Ganglion Cell Layer Measurements Research Articles

Single-line macular optic coherence tomography to confirm optic neuropathies in awake infants and young children

BackgroundHandheld optical coherence tomography (HH-OCT) can image awake, young children but lacks integrated segmentation/analysis software. OCT imaging of eyes with optic neuropathies demonstrates ganglion cell layer (GCL) and ganglion cell complex (GCC) thinning, with a normal or thickened inner nuclear layer (INL). We compared pediatric normative data with GCL/INL and GCC/INL ratios from HH-OCT macular scans of awake young children with clinically diagnosed optic neuropathies. MethodsMacular HH-OCT from awake children with optic neuropathies was prospectively obtained using Bioptigen (Leica Microsystems, Wetzlar, Germany). The GCL, GCC, and INL were manually measured by two readers using ImageJ from single-line macular scans at the thickest points nasal and temporal to the fovea, respectively, and the GCL/INL and GCC/INL ratios were calculated and compared with normative data. ResultsHH-OCT images from 17 right eyes of 17 children (mean age, 4.3 ± 2.9 years) with optic neuropathies were analyzed. Mean nasal (17 eyes) and temporal (16 eyes) GCL/INL ratios with optic neuropathies were 0.44 ± 0.38 (95% CI, 0.26-0.62) and 0.26 ± 0.22 (95% CI, 0.15-0.36), respectively. Corresponding normative GCL/INL ratios are 1.26 ± 0.20 (95% CI, 1.19-1.34) and 1.23 ± 0.27 (95% CI, 1.13-1.33), respectively (P < 0.0001). Severe thinning precluded GCL measurements in 2 eyes nasally and 5 eyes temporally, resulting in GCL measurements of zero. Mean nasal (17 eyes) and temporal (16 eyes) GCC/INL ratios were 1.93 ± 0.70 (95% CI,1.60-2.27) and 1.67 ± 0.44 (95% CI,1.46-1.87). Corresponding normative ratios are 2.85 ± 0.38 (95% CI, 2.71-2.99) and 2.87 ± 0.42 (95% CI, 2.70-3.03), respectively (P < 0.0001). ConclusionsGCL/INL and GCC/INL ratios calculated from single-line macular HH-OCT scans in awake young children with optic neuropathies differ significantly from normative values and may thus have utility in helping to establish a diagnosis of optic neuropathy.

A Case of Pituitary Rathke’s Cleft Cyst Associated with Decreased Visual Acuity after Cataract Surgery

Purpose: To report a case of suprasellar Rathke's cleft cyst accompanying visual field defect found in a patient complaining of decreased visual acuity after cataract surgery.Case Summary: A 62-year-old male patient who showed a best-corrected visual acuity (BCVA) of 0.6 after left eye cataract surgery visited our hospital two months after surgery with decreased vision. He showed a best corrected visual acuity of 0.2, did not have relative afferent pupillary defect, and there were no specific findings on fundus examination. In the full field perimetry test, partial visual field loss in superior temporal quadrants were found in both eyes, being more prominent in left eye. In ganglion cell layer measurements using optical coherence tomography, a symmetric thinning in the thickness of the nasal ganglion cell layer was observed in both eyes, which was consistent with the visual field test. It was discovered that a liquid solid mass with a diameter of 21 mm in the upper part of the pituitary gland was compressing the optic chiasm in orbit magnetic resonance imaging. The patient was then referred to neurosurgery for pituitary surgery using transsphenoidal approach and diagnosed with Rathke's cleft cyst on histopathologic examination. Three months after surgery, the BCVA has increased to 0.5 and the visual field test showed no scotoma.Conclusions: We report a case that Rathke's cleft cyst above the sella turcica inducing visual disturbances, emphasizing the importance of early detection and treatment through neuroophthalmological evaluation in a patient presenting with unexplained visual impairment.

Agreement between Two Swept-source Optical Coherence Tomography: Optic Nerve Head, Retinal Nerve Fiber Layer and Ganglion Cell Layers in Healthy Eyes.

Precision of optical coherence tomography (OCT) measurements of the optic nerve head (ONH), retinal nerve fiber layer (RNFL), and macular ganglion cell layer (GCL) is essential for the diagnosis and monitoring of glaucoma. The purpose of this research was to evaluate the repeatability and reproducibility of retinal and ONH parameters measured with two identical swept-source optical coherence devices. A cross-sectional study was conducted. A total of 30 eyes of 15 healthy subjects were included. Two technicians performed four OCT-wide protocol scans in the same visit using two identical Triton swept-source OCT (DRI-OCT) instruments. The interdevice and interobserver reproducibility and the repeatability of both instruments for all ONH, RNFL, and macular GCL parameters were evaluated by the intraclass correlation coefficient (ICC). Additionally, Bland-Altman test analysis was used for repeatability and reproducibility measurements. Intraclass correlation coefficient (ICCs) of the ONH, RNFL, and GCL measurements were excellent for repeatability and interdevice reproducibility (>0.9). Interobserver reproducibility was good for all parameters except for RNFL clock hour 11 (ICC = 0.72). The variability of the average RNFL was from -4.103 to 4.97 µm, with a mean percentage of the difference (PD) of 0.37 ± 2.03%. Among GCL parameters, the greatest variability was found in the inferior sector (PD = -0.88 ± 5.39%, limits of agreement (LoA) = -8.345-7.078 μm). Using two identical swept-source OCT instruments for the evaluation of the structural parameters of the ONH, RNFL, and macular GCL showed high repeatability and reproducibility. This allows the clinician to make a therapeutic decision based on OCT findings coupled with the clinical evaluation of the patient. When evaluating RNFL clock hours measurements, interobserver reproducibility might decrease. The understanding of measurement variability while using different devices and the impact of the observer capturing the images, is clinically relevant. Prada AM, Tello A, Rangel CM, et al. Agreement between Two Swept-source Optical Coherence Tomography: Optic Nerve Head, Retinal Nerve Fiber Layer and Ganglion Cell Layers in Healthy Eyes. J Curr Glaucoma Pract 2023;17(2):85-90.

Optic disc, macula and ganglion cell layer measurements obtained with optical coherence tomography in patients with thyroid disorder

Purpose: The aim of this study was to compare retinal nerve layer thickness, central macula thickness and ganglion cell layer measurements using optical coherence tomography (OCT) between thyroid patients and age- and sex-matched healthy controls.&#x0D; Materials and Methods: Eighty eyes of 80 patients in the thyroid patient group and 48 eyes of 48 patients in the control group were included in the study. After evaluating the exclusion criteria, visual acuity, anterior segment biomicroscopy, intraocular pressure, fundoscopy and spectral field optic coherence tomography (SF-OCT) imaging tests were performed on all patients included in the study. These data have been recorded. Central macular thickness (CMT), retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) measurements were evaluated by statistical methods for both groups.&#x0D; Results: There was no statistically significant difference between the demographic data of the groups included in the study. IOP measurements were found to be statistically significantly higher in the patient group compared to the control group. CMT values were 258.2±16.1 µm in the patient group and 273.1±23.8 µm in the control group, and statistically significant differences were observed between the groups. &#x0D; Conclusion: The findings supports that changes in the optic nerve and macula develop before vision loss in TO patients compared to the healthy control group. We can follow TO patients more objectively and reliably and make treatment planning more accurately by adding OCT, which is a noninvasive test, to our clinical practice, since structural changes develop before functional deterioration in TO patients.

Posterior pole analysis and ganglion cell layer measurements in Alzheimer’s disease

Aim To compare posterior pole analysis and ganglion cell layer (GCL) of patients with Alzheimer’s disease (AD) and controls. Method Patients diagnosed with mild and moderate AD included in the study. Posterior pole analysis and GCL measurements were investigated by dividing the macula into superior and inferior hemifields and 5 corresponding zones. Results There were no significant differences between groups for retinal thickness measurements in any retinal zone. GCL measurements showed lower measurements in moderate AD group for GCL thickness in the superior zone 2 (p:0.025) and inferior zone 2 (p=0.048) compared to mild AD and controls. A moderate AD status was found to cause a decrease of 5.349 µm in the GCL-SZ2 value [p:0.037]. Conclusion GCL measurements in the moderate AD group show significant thinning in superior and inferior Zone 2, which may be a biomarker for AD.

Retinal ganglion cell layer thickness and volume measured by OCT changes with age, sex, and axial length in a healthy population

BackgroundThe ganglion cell layer (GCL) measurements with Optical Coherence Tomography (OCT) are important for both ophthalmologists and neurologists because of their association with many ophthalmic and neurological diseases. Different factors can affect these measurements, such as brain pathologies, ocular axial length (AL) as well as age and sex. Studies conducted to measure the GCL have overlooked many of these factors. The purpose of this study is to examine the effect of age, sex, and AL on normal retinal GCL thickness and volume in a healthy population without any neurological diseases.MethodsA prospective cross-sectional study was designed to measure GCL thickness and total volume with OCT with automated segmentation and manual correction where needed. Visual acuity, AL, and autorefraction were also measured. A mixed linear model was used to determine the association of the effect of the various parameters on the GCL thickness and volume.ResultsOne hundred and sixteen eyes of 60 subjects (12–76 years of age, 55% female) were examined of which 77% had 0 ± 2 D of spherical equivalent, and mean axial length was 23.86 mm. About 25% of the OCT-automated GCL measurements required manual correction. GCL thickness did not differ in similar anatomic regions in right and left eyes (P > 0.05). GCL volume was greater in males relative to females after adjustment for age and axial length (1.13 ± 0.07 mm3 for males vs 1.09 ± 0.09 mm3 for females; P = 0.031). GCL thickness differed between males and females in the inner retinal ring (P = 0.025) but not in the outer ring (P = 0.66). GCL volume declined with age (P = 0.031) but not after adjustment for sex and axial length (P = 0.138). GCL volume declined with longer axial length after adjustment for age and sex (P = 0.048).ConclusionAge, sex and axial length should be taken into consideration when measuring the GCL thickness and volume with OCT. Automated OCT segmentation should be reviewed for manual adjustments.

Comparison of Different Machine Learning Classifiers for Glaucoma Diagnosis Based on Spectralis OCT.

Early detection is important in glaucoma management. By using optical coherence tomography (OCT), the subtle structural changes caused by glaucoma can be detected. Though OCT provided abundant parameters for comprehensive information, clinicians may be confused once the results conflict. Machine learning classifiers (MLCs) are good tools for considering numerous parameters and generating reliable diagnoses in glaucoma practice. Here we aim to compare different MLCs based on Spectralis OCT parameters, including circumpapillary retinal nerve fiber layer (cRNFL) thickness, Bruch’s membrane opening-minimum rim width (BMO-MRW), Early Treatment Diabetes Retinopathy Study (ETDRS) macular thickness, and posterior pole asymmetry analysis (PPAA), in discriminating normal from glaucomatous eyes. Five MLCs were proposed, namely conditional inference trees (CIT), logistic model tree (LMT), C5.0 decision tree, random forest (RF), and extreme gradient boosting (XGBoost). Logistic regression (LGR) was used as a benchmark for comparison. RF was shown to be the best model. Ganglion cell layer measurements were the most important predictors in early glaucoma detection and cRNFL measurements were more important as the glaucoma severity increased. The global, temporal, inferior, superotemporal, and inferotemporal sites were relatively influential locations among all parameters. Clinicians should cautiously integrate the Spectralis OCT results into the entire clinical picture when diagnosing glaucoma.

Reproducibility of SD-OCT inner macular layer thickness measurements in children with primary congenital glaucoma

To examine the reproducibility of spectral domain optical coherence tomography (SD-OCT) segmented ganglion cell complex and circumpapillary retinal nerve fiber layer (cpRNFL) measurements in children with primary congenital glaucoma (PCG) in comparison with healthy children. 12 children with PCG (G1) and 24 healthy children (G2) were recruited. The following SD-OCT measurements (Spectralis, Heidelberg Engineering) were made in one eye per child: total macular thickness (MT), thicknesses in several subfields and volumes of the three inner macular layers, macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) and cpRNFL thickness. In a single day, an expert operator obtained 3 circumpapillary and 3 macular measurements in each participant to determine intraoperator variability. Intraoperator repeatability was defined by the coefficient of variation (CoV) and intraclass correlation (ICC). ICC was excellent in both groups for cpRNFL measurements (G1 ICC=0.950 and G2 ICC=0.995) and for MT was excellent in G1 (ICC=0.957) and moderate in G2 (ICC=552). For the inner macular layer measurements, all ICCs were better in PCG group (mRNFL-ICC: 0.915 vs. 0.765; ICC-GCL: 0.584 vs. 0.263 and ICC-IPL: 0.979 vs. 0.742; G1 and G2 respectively). Greater CoV were recorded for macular measurements (from 0.71% to 9.82%) compared to cpRNFL measurements (from 0.52% to 1.50%). In children with PCG, Spectralis SD-OCT showed excellent intrasession repeatability for cpRNFL, MT, mRNFL and IPL measurements and moderated for GCL measurements. For all macular measurements, ICC were higher in children with PCG than healthy children.

Development of a Spatial Model of Age-Related Change in the Macular Ganglion Cell Layer to Predict Function From Structural Changes

To develop location-specific models of normal, age-related changes in the macular ganglion cell layer (GCL) from optical coherence tomography (OCT). Using these OCT-derived models, we predicted visual field (VF) sensitivities and compared these results to actual VF sensitivities. Retrospective cohort study. Single eyes of 254 normal participants were retrospectively enrolled from the Centre for Eye Health (Sydney, Australia). Macular GCL measurements were obtained using Spectralis OCT. Cluster algorithms were performed to identify spatial patterns demonstrating similar age-related change. Quadratic and linear regression models were subsequently used to characterize age-related GCL decline. Forty participants underwent additional testing with Humphrey VFs, and 95% prediction intervals were calculated to measure the predictive ability of structure-function models incorporating cluster-based pooling, age correction, and consideration of spatial summation. Quadratic GCL regression models provided a superior fit (P value <.0001-.0066), establishing that GCL decline commences in the late 30s across the macula. The equivalent linear rates of GCL decline showed eccentricity-dependent variation (0.13μm/yr centrally vs 0.06μm/yr peripherally); however, average, normalized GCL loss per year was consistent across the 64 macular measurement locations at 0.26%. The 95% prediction intervals describing predicted VF sensitivities were significantly narrower across all cluster-based structure-function models (3.79-4.99 dB) compared withmodels without clustering applied (5.66-6.73 dB, P < .0001). Combining spatial clustering with age-correction based on regression models allowed the development of robust models describing GCL changes with age. The resultant superior predictive ability of VF sensitivity from ganglion cell measurements may be applied to future models of disease development to improve detection of early macular GCL pathology.

Use of ganglion cell layer measurements on spectral-domain optical coherence tomography as an adjunct for determining the chronicity of occipital lobe lesions (P6.033)

Use of ganglion cell layer measurements on spectral-domain optical coherence tomography as an adjunct for determining the chronicity of occipital lobe lesions (P6.033)

Evaluation of retinal nerve fiber layer, ganglion cell layer and macular changes in patients with migraine.

The aim of this study was to investigate retinal nerve fiber layer (RNFL), ganglion cell layer (GCL) thickness, macular changes (central subfield thickness (CST), cube average thickness (CAT), cube volume (CV) in patients with migraine using spectral-domain optical coherence tomography (OCT) and to assess if there was any correlation with white matter lesions (WML). In this prospective case-control study, RNFL, GCL thickness and macular changes of 19 migraine patients with aura (MA), 41 migraine without aura (MO) and 60 age- and gender-matched healthy subjects were measured using OCT device. OCT measurements were taken at the same time of the day to minimize the effects of diurnal variation. The average, inferior and superior quadrant RNFL thickness were significantly thinner in patients with migraine (p=0.017, p=0.010, p=0.048). There was also a significant difference between patients with and without aura in the mean and superior quadrant RNFL thickness (p=0.02, p=0.043).While there was a significant thinning in CST and CAT in patients with migraine (p=0.020), there were no significant difference in GCL measurements (p=0.184). When the groups were compared to the control group, there were significant differences between MA and the control group regarding average, superior and inferior quadrant RNLF thickness (p<0.001, p=0.025, p<0.001). On the other hand, there were significant differences between MO and the control group regarding average and inferior faces (p=0.037, p=0.04). When OCT measurements were evaluated according to the frequency of attacks, CST and GCL thickness were significantly thinner in patients who had more than four attacks a month (p=0.024, p=0.014). In patients with WML, only CV measurements were significantly thinner than migraine patients without WML (p=0.014). The decreased RNFL, CST, CAT and CV of the migraine patients might be related to the vascular pathology of the disease. Because WML was not correlated with the same measurements except CV, we think that further studies are needed to evaluate the etiopathologic relationship between OCT measurements and WML in migraine patients.

Visual dysfunction and retinal changes in patients with multiple sclerosis

PurposeTo evaluate structural changes in the retina and their correlation with visual dysfunction in patients with multiple sclerosis.MethodsPatients with multiple sclerosis (n = 84) and healthy controls (n = 84) underwent structural evaluation of the retinal nerve fiber layer, and macular and ganglion cell layer thicknesses using Spectral domain optical coherence tomography (SD‐OCT). All subjects underwent high and low contrast visual acuity, color vision (using the Farnsworth and L′Anthony desaturated D15 color tests), and contrast sensitivity vision using the Pelli Robson chart and CSV 1000E test.ResultsMacular, retinal nerve fiber layer, and ganglion cell layer thinning was observed in multiple sclerosis patients compared to healthy controls (p &lt; 0.05). High and low contrast visual acuity and contrast sensitivity vision at four different spatial frequencies were significantly reduced, compared with healthy subjects (p &lt; 0.05). Macular, retinal nerve fiber layer and ganglion cell layer measurements correlated with high and low contrast visual acuity, and contrast sensitivity vision. Contrast sensitivity vision was the functional parameter that most strongly correlated with the structural measurements in multiple sclerosis and was associated with ganglion cell layer measurements. The L′Anthony color vision score (age‐corrected color confusion index) was associated with macular measurements.ConclusionsPatients with multiple sclerosis had visual dysfunction that correlated with structural changes evaluated by SD‐OCT. Macular and ganglion cell layer measurements may be good indicators of visual impairment in multiple sclerosis patients.

Visual dysfunction and its correlation with retinal changes in patients with Parkinson disease

PurposeTo evaluate visual dysfunction and its correlation with structural changes in the retina in patients with Parkinson disease (PD).MethodsPatients with PD (n = 37) and controls (n = 37) underwent visual acuity (VA), color vision (using the Farnsworth and L'Anthony desaturated D15 color tests), and contrast sensitivity vision (CSV; using the Pelli Robson chart and CSV 1000E test) evaluation to measure visual dysfunction. Structural measurements of the retinal nerve fiber layer (RNFL), and macular and ganglion cell layer (GCL) thicknesses were obtained using spectral domain optical coherence tomography (SD‐OCT). Comparison of obtained data and correlation analysis between functional and structural results were performed.ResultsVA (in all different contrast levels) and all CSV spatial frequencies were significantly worse in PD patients than in controls (p &lt; 0.05). Color vision was significantly affected (p &lt; 0.05) based on the L'Anthony color test. Macular thinning was detected in the central, outer (inferior and temporal), and superior (inner and outer) sectors (p &lt; 0.05), and the RNFL had significant thinning in the temporal quadrant (p &lt; 0.05). Significant GCL loss was observed in the superior and superonasal sectors and the minimum GCL + inner plexiform layer (p &lt; 0.05). CSV was the functional parameter most strongly correlated with structural measurements in PD. Color vision was associated with most GCL measurements. Macular thickness was strongly correlated with macular volume and functional parameters (r &gt; 0.70, p &lt; 0.05).ConclusionsPatients with PD had visual dysfunction that correlated with structural changes evaluated by SD‐OCT. Macular and GCL measurements may be reliable indicators of visual impairment in PD patients.

Macular SD-OCT Outcome Measures: Comparison of Local Structure-Function Relationships and Dynamic Range

PurposeWe tested the hypothesis that the macular ganglion cell layer (GCL) thickness demonstrates a stronger structure-function (SF) relationship and extends the useful range of macular measurements compared with combined macular inner layer or full thickness.MethodsNinety-eight glaucomatous eyes and eight normal eyes with macular spectral domain optical coherence tomography (SD-OCT) volume scans and 10-2 visual fields were enrolled. Inner plexiform layer (IPL), GCL, macular retinal nerve fiber layer (mRNFL), ganglion cell-inner plexiform layer (GCIPL), ganglion cell complex (GCC), and full thickness (FT) measurements were calculated for 8 × 8 arrays of 3° superpixels. Main outcome measures were local structure-function relationships between macular superpixels and corresponding sensitivities on 10-2 fields after adjusting for ganglion cell displacement, dynamic range of measurements, and the change point (total deviation value where macular parameters reached measurement floor).ResultsMedian (interquartile range [IQR]) mean deviation was −7.2 (−11.6 to −3.2) dB in glaucoma eyes. Strength of SF relationships was highest for GCIPL, GCL, GCC, and IPL (ρ = 0.635, 0.627, 0.621, and 0.577, respectively; P ≤ 0.046 for comparisons against GCIPL). Highest SF correlations coincided with the peak of GCL thickness, where the dynamic range was widest for FT (81.1 μm), followed by GCC (65.7 μm), GCIPL (54.9 μm), GCL (35.2 μm), mRNFL (27.5 μm), and IPL (20.9 μm). Change points were similar for all macular parameters (−7.8 to −8.9 dB).ConclusionsGCIPL, GCL, and GCC demonstrated comparable SF relationships while FT, GCC, and GCIPL had the widest dynamic range. Measurement of GCL did not extend the range of useful structural measurements. Measuring GCL does not provide any advantage for detection of progression with current SD-OCT technology.

Retinal Ganglion Cell Layer Thinning Within One Month of Presentation for Non-Arteritic Anterior Ischemic Optic Neuropathy.

PurposeOptical coherence tomography reveals retinal ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thinning in chronic optic nerve injury. With acute optic nerve injury, as in acute nonarteritic anterior ischemic optic neuropathy (NAION), swelling obscures early demonstration of RNFL thinning, which might be used to evaluate therapies. We hypothesized that measurement of GCL plus inner plexiform layer (IPL) thickness and trajectory of thinning would show it is an earlier and more accurate biomarker of early permanent neuronal injury.MethodsWe prospectively studied 29 acute NAION eyes with standard automated perimetry and spectral domain (SD) optical coherence tomography for 6 months. We used a three-dimensional layer segmentation (method 1) and a commercial proprietary (method 2), to compute the combined thickness of macular GCL+IPL and method 2 to compute peripapillary RNFL thickness.ResultsAt presentation, the mean GCL+IPL thickness (78.7 μm ± 8.9) for NAION eyes, did not differ from unaffected fellow eyes (83 μm ± 6.4), using method 1 while method 2 (66.8 μm ± 18.7) failed in 34% of NAION eyes. At 1 to 2 months, 12% had RNFL loss compared to baseline, while 68% of NAION eyes had GCL+IPL thinning. The ganglion cell layer plus inner plexiform layer reduction was greatest at 1 to 2 months (19.6 μm ± 12.6) and was minimally worse after month 3. Ganglion cell layer plus inner plexiform layer thinning showed moderate to strong significant correlation with the visual acuity and mean deviation at each exam time. The retinal nerve fiber layer was not thinned until month 3.ConclusionsGanglion cell layer plus inner plexiform layer is acutely unaffected and provides a reliable measure of retinal neuronal structure using three-dimensional segmentation. Thinning develops within 1 to 2 months of onset, which is prior to RNFL swelling resolution. This suggests GCL+IPL measurement is better than the RNFL thickness to use as biomarker of early structural loss in NAION.

Relationship between Visual Dysfunction and Retinal Changes in Patients with Multiple Sclerosis.

AimTo evaluate structural changes in the retina and their correlation with visual dysfunction in patients with multiple sclerosis.MethodsPatients with multiple sclerosis (n = 84) and healthy controls (n = 84) underwent structural evaluation of the retinal nerve fiber layer, and macular and ganglion cell layer thicknesses using Spectral domain optical coherence tomography (SD-OCT). All subjects underwent high and low contrast visual acuity, color vision (using the Farnsworth and L´Anthony desaturated D15 color tests), and contrast sensitivity vision using the Pelli Robson chart and CSV 1000E test.ResultsMacular, retinal nerve fiber layer, and ganglion cell layer thinning was observed in multiple sclerosis patients compared to healthy controls (p<0.05). High- and low-contrast visual acuity and contrast sensitivity vision at four different spatial frequencies were significantly reduced in comparison with healthy subjects (p<0.05). Macular, retinal nerve fiber layer and ganglion cell layer measurements correlated with high and low contrast visual acuity, and contrast sensitivity vision. Contrast sensitivity vision was the functional parameter that most strongly correlated with the structural measurements in multiple sclerosis and was associated with ganglion cell layer measurements. The L´Anthony color vision score (age-corrected color confusion index) was associated with macular measurements.ConclusionsPatients with multiple sclerosis had visual dysfunction that correlated with structural changes evaluated by SD-OCT. Macular and ganglion cell layer measurements may be good indicators of visual impairment in multiple sclerosis patients.

Visual dysfunction and its correlation with retinal changes in patients with Parkinson's disease: an observational cross-sectional study

ObjectivesTo evaluate visual dysfunction and its correlation with structural changes in the retina in patients with Parkinson's disease (PD).MethodsPatients with PD (n=37) and controls (n=37) were included in an observational...

Ganglion cell layer measurements correlate with disease severity in patients with Alzheimer's disease.

To evaluate the thickness of the 10 retinal layers of patients with Alzheimer's disease (AD) using a new segmentation technology of the Spectralis optical coherence tomography (OCT) and to determine whether the thickness of specific layers predicts neurodegeneration or AD severity. Patients with AD (n=150) and age-matched healthy controls (n=75) were analysed using the segmentation application prototype to automatically segment all retinal layers in a macular scan. Thicknesses of each layer were compared between patients with AD and controls, and between patients with disease durations of less than or at least 3years. Associations between retinal layer thicknesses, disease duration and AD severity were evaluated. Patients with AD had reduced thickness in the retinal nerve fibre, ganglion cell, inner plexiform and outer nuclear layers (p<0.05). The inner retinal layers were more affected in patients with long disease duration. Ganglion cell and retinal nerve fibre layer thicknesses were inversely correlated with AD duration and severity. Ganglion cell and inner plexiform layers thicknesses were predictive of axonal damage. The segmentation application revealed ganglion cell and retinal layer atrophy in patients with AD compared with controls, especially in the inner layers of patients with long disease duration. Ganglion cell layer reduction was associated with increased axonal damage and may predict greater disease severity.

Diagnostic Ability of Macular Ganglion Cell Layer Measurements in Glaucoma Using Swept Source Optical Coherence Tomography

Diagnostic Ability of Macular Ganglion Cell Layer Measurements in Glaucoma Using Swept Source Optical Coherence Tomography

Visual dysfunction and its correlation with retinal changes in patients with Parkinson disease

PurposeTo evaluate visual dysfunction and its correlation with structural changes in the retina in patients with Parkinson disease (PD).MethodsPatients with PD (n = 37) and controls (n = 37) underwent visual acuity (VA), color vision (using the Farnsworth and L´Anthony desaturated D15 color tests), and contrast sensitivity vision (CSV; using the Pelli Robson chart and CSV 1000E test) evaluation to measure visual dysfunction. Structural measurements of the retinal nerve fiber layer (RNFL), and macular and ganglion cell layer (GCL) thicknesses were obtained using spectral domain optical coherence tomography (SD‐OCT). Comparison of obtained data and correlation analysis between functional and structural results were performed.ResultsVA (in all different contrast levels) and all CSV spatial frequencies were significantly worse in PD patients than in controls (P &lt; 0.05). Color vision was significantly affected (p &lt; 0.05) based on the L´Anthony color test. Macular thinning was detected in the central, outer (inferior and temporal), and superior sectors (p &lt; 0.05), and the RNFL had significant thinning in the temporal quadrant (p &lt; 0.05). Significant GCL loss was observed in the superior and superonasal sectors and the GCL + minimum inner plexiform layer (p &lt; 0.05). CSV was the functional parameter most strongly correlated with structural measurements in PD. Color vision was associated with most GCL measurements. Macular thickness was strongly correlated with macular volume and functional parameters (r &gt; 0.70, p &lt; 0.05).ConclusionPatients with PD had visual dysfunction that correlated with structural changes evaluated by SD‐OCT. Macular and GCL measurements may be reliable indicators of visual impairment in PD patients.