF1) since it can cause visual impairment in young children. The main goal of screening is to detect symptomatic OPGs that require treatment. Optical coherence tomography (OCT) has been suggested as a tool for detection of neuro-retinal damage. To investigate whether the ganglion cell layer assessed by OCT is a reliable measure to identify and detect relapses of symptomatic OPGs in children with NF1. Children (3-6 years) with NF1, with and without known OPG and children with sporadic OPG (S-OPG) resident in the Stockholm area, were invited and followed in a prospective study during a three-year period. Brain magnetic resonance tomography (MRI) had been performed in children with symptoms of OPG. Outcome measures were VA in logMAR, visual field index (VFI), average thicknesses of the ganglion cell-inner plexiform layer (GC-IPL), and peripapillary retinal nerve fiber layer (pRNFL). There were 25 children with MRI-verified OPG and 52 with NF1 without symptomatic OPG. Eyes from NF1 patients without symptoms of OPG showed significantly better results in all four analyzed parameters compared to eyes with NF1-associated OPG. Mean GC-IPL measurements seemed stable and reliable, significantly correlated to pRNFL (correlation coefficient (r) = 0.662, confidence interval (CI) = .507 to .773 p<0.001), VA (r = -0.661, CI = -7.45 to -.551, p<0.001) and VFI (r = 0.644, CI = .452 to .774, p<0.001). GC-IPL measurements were easy to obtain and acquired at considerably younger age than pRNFL (5.6±1.5 vs 6.8±1.3; p<0.001). The mean GC-IPL thickness could distinguish well between eyes with OPG and eyes without symptomatic OPG in children with NF1. As thinning of GC-IPL assessed with OCT could indicate underlying OPG, it should be included in the screening protocol of children with questionable VA measurements and in particular in children with NF1.

Retinal nerve fiber layer and ganglion cell complex thickness in diabetic smokers without diabetic retinopathy

Purpose To compare the thickness of the retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GC-IPL) in smoker and nonsmoker diabetics without diabetic retinopathy. Materials and Methods Patients with diabetes were divided into two groups according to their smoking status: Group 1 consisted of 38 smoker diabetics who had chronically smoked more than 20 cigarettes per day for more than five years; Group 2 consisted of 38 nonsmoker diabetics. After a detailed ophthalmologic examination, the mean and regional (superior, supratemporal, inferior, inferotemporal, temporal, nasal, superonasal, and inferonasal) RNFL and GC-IPL thicknesses were measured with spectral-domain optic coherence tomography (SD-OCT) and compared between groups. Results The mean age was 54.7 ± 10.5 and 51.2 ± 9.7 years in the smoker and nonsmoker groups, respectively (p = 0.14). Gender, duration of diabetes, and the mean axial length were similar between groups (p:0.43, p:0.54, p: 0.52, respectively). Mean RNFL thickness was 89.1 ± 8.0 µm in the smoker group and 93.4 ± 7.0 µm in the nonsmoker group, and it was significantly thinner in the smoker group (p = 0.01). The temporal RNFL thickness in the smoker group was thinner than in the nonsmoker group (p = 0.02). There was no difference in superior, inferior, and nasal RNFL thicknesses between the groups (p = 0.31, p = 0.12, p = 0.39, respectively). The mean macular GC-IPL thickness of the smoker and nonsmoker groups was 78.53 ± 15.74 µm and 83.08 ± 5.85 µm, respectively (p = 0.09). Superior, superonasal, inferonasal, inferior, inferotemporal, and superotemporal quadrant GC-IPL thicknesses were similar between the groups (p = 0.07, p = 0.60, p = 0.55, p = 0.77, p = 0.71, p = 0.08, respectively). The groups showed no difference in minimum GC-IPL thickness (p = 0.43). There was a significant negative correlation between smoking exposure and mean, inferior quadrant RNFL thicknesses in the smoker group (p = 0.04, r= −0.32, and p = 0.01, r= −0.39, respectively). Conclusion Mean RNFL thickness was significantly thinner in smoker diabetics. Although not statistically significant, especially mean, superior, and superotemporal GC-IPL was thinner in smoker diabetics. The results suggest a potential association between the coexistence of diabetes and smoking with alterations in RNFL and GC-IPL thickness.

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

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

Changes in and the association of retinal blood perfusion and retinal nerves in diabetic patients without retinopathy.

To explore intraretinal blood flow perfusion and nerve changes, as well as the correlation between them, in diabetic patients without diabetic retinopathy (NDR). Eighty-six NDR patients (86 eyes) who attended the ophthalmology clinic between December 2019 and December 2021 were included. Sixty-four eyes of 64 healthy examined controls in the same period were selected as the control group. The patients underwent routine ophthalmological examination, optical coherence tomography (OCT) and OCT angiography. The average thickness, minimum thickness and thickness of each quadrant except for the superior temporal quadrant of the ganglion cell-inner plexiform layer (GCIPL) in the macular area of the affected eyes in the NDR group were lower than that of the tested eyes in the control group (P < 0.05). The average retinal nerve fibre layer (RNFL) thickness of the NDR group and the superior, inferior and nasal quadrants around the optic disc of the affected eyes in the NDR group were lower compared with the tested eyes in the control group (P < 0.001, P = 0.003, P = 0.001, P = 0.009). The mean vessel length density in the parafoveal and perifoveal areas in the NDR group was positively associated with the mean GCIPL thickness in the macular area (ρ = 0.265, ρ = 0.257 and P < 0.001). No blood flow perfusion parameters in the NDR group were correlated with the RNFL thickness of the corresponding quadrant around the optic disc (P > 0.05). In diabetic patients without diabetic retinopathy, the superficial retinal vessel density in the macular area positively correlated with GCIPL thickness, and the superficial retinal vessel density around the optic disc was not correlated with RNFL thickness.

Different characteristics of retinal damage between chronic hypertension and hypertensive retinopathy

The purpose of this study was to identify how chronic hypertension (HTN) and hypertensive retinopathy (HTNR) have different effects on retinal damage including inner retinal thinning and microvasculature impairment. The subjects were divided into three groups: controls, HTN patients without HTNR (HTN group), and patients with relieved HTNR (HTNR group). The ganglion cell-inner plexiform layer (GC-IPL) thickness, vessel density (VD), and GC-IPL/VD ratio were compared among the groups. A total of 241 eyes were enrolled; 101 in the control group, 92 in the HTN group, and 48 in the HTNR group. The mean GC-IPL thicknesses were 83.5 ± 5.7, 82.1 ± 6.2, and 75.9 ± 10.7 μm in each group, respectively (P < 0.001). The VD was 20.5 ± 1.3, 19.6 ± 1.4, and 19.5 ± 1.6 mm−1 in each group, respectively (P = 0.001). The GC-IPL/VD ratio was 4.10 ± 0.33, 4.20 ± 0.40, and 3.88 ± 0.56 in each group, respectively (P < 0.001). In the HTNR group, HTN duration (B = 0.054, P = 0.013) and systolic blood pressure (SBP) (B = −0.012, P = 0.004) were significantly associated with the GC-IPL/VD ratio. In conclusion, inner retinal reduction and retinal microvasculature impairment were observed in patients with HTN and HTNR, and the GC-IPL/VD ratio of HTNR patients was significantly lower than that of HTN patients, indicating more prominent damage to the inner retina than microvasculature in HTNR patients. Additionally, the GC-IPL/VD ratio was significantly associated with SBP in HTNR patients, so more strict BP control is required in HTNR patients.

GANGLION CELL-INNER PLEXIFORM LAYER THICKNESS IN EYES WITH NONEXUDATIVE AGE-RELATED MACULAR DEGENERATION OF DIFFERENT DRUSEN SUBTYPES.

We sought to investigate the ganglion cell-inner plexiform layer (GCIPL) thickness in eyes with nonexudative age-related macular degeneration. We classified eyes into four categories-pachydrusen, soft drusen, subretinal drusenoid deposit (SDD), and soft drusen with SDD-and compared the baseline mean macular GCIPL thickness according to the Early Treatment Diabetic Retinopathy Study grid and its change between groups. We classified 53, 29, 36, and 34 eyes into the four categories, respectively. The mean GCIPL thickness values in the 3-mm area were 82.61 ± 9.54 µm for the pachydrusen group, 79.11 ± 10.26 µm for the soft drusen group, 77.72 ± 6.04 µm for the SDD group, and 71.63 ± 8.69 µm for the soft drusen with SDD group (P < 0.001). The soft drusen with the SDD group showed a greater change in GCIPL thickness (-2.50 ± 0.29 µm/year) in the 3-mm area as compared with the pachydrusen group (-0.18 ± 0.35 µm/year), soft drusen group (-0.55 ± 0.36 µm/year), and SDD group (-0.55 ± 0.37) (all P < 0.001). The GCIPL thickness varied according to the type of nonexudative age-related macular degeneration. The thinner baseline GCIPL and its greater change in eyes with soft drusen with SDD may suggest that these eyes are experiencing more prominent neuroretinal degeneration in the central 3-mm area than those in the other groups.

Optical Coherence Tomography Is Associated With Cognitive Impairment in Multiple Sclerosis.

Optical coherence tomography (OCT) is a sensitive method for quantifying retinal neuronal and axonal structures. Reductions in retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) thicknesses have a reported association with white and grey matter atrophy in multiple sclerosis (MS). We hypothesized that the thinning of intraretinal layer measurements associates with cognitive decline in MS patients with no prior event of optic neuritis (ON). OCT and NeuroTrax computerized cognitive assessments were performed in 204 relapsing remitting MS patients with no history of ON or other conditions affecting the eye. Data were collected between 2010 and 2020 and retrospectively analyzed. Correlations were examined between cognitive performance and a lower RNFL or GCIPL thickness. A multilinear regression model was generated to assess the significance of these correlations regarding the disability score and disease duration. The 204 study participants had a mean age of 40.52 ± 11.8 years (mean ± SD) and disease duration of 9.80 ± 9.40 years. The mean RNFL thickness in this whole cohort was 82.22 ± 10.85 μm and the global cognitive score was 95.32 ± 12.32. The mean GCIPL thickness measured in a subgroup of 104 patients was 74.27 ± 10.37 μm. The RNFL and GCIPL both correlated with the global cognitive score (r = 0.174, P = 0.013 and r = 0.29, P = 0.03, respectively), and with various cognitive domains. However, the GCIPL showed stronger correlations than RNFL, particularly with executive function (r = 0.29, P = 0.003), attention (r = 0.332, P = 0.001), and the information processing speed (r = 0.25, P = 0.012). These correlations remained significant after correcting for confounders. OCT measurements correlate with cognitive performance in MS patients. OCT can thus be used to evaluate central nervous system neurodegeneration in MS, as reflected by cognitive decline.

How do intracranial tumors associated with visual pathways affect quadrant and sectoral based optical coherence tomography measurements: The effect of intracranial tumors on RNFL and GC-IPL thickness.

To investigate the quantitative sectoral and regional changes of retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness in different types of intracranial tumors associated with visual pathways. This comparative retrospective study included 58 eyes of 30 patients with intracranial tumors and the data of 62 eyes of 31 healthy subjects. The RNFL and GCIPL thicknesses were analyzed using spectral-domain optical coherence tomography (OCT). The tumors were classified into ones that affect pre-geniculate and post-geniculate pathway. The mean RNFL thickness in temporal quadrant was significantly thinner in eyes with intracranial tumors affecting the pre-geniculate optic pathway compared to controls (p = 0.04). In contrast, the mean superior quadrant RNFL thickness was significantly thicker in eyes with brain tumors associated with post-geniculate optic pathway (p = 0.01). The mean GC-IPL thicknesses of the inner ring superotemporal, superonasal, inferotemporal and inferionasal sectors and outer ring superonasal and inferonasal sectors were significantly thinner in eyes with intracranial tumors affecting the pre-geniculate optic pathway compared to control eyes (p = 0.02, p = 0.001, p = 0.02, p = 0.003, p = 0.008 and p = 0.03 respectively). The results of this study showed that significant changes can be seen in the different RNFL quadrants and GC-IPL sectors in eyes with intracranial tumors affecting pre-geniculate or post-geniculate optic pathway. OCT is a very useful imaging technique to quantify these structural changes which take place during the neurodegeneration process of visual pathways in intracranial tumors.

Association of Spectral-Domain OCT With Long-term Disability Worsening in Multiple Sclerosis

To evaluate whether a retinal spectral-domain optical coherence tomography (SD-OCT) assessment at baseline is associated with long-term disability worsening in people with multiple sclerosis (PwMS), we performed SD-OCT and Expanded Disability Status Scale (EDSS) assessments among 132 PwMS at baseline and at a median of 10 years later. In this prospective, longitudinal study, participants underwent SD-OCT, EDSS, and visual acuity (VA) assessments at baseline and at follow-up. Statistical analyses were performed using generalized linear regression models, adjusted for age, sex, race, multiple sclerosis (MS) subtype, and baseline disability. We defined clinically meaningful EDSS worsening as an increase of ≥2.0 if baseline EDSS score was <6.0 or an increase of ≥1.0 if baseline EDSS score was ≥6.0. A total of 132 PwMS (mean age 43 years; 106 patients with relapsing-remitting MS) were included in analyses. Median duration of follow-up was 10.4 years. In multivariable models excluding eyes with prior optic neuritis, relative to patients with an average baseline ganglion cell + inner plexiform layer (GCIPL) thickness ≥70 µm (the mean GCIPL thickness of all eyes at baseline), an average baseline GCIPL thickness <70 µm was associated with a 4-fold increased odds of meaningful EDSS worsening (adjusted odds ratio [OR] 3.97, 95% confidence interval [CI] 1.24-12.70; p = 0.02) and an almost 3-fold increased odds of low-contrast VA worsening (adjusted OR 2.93, 95% CI 1.40-6.13; p = 0.04). Lower baseline GCIPL thickness on SD-OCT is independently associated with long-term disability worsening in MS. Accordingly, SD-OCT at a single time point may help guide therapeutic decision-making among individual PwMS. This study provides Class I evidence that lower baseline GCIPL thickness on SD-OCT is independently associated with long-term disability worsening in MS.

Longitudinal changes in the ganglion cell-inner plexiform layer thickness of age-related macular degeneration.

To determine longitudinal changes of the ganglion cell-inner plexiform layer (GC-IPL) thickness in patients with non-exudative age-related macular degeneration (AMD) without other ophthalmic disease. Thirty-three eyes of 33 patients with early and intermediate non-exudative AMD (non-exudative AMD group) and 33 normal control eyes were followed for 2years, and GC-IPL thickness was measured by spectral domain optical coherence tomography at 1-year intervals. The mean rate of GC-IPL reduction was estimated using a linear mixed model and compared between two groups. The mean age of patients in the non-exudative AMD group and control groups were 68.82±6.81years and 67.73±5.87years, respectively (p=0.488). The mean GC-IPL thickness at the first visit was 76.61±16.33μm in the non-exudative AMD and 81.76±3.69μm in control group (p=0.387), and these values significantly decreased over time, with an average reduction rate of average GC-IPL -0.86μm/year in the non-exudative AMD group and -0.32μm/year in the control group. The difference between two groups was statistically significant (p<0.001), and there was also a significant interaction between group and duration in linear mixed models in mean GC-IPL thickness (p=0.001). The reduction rate of the GC-IPL thickness was greater in non-exudative AMD eyes, even at relatively early stages of the disease. Physicians should maintain awareness of the presence of non-exudative AMD in various cases of ophthalmic diseases where GC-IPL thickness evaluation is necessary.

Determinants of Optical Coherence Tomography Parameters in a Population-based Study

To study the effects of age, sex, intraocular pressure (IOP), corneal thickness, axial length (AXL), disc area, and the signal strength of the scan on optical coherence tomography (OCT) parameters of normal subjects in the L V Prasad Eye Institute-Glaucoma Epidemiological and Molecular Genetic Study (LVPEI-GLEAMS), a population-based study. Cross-sectional study. A total of 1,100 eyes (1,100 subjects) of normal adults aged between 40 and 80 years from LVPEI-GLEAMS underwent macular and optic nerve head imaging with spectral-domain OCT (SDOCT). Effect of age, sex, IOP, central corneal thickness (CCT) and AXL, disc area, and signal strength of the OCT scan on retinal nerve fiber layer (RNFL) thickness, rim area, and ganglion cell-inner plexiform layer (GC-IPL) thickness measurements were evaluated using univariate and multivariate regression models. Mean rim area, RNFL, and GC-IPL thickness were 1.31mm2 (standard deviation [SD]= 0.22), 93.7μm (SD= 9.3) and 79.6μm (SD= 8.7), respectively. Age had a negative association with RNFL thickness (coefficient:-0.18, P < .001) and GC-IPL thickness (-0.18, P < .001). GC-IPL thickness was significantly less in women than in men (-1.05, P < .001). AXL had a negative association with rim area (-0.05, P < .001). Disc area was positively associated with RNFL thickness (4.90, P < .001) and rim area (0.15, P < .001). Signal strength of OCT scan was positively associated with RNFL thickness (1.6, P < .001) and negatively associated with rim area (-0.02, P < .001). Age, sex, AXL, disc area, and signal strength of the scan were significantly associated with OCT measurements. These factors may need to be considered while interpreting the OCT parameters in pathologic conditions such as glaucoma.

Three-Year Outcomes of Second-generation Trabecular Micro-bypass Stents (iStent inject) With Phacoemulsification in Various Glaucoma Subtypes and Severities.

This longitudinal case series provides valuable long-term data on the safety and efficacy of iStent inject with concomitant cataract surgery. Patients experienced significant and durable reductions in both intraocular pressure (IOP) and medication burden through 3 years postoperative. The purpose of this study was to examine the 3-year effectiveness and safety of iStent inject second-generation trabecular micro-bypass stent implantation with concomitant phacoemulsification cataract surgery in eyes with various glaucoma subtypes and severities. This was a single-center consecutive case series. Three-year outcomes included mean IOP and medications, the proportions of eyes with IOP ≤18, ≤15, and ≤12 mm Hg, and success (absence of secondary glaucoma interventions). Safety included best-corrected visual acuity (BCVA), cup-to-disc ratio, visual field (VF) mean deviation, retinal nerve fiber layer (RNFL), and ganglion cell-inner plexiform layer (GCIPL) thickness, and adverse events. A total of 124 eyes with different glaucoma subtypes and severities were included. At 3 years postoperative, mean IOP reduced from 16.90±3.85 mm Hg preoperatively to 13.17±2.83 mm Hg (22% reduction, P<0.001) and mean medication burden decreased from 2.38±1.29 medications preoperatively to 1.16±1.22 medications (51% reduction, P<0.001). At 3 years, 96% of eyes achieved IOP ≤18 mm Hg (vs. 69% preoperatively), 80% of eyes achieved IOP ≤15 mm Hg (vs. 40% preoperatively), and 42% of eyes achieved IOP ≤12 mm Hg (vs. 7% preoperatively) with 76% of eyes eliminating ≥1 medication and 37% of eyes eliminating ≥2 medications versus preoperative medication burden. The 3-year cumulative survival rate was 74%. Postphacoemulsification BCVA improvement was preserved, and cup-to-disc ratio, VF mean deviation, and RNFL and GCIPL thickness remained stable. A favorable safety profile included no intraoperative complications and few, transient, postoperative adverse events. Significant and sustained IOP and medication reductions were achieved through 3 years after iStent inject implantation with cataract surgery in a real-world clinical population with mild-to-severe glaucoma, along with favorable safety including stable BCVA, VF, and RNFL and GCIPL thickness.

Prospective study to evaluate incidence and indicators for early detection of ethambutol toxicity

AimsTo evaluate incidence of toxic optic neuropathy in patients receiving ethambutol (EMB) for 6 months and to identify its early indicators.MethodsWe included 50 patients on anti-tubercular therapy (ATT) including EMB...

Changes in the Ganglion Cell-inner Plexiform Layer after Consecutive Intravitreal Injections of Anti-vascular Endothelial Growth Factor in Age-related Macular Degeneration Patients.

PurposeTo investigate the effect of intravitreal anti-vascular endothelial growth factor (VEGF) injections on ganglion cell-inner plexiform layer (GCIPL) thickness in patients with age-related macular degeneration (AMD).MethodsThis retrospective study included patients with continuous anti-VEGF treatment who were administered at least three consecutive injections for unilateral neovascular AMD. The GCIPL thickness of the study eyes was compared before and after treatment and with healthy fellow eyes using spectral-domain optical coherence tomography. We also evaluated best-corrected visual acuity, age, and intraocular pressure.ResultsIn total, 96 eyes of 48 patients (14 females and 34 males; mean ± standard deviation [SD] age, 70.10 ± 8.89 years) with mean number of 6.29 (SD ± 3.76) anti-VEGF injections and a mean follow-up period of 24.93 months (SD ± 19.86) were included in the study. After three consecutive intravitreal injections of anti-VEGF, the mean GCIPL thickness was significantly reduced from 70.50 (SD ± 14.06) to 65.97 (SD ± 13.91) µm. Borderline or nonsignificant decrease was also observed in GCIPL thickness for each sector. At the end of the study, the mean GCIPL thickness was further reduced to 62.56 (SD ± 16.30) µm, and significant decreases were also observed in all other sectors compared with baseline.ConclusionsIt has been observed that GCIPL thickness can decrease with only three consecutive anti-VEGF injections as well as with long-term treatment in AMD patients.

Comparison of Associations with Different Macular Inner Retinal Thickness Parameters in a Large Cohort: The UK Biobank

To describe and compare associations with macular retinal nerve fiber layer (mRNFL), ganglion cell complex (GCC), and ganglion cell-inner plexiform layer (GCIPL) thicknesses in a large cohort. Cross-sectional study. We included 42 044 participants in the UK Biobank. The mean age was 56 years. Spectral-domain OCT macular images were segmented and analyzed. Corneal-compensated intraocular pressure (IOPcc) was measured with the Ocular Response Analyzer (Reichert, Corp., Buffalo, NY). Multivariable linear regression was used to examine associations with mean mRNFL, GCC, and GCIPL thicknesses. Factors examined were age, sex, ethnicity, height, body mass index (BMI), smoking status, alcohol intake, Townsend deprivation index, education level, diabetes status, spherical equivalent, and IOPcc. Thicknesses of mRNFL, GCC, and GCIPL. We identified several novel independent associations with thinner inner retinal thickness. Thinner inner retina was associated with alcohol intake (most significant for GCIPL: -0.46 μm for daily or almost daily intake compared with special occasion only or never [95% confidence interval (CI), 0.61-0.30]; P= 1.1×10-8), greater social deprivation (most significant for GCIPL: -0.28 μm for most deprived quartile compared with least deprived quartile [95% CI, -0.42 to -0.14]; P= 6.6×10-5), lower educational attainment (most significant for mRNFL: -0.36 μm for less than O level compared with degree level [95% CI, -0.45 to 0.26]; P= 2.3×10-14), and nonwhite ethnicity (most significant for mRNFL comparing blacks with whites: -1.65 μm [95% CI, -1.86 to -1.43]; P= 2.4×10-50). Corneal-compensated intraocular pressure was associated most significantly with GCIPL (-0.04 μm/mmHg [95% CI, -0.05 to -0.03]; P= 4.0×10-10) and was not associated significantly with mRNFL (0.00 μm/mmHg [95% CI, -0.01 to 0.01]; P= 0.77). The variables examined explained a greater proportion of the variance of GCIPL (11%) than GCC (6%) or mRNFL (7%). The novel associations we identified may be important to consider when using inner retinal parameters as a diagnostic tool. Associations generally were strongest with GCIPL, particularly for IOP. This suggests that GCIPL may be the superior inner retinal biomarker for macular pathophysiologic processes and especially for glaucoma.

Comparison of peripapillary and macular choroidal thickness and ganglion cell complex thickness in glaucomatous and healthy eyes.

To assess choroidal thickness (CT) and its association with ganglion cell-inner plexiform layer thickness (GCIPLT) and retinal nerve fiber layer thickness (RNFLT) in open angle glaucoma (OAG) comparing with preperimetric glaucoma (PPG) and normal eyes. Totally 55 eyes of OAG, 40 eyes of PPG, and 40 eyes of age-matched normal eyes were studied. Peripapillary CT (PCT), macular CT (MCT), RNFLT, and GCIPLT were evaluated. Relationship between the CT with RNFLT and GCIPLT were studied. The correlation between CT and confounding variables as gender, age, intraocular pressure, and visual field mean deviation were analyzed. Mean PCT were 113.6±39.1 µm in OAG, 116.3±42.7 µm in PPG, and 148.9±41.7 µm in normal eyes. PCT and MCT was thinner in OAG compared to healthy eyes. There was a significant correlation for PCT and mean RNFLT in 1, 2, 6, and 7 clock hours of OAG eyes. The difference in PCT remained after adjusting for axial length, age, and disc area (P=0.003). No significant correlation was shown between MCT and mean GCIPLT in all eyes. PCT is thinner in OAG and PPG compared with healthy eyes. The correlation of RNFLT and PCT found in OAG and PPG is not revealed in normal eyes.

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

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

Repeatability of vessel density measurements using optical coherence tomography angiography in retinal diseases

AimTo analyse the repeatability of vessel density (VD) measurements using optical coherence tomography angiography (OCTA) in patients with retinal diseases.MethodsTwo consecutive VD measurements using OCTA were analysed prospectively in patients...

Structural and Functional Associations of Macular Microcirculation in the Ganglion Cell-Inner Plexiform Layer in Glaucoma Using Optical Coherence Tomography Angiography.

To quantify retinal microvasculature within the macular ganglion cell-inner plexiform layer (GCIPL) in primary open-angle glaucoma (POAG) and normal eyes, determine association of vessel parameters with structural and functional measures, and report diagnostic accuracy of vessel parameters. POAG and normal patients underwent 6×6 mm macula scans [Angioplex optical coherence tomography angiography (OCTA); Cirrus HD-OCT 5000]; and Humphrey Field Analyzer II-i 24-2 visual field (VF). Prototype software performed semiautomatic segmentation to create GCIPL en face images, and quantified vessel area density (VAD), vessel skeleton density (VSD), and vessel complexity index (VCI) for the macula (globally, hemifields, and 6 focal sectors). Linear regression assessed association of OCTA parameters with VF mean deviation (MD) and GCIPL thickness globally and focally. A total of 34 POAG and 21 normal eyes were studied. VAD, VSD, and VCI were reduced in POAG versus normal (0.463 vs. 0.486, P=0.00029; 0.230 vs. 0.219, P=0.0014; 1.15 vs. 1.09, P=0.0044, respectively), with a trend of worsening with increased POAG severity. Reduced global VF MD was associated with reduced VAD and VCI, controlling for age and intereye correlation (P=0.0060, 0.0080; R=0.205, 0.211). Both superior and inferior hemifield MD were associated with corresponding VAD, VSD, and VCI (all P<0.007; R ranged from 0.12 to 0.29). Global GCIPL thickness was not associated with global OCTA parameters, and only inferior sector GCIPL thickness was associated with corresponding VAD, VSD, and VCI (P<0.05; R ranged from 0.15 to 0.16). Area under curves for VAD, VSD, and VCI were fair to good (0.83, 0.79, 0.82; respectively; P<0.0001). Glaucomatous eyes had reduced GCIPL microcirculation. OCTA parameters had stronger associations with functional rather than structural measures of glaucoma. This observation deserves further study.