Posterior Pole Retinal Thickness Research Articles

Posterior Pole Asymmetry Analysis as a Diagnostic Tool in Glaucoma Suspects: An Electrophysiological Approach.

Spectral domain optical coherence tomography (SD-OCT) with posterior pole asymmetry analysis (PPAA) provides a mapping of posterior pole retinal thickness with asymmetry analysis between hemispheres of each eye. We investigated whether these structural abnormalities were correlated with functional retinal ganglion cell (RGC) loss, quantified by steady state pattern electroretinogram (ssPERG), in glaucoma suspects (GS). Twenty GS (34 eyes) were enrolled in a prospective study at the Manhattan Eye, Ear, and Throat Hospital. All subjects underwent ophthalmological examination, including Humphrey visual field, Spectralis Glaucoma Module Premium Edition (GMPE) SD-OCT PPAA, and ssPERG testing. The ability of ssPERG parameters (Magnitude [Mag, µv], MagnitudeD [MagD, µv], and MagD/Mag ratio) to predict PPAA thickness (total, superior, and inferior thickness, [µm]) was tested via adjusted multivariate linear regression analysis. Mag explained 8% of variance in total PPAA change (F(1,29)=6.33, B=6.86, 95% CI: 1.29-12.44, p=0.018), 8% in superior PPAA change (F(1,29)=5.57, B=6.92, 95% CI: 0.92-12.92, p=0.025), and 7.1% in inferior PPAA change (F(1,29)=5.83, B=6.80, 95% CI: 1.04-12.56, p=0.022). Similarly, MagD explained 9.7% of variance in total PPAA change (F(1,29)=8.09, B=6.47, 95% CI: 1.82-11.13, p=0.008), 10% in superior PPAA change (F(1,29)=7.33, B=6.63, 95% CI: 1.62-11.63, p=0.011), and 8.5% in inferior PPAA change (F(1,29)=7.25, B=6.36, 95% CI: 1.53-11.18, p=0.012). MagD/Mag ratio and PPAA were not significantly associated. To the best of our knowledge, this is the first study demonstrating a positive relationship between RGC dysfunction and retinal thickness changes between the superior and inferior hemispheres. The detection of asymmetrical structural loss, combined with functional RGC assessment using ssPERG, may be an informative tool for early glaucoma diagnosis.

Posterior pole retinal thickness distribution pattern in keratoconus.

To evaluate the pattern of retinal thickness distribution in patients with keratoconus (KCN) and its correlation with disease severity. For this cross-sectional cohort study, the study subjects with documented keratoconus and normal eyes were prospectively enrolled. All subjects had anterior segment (Pentacam HR) and posterior segment (Spectralis) imaging. Posterior segment imaging by optical coherence tomography included the posterior pole asymmetry analysis map. Data were analyzed with multiple linear regression models and correlation tests to examine the mean and variance of the measured thickness of the retina and its distribution relative to the presence and severity of KCN. A total of 24 subjects with keratoconus (48 eyes) and 14 normal subjects (28 eyes) enrolled in this study. The posterior pole retinal thickness, both superior and inferior hemifields, as well as the overall retinal thickness in KCN patients was greater than the control group. There was a direct correlation between the overall retinal thickness of the posterior pole and the severity of KCN (R2 = 0.422, P < 0.001). However, the variability of the retinal thickness showed no difference between KCN-afflicted and healthy eyes. Although KCN is a disease of the anterior segment of the eye, we found an orderly increase in posterior pole retinal thickness that is correlated with the severity of disease in KCN eyes compared to control. These findings suggest that the retina may maintain some degree of plasticity to respond to the degraded optical system of the eye.

Neuro‐retinal alteration in dizygotic twins with multiple sclerosis

AbstractPurposeThe aim was to evaluate the retina and the optic nerve in two dizygotic twins suffering from multiple sclerosis (MS).MethodThe neuroretinal structures were analysed at diagnosis from only the right eyes of both two (A and B) dizygotic twins by the optical coherence tomography (OCT) device Heidelberguffered in her left eye. The protocol used was Posterior Pole (with an area of examin Spectralis®, in order to avoid bias due to a previous optic neuritis that the twin A sation 30° × 25°) that measured the thickness in microns (μm) of the whole retina, the ganglion cell layer (GCL) by segmentation in the macular area and the peripapilar retinal nerve fibre layer (RNFL). The functional situation of the disease was evaluated with the Expanded Disability Status Scale (EDSS) by neurologist.ResultsThe onset of the disease of twin A was with an episode of left optic neuritis in 2017, whereas twin B with a cerebellar syndrome in 2013. Both twins were diagnosed of MS in 2018. At that moment, the twin B showed worse systemic functional status than twin A (EDSS: 3.5 versus 0 respectively), lower thickness in the peripapilar RNFL at temporal (54 versus 96 μm) and inferior temporal (109 versus 180 μm) sectors and also in GCL specifically at the inferior (31 versus 45 μm) and temporal (30 versus 40 μm) sectors.ConclusionsThe analysis of the posterior pole retinal thickness with segmentation could be a useful tool for the management of MS. The GCL showed an early and more intense damage than RNFL at the earliest years of the disease without previous episodes of optic neuritis in this case of two dizygotic twins.

Differences in the retina of patients with confirmed diagnosis of multiple sclerosis versus isolated clinical syndrome

AbstractPurposeTo assess the differences in the retina nerve fiber layer (RNFL) and the ganglion cell layer (GCL) in subjects with multiple sclerosis (MS) versus subjects diagnosed as clinically isolated syndrome (CIS).Methods58 eyes of healthy controls, 67 eyes of MS patients (&lt;10 years) and 10 eyes of patients diagnosed with CIS (&lt;10 years) were included in the study. Measurements were taken using the Posterior Pole Retinal Thickness Map protocol [shows the thickness of the retina throughout the posterior pole (volumetric examination of 30° × 25° OCT]) with the Heidelberg Spectralis optical coherence tomography (OCT) device. We analyzed the 8x8 grid placed along the fovea symmetrically with the papilla. We analyzed the average thickness of the RNFL and the GCL in the 64 cells obtained.ResultsBoth groups, EM and CIS, present a significant thinning of the RNFL (27 and 32 cells respectively) and the GCL (45 and 20 cells respectively) with respect to the healthy controls. On the other hand, there has been a significant thinning of the RNFL in patients with MS (9 cells) versus GCL and a slightly significant thinning of the GCL (3 cells) in MS patients with CIS.ConclusionsOCT is able to detect significant changes in the retina of patients who do not meet dissemination criteria in time and space for the diagnosis of MS. These CIS patients present a significant thinning of the RNFL and the GCL with respect to healthy controls and there are slightly differences between MS and CIS in the RNFL and the GCL.

Relationship between retinal thinning, disease duration and disability status in multiple sclerosis patients

AbstractPurposeTo assess changes in the pattern of the neuro‐retina thinning during the evolution of multiple sclerosis (MS).Method64 eyes of healthy controls and 89 eyes of patients with MS without previous episode of optic neuritis were included in the study. Measurements were performed using the Posterior Pole Retinal Thickness Map protocol [shows the thickness of the retina throughout the posterior pole (volumetric examination of 30° × 25° OCT]) with the Heidelberg Spectralis optical coherence tomography (OCT) device. We analysed the 8 × 8 grid placed along the fovea symmetrically with the papilla, dividing patients with MS into 5 different groups at intervals of 5 years of disease duration and a group of patients with a few months of diagnosis.ResultsMS patients presented a significant thinning of the retinal nerve fibre layer (RNFL) and the ganglion cell layer (GCL). This thinning is visible and significant even in the first year after symptoms onset in RNFL and GCL. In addition, an inverse relationship between the thickness of these layers and the time of disease evolution was found, existing cells with a moderate‐strong relationship mainly in the GCL and RNFL. In contrast there is negative but poor correlation between retinal thinning of these 2 retinal layers and Expanded Disability Status Scale (EDSS).ConclusionAlthough there is no significant peripapillary damage in the first months of the disease, we can find a significant thinning in the RNFL and GCL around the macula. GCL seems to be the layer that presents a significant thinning earlier than the RNFL and stronger relationship with disease duration. On the other hand, EDSS does not seems to be so influent on retinal thinning than disease duration.

Posterior pole asymmetry analysis and retinal nerve fibre layer thickness measurements in primary angle-closure suspect patients

PurposeTo measure peripapillary retinal nerve fiber layer (RNFL) thickness and posterior pole retinal thickness in primary angle-closure suspects (PACS) by Spectral domain optical coherence tomography (SD-OCT) and to be compared with normal subjects.MethodsThirty five primary angle-closure suspect patients and thirty normal subjects were enrolled in this study. Peripapillary RNFL and posterior pole retinal thickness by posterior pole asymmetry analysis (PPAA) in SD-OCT were measured.ResultsNo significant difference was found in both groups on age, sex distribution, refractive error, intraocular pressure (IOP) and axial length. The PACS group exhibited significantly thinner macular retinal thickness and larger asymmetry on posterior pole region compared with the control group. Yet no significant difference of peripapillary RNFL parameters was found between PACS group and normal control group. A negative correlation was observed between the total retinal thickness on posterior pole region and age when all the PACS participants were analyzed.ConclusionsPosterior pole retinal thickness measurements obtained by Heidelberg Spectralis SD-OCT using PPAA showed significant thinner change in PACS group than healthy controls. Only age seemed to be an indicator in the occurrence of glaucomatous damage in PACS patients.

Late Postoperative Evaluation of Retinal and Choroidal Thickness and Retinal Vessel Caliber after Surgical Repair of Corneal Perforation.

Objectives:To examine the late period retinal and choroidal alterations in the posterior pole of eyes that underwent primary suturing due to traumatic corneal perforation.Materials and Methods:This cross-sectional case series included 21 eyes of 21 patients. The fellow eyes served as the control group. Macular thickness, peripapillary retinal nerve fiber layer (RNFL) thickness, choroidal thickness, and retinal vessel caliber measurements were performed by spectral-domain optical coherence tomography (SD-OCT).Results:The mean RNFL thickness was 102.1±10.9 µm in the perforated eyes and 99.5±8.5 µm in the fellow eyes (p=0.29). The mean central macular thickness was 300.1±25.6 µm in the perforated eyes and 295.6±23.2 µm in the fellow eyes (p=0.62). The choroidal thickness and retinal vascular caliber measurements were also similar between the groups (p>0.05).Conclusion:Operated traumatic corneal perforations do not cause significant posterior pole retinal and choroidal SD-OCT thickness changes in the late postoperative period.

Diagnostic Power of Macular Retinal Thickness Analysis and Structure-Function Relationship in Glaucoma Diagnosis Using SPECTRALIS OCT

Aims: To evaluate the diagnostic power of the Posterior Pole Asymmetry Analysis (PPAA) from the SPECTRALIS OCT in glaucoma diagnosis and to define the correlation between the visual field sensitivity (VFS) and macular retinal thickness (MRT).Methods: 90 consecutive open-angle glaucoma patients and 23 healthy subjects were enrolled. All subjects underwent Visual Field test (Humphrey Field Analyzer, central 24-2 SITA-Standard) and SD-OCT volume scans (SPECTRALIS, Posterior Pole Asymmetry Analysis). The areas under the Receiving Operating Characteristic curve (AROC) were calculated to assess discriminating power for glaucoma, at first considering total MRT values and hemisphere MRT value and then quadrant MRT values from 16 square cells in a 8 x 8 posterior pole retinal thickness map that were averaged for a mean retinal thickness value. Structure function correlation was performed for total values, hemisphere values and for each quadrant compared to the matching central test points of the VF.Results: The AROCs ranged from 0.70 to 0.82 (p < 0.0001), with no significant differences between each other. The highest AROC observed was in inferior nasal quadrant. The VFS showed a strong correlation only with the corresponding MRT value s for quadrant analysis: Superior Temporal (r = 0.33, p = 0.0013), Superior Nasal (r = 0.43, p < 0.0001), Inferior Temporal (r = 0.57, p < 0.0001) and Inferior Nasal (r = 0.55, p < 0.0001).Conclusion: the quadrant analysis showed statistically significant structure-function correlations and may provide additional data for the diagnostic performance of SPECTRALIS OCT.

Posterior pole asymmetry analysis and retinal thickness measurements in young relatives of glaucoma patients

The presence of a family history of glaucoma is a known risk factor for primary open-angle glaucoma (POAG) in middle-aged and older individuals. In this study, our aim was to demonstrate possible early glaucomatous alterations in young first- and second-degree relatives of POAG patients by spectral-domain optical coherence tomography. A total of 104 participants (52 relatives of POAG patients and 52 healthy individuals) were recruited in this cross-sectional study. All the participants were between 17 years and 45 years of age. All eyes underwent testing with spectral-domain optical coherence tomography. Peripapillary retinal nerve fiber layer thickness, hemifield macular thickness, macular ganglion cell complex thickness, posterior pole asymmetry analysis, and retinal arteriolar caliber measurements were taken for comparison between the study and control groups. The mean peripapillary retinal nerve fiber layer thickness was 104.9 ± 8.8 μm in the study group and 105.6 ± 7.4 μm in the control group (p = 0.68). Although whole macular thickness measurements were higher in the control group when compared with the study group (p = 0.008), the macular ganglion cell complex thickness was similar in both groups (p = 0.87). The posterior pole asymmetry analysis revealed no statistically significant difference between the groups in the aspect of consecutive black squares (p = 0.79). The mean retinal arteriolar caliber was 85.9 ± 4.8 μm in the study group and 86.0 ± 5.0 μm in the control group (p = 0.90). In conclusion, young relatives of POAG patients do not show characteristic glaucomatous damage when compared with the controls.

Diagnostic Abilities to Detect Glaucomatous Abnormality Using Normal Retinal Thickness Measured by Optical Coherence Tomography

Purpose: Recently, the introduction of spectral-domain optical coherence tomography (SD-OCT) has enabled measurement of retinal thickness in the posterior pole in 64 sectors. SD-OCT was used to evaluate the diagnostic effectiveness in detecting glaucomatous abnormality of visual field sensitivity. A normal value for retinal thickness was determined and then compared in corresponding local sectors. Methods: Thirty healthy controls and 30 glaucoma subjects were evaluated. Macular thickness values from the 4 adjacent square cells in an 8 x 8 posterior pole retinal thickness map were averaged for a mean retinal thickness (MRT) value. A normative database was prepared using the data from the healthy eyes of this study to determine the diagnostic criteria for MRT. If the MRT value was <5% (Criteria A) or <1% (Criteria B) of the normative database, it was considered to be abnormal. The abnormalities of the MRT value for each diagnostic criteria were compared with the visual field sensitivity results in the corresponding positions. Results: The concordance of abnormalities between MRT and visual field sensitivity at 16 measured points was low in both criteria A (Kappa value; -0.418~0.429) and B (Kappa value; -0.363~0.444). Based on the results of the visual field at each focal point, the sensitivities and specificities of MRT values using the 2 criteria ranged from 0% to 100%. Conclusions: In this study, MRT values showed low correlation and diagnostic ability to detect decreased sensitivity of the visual field in corresponding points, when customized criteria derived from a normative database were applied. J Korean Ophthalmol Soc 2014;55(6):860-867

NEW PROFILES OF POSTERIOR POLE RETINAL THICKNESS MAP IN HEALTHY KOREAN EYES MEASURED BY SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY

To analyze posterior pole retinal thickness using the new Spectralis HRA + OCT protocol and compare two commercially available spectral-domain optical coherence tomography instruments (Spectralis HRA + OCT and Cirrus HD-OCT) in young healthy eyes. Retinal thickness in 178 young healthy eyes was measured using the volume scan mode and Posterior Pole Asymmetry Analysis of the Spectralis HRA + OCT and the macular cube 512 × 128 protocol of the Cirrus HD-OCT. Topologic differences in posterior pole retinal thickness between the two spectral-domain optical coherence tomographies were compared, and the relationship between retinal thickness and age or refractive error/axial length was assessed. Mean retinal thickness measurements in all 9 Early Treatment Diabetic Retinopathy Study Report areas were significantly greater with the Spectralis HRA + OCT than with the Cirrus HD-OCT (P < 0.001). Retinal thickness measured with the new Spectralis HRA + OCT protocol positively correlated with refractive error (P < 0.05) and negatively correlated with axial length (P < 0.05), mainly in the temporal areas. As axial length increased and refractive error decreased, retinal thickness decreased significantly at the outer temporal areas compared with the nasal areas (P < 0.05). Foveal thickness measured with the Spectralis HRA + OCT correlated significantly with refractive error (r = -0.151; P = 0.022) and axial length (r = 0.352; P < 0.001). Posterior pole retinal thickness measurements in young healthy eyes should provide more detailed standard values for diagnosing and managing retinal disease.

Posterior Pole Retinal Thickness for Detection of Structural Damage in Anterior Ischaemic Optic Neuropathy

This objectives of this study were to compare posterior pole retinal thickness (PPRT) and peripapillary retinal nerve fibre layer thickness (RNFLT) between the affected eyes of patients with previous nonarteritic anterior ischaemic optic neuropathy (NAION) and their unaffected eyes and to assess the structure-function relationship. Eighteen eyes with NAION and 14 contralateral unaffected eyes were included in this cross-sectional study. Humphrey visual field (VF) sensitivities were obtained. RNFLT (six sectors) and PPRT (four quadrants) were measured with spectral-domain optical coherence tomography (Spectralis; Heidelberg Engineering, Heidelberg, Germany). These parameters were compared between both eyes of patients with unilateral NAION. The correlation of RNFLT and PPRT with VF mean sensitivity (MS) values (linear units) was also analysed. The main outcome measure was the correlation of MS values with PPRT and RNFLT. A significant difference existed between the affected eyes and the unaffected fellow eyes in the MS values, all sectors of RNFLT, and all quadrants of PPRT. A significant linear correlation was observed between RNFLT and PPRT and corresponding MS values in global and regional measures. The strongest correlation was between inferior temporal VF and its corresponding superior nasal retinal quadrant thickness. The area under the receiver operator characteristic curves comparing superior nasal PPRT and RNFLT between the normal and affected eyes was 0.97 and 0.96, respectively. The results show that PPRT and RNFLT provide equivalent performance to detect structural damage in ischaemic optic neuropathy.

Correlation of optical coherence tomography parameters with clinical and radiological progression in patients with symptomatic optic pathway gliomas

To study the optical coherence tomography (OCT) characteristics in children with optic pathway glioma (OPG) to determine if OCT changes occur alongside clinical/radiological changes at diagnosis and during the second-year follow-up. Twenty-three patients (38 eyes) diagnosed with symptomatic OPG in a single institution were enrolled in this longitudinal observational cohort study. Complete ophthalmologic evaluation, including determination of visual acuity, visual fields, retinal nerve fiber layer ,and posterior pole retinal thickness scanning with spectral-domain optical coherence tomography, and neuroimaging was performed at the time of diagnosis and 6 months and 1 and 2 years after presentation. Patients who experienced visual decline or radioagraphic tumor enlargement of the OPG were classified as progressors. OCT data were compared between progressors and nonprogressors. The average age at diagnosis was 5.8 years. All patients were followed up for 24 months. Five patients (21%) (eight eyes) had clinical or radiological progression of their OPG during follow-up and were classified as progressors. Mean changes in average nerve fiber layer and posterior pole retinal thickness were significantly higher for progressors compared with nonprogressors (P < 0.001). The area under the receiver operator characteristic curves comparing average nerve fiber layer and posterior pole retinal thinning between the progressors and nonprogressors were 0.94 and 0.95 respectively. Optical coherence tomography of average nerve fiber layer and posterior pole retinal thickness may be helpful in monitoring OPG.

Sectoral Loss of Myelin and Axons in Anterior Ischemic Optic Neuropathy

We report a case of focal myelinated nerve fiber (MNF) loss caused by anterior ischemic optic neuropathy. A 62-year-old woman with segmental MNF presented with anterior ischemic optic neuropathy. One year later, MNF lost superiorly, with preservation of inferior segment MNF. Spectral-domain optical coherence tomography of the optic nerve head and posterior pole retinal thickness showed localized thinning of superior nerve fibers (axons) and retinal thickness. This case highlights the focal nature of anterior ischemic optic neuropathy and may be the first patient in whom sectoral loss of myelinated nerve fiber has been photographically documented.

Point-wise Relationships Between Visual Field Sensitivity and Macular Thickness Determined by Spectral-domain Optical Coherence Tomography

Purpose: To evaluate the point-wise relationships between visual field sensitivity (VFS), as measured by standard automated perimetry (SAP), and macular thickness, as determined by spectral-domain optical coherence tomography (SD-OCT), in patients with glaucoma.Materials and methods: One hundred and six glaucoma subjects (one eye per subject) recruited from an academic institution underwent SAP tests (Humphrey field analyzer, central 24-2 of Swedish Interactive Thresholding Algorithm standard) and SD-OCT volume scans (SPECTRALIS, posterior pole asymmetry analysis). The retinal sensitivities of 16 central test points from the SAP results were recorded. Macular thickness values from 4 square cells in an 8 × 8 posterior pole retinal thickness map were averaged for a mean retinal thickness (MRT) value, which corresponded to the 16 central test points in the SAP. In each 16-point area, linear regression analyses of the VFS and the MRT value were performed.Results: The VFS of each 16 central test point showed a significant relationship with the corresponding MRT values (R2 = 0.133–0.383, all p < 0.001). Central and nasal test points corresponding to an arcuate region revealed a relatively strong correlation in both the superior and inferior hemispheres (R2 = 0.311–0.383 and 0.288–0.345, respectively), but the superior and inferior-temporal points revealed a relatively weaker correlation (R2 = 0.149 and 0.133, respectively).Conclusions: The VFS showed a significant reciprocal relationship with corresponding macular thickness at each test point. However, the level of the relationship varied among different macular sectors, showing the strongest relationship in the arcuate region.

Relationship between the Retinal Thickness Analyzer and the GDx VCC Scanning Laser Polarimeter, Stratus OCT Optical Coherence Tomograph, and Heidelberg Retina Tomograph II Confocal Scanning Laser Ophthalmoscopy

PurposeTo assess the relationship between the retinal thickness analyzer (RTA) parameters, and those of the GDx VCC scanning laser polarimeter (GDx VCC), Stratus OCT optical coherence tomography (Stratus OCT), and Heidelberg retinal tomograph II confocal scanning laser ophthalmoscopy (HRT II).MethodsTwenty-nine primary open-angle glaucoma patients were retrospectively included in this study. Measurements were obtained using the RTA, GDx VCC, Stratus OCT, and HRT II. We calculated the correlation coefficients between the parameters of RTA and those of the other studies.ResultsAmong the optic disc parameters of RTA, the cup volume was best correlated with Stratus OCT (R=0.780, p<0.001) and HRT II (R=0.896, p<0.001). Among the posterior pole retinal thickness parameters, the posterior pole abnormally thin area (PPAT) of the RTA and the inferior average of the GDx VCC were best correlated (R=-0.596, p=0.001). The PPAT of the RTA and the inferior maximum of the Stratus OCT were best correlated (R=-0.489, p=0.006). The perifoveal minimum thickness (PFMT) of the RTA and the cup shape measurement of the HRT II were best correlated (R=-0.565, p=0.004).ConclusionsMany RTA optic disc parameters were significantly correlated with those of the Stratus OCT and HRT II. The RTA posterior pole retinal thickness parameters were significantly correlated with those of the GDx VCC, Stratus OCT and HRT II. The RTA optic disc and posterior pole retinal thickness parameters may be valuable in the diagnosis of glaucoma.

Quantitative In Vivo Retinal Thickness Measurement in Chinese Healthy Subjects with Retinal Thickness Analyzer

To measure the retinal thickness of the posterior pole in healthy Chinese subjects using a retinal thickness analyzer and to compare the retinal thicknesses between different age, gender, and refractive error groups. Between February 2002 and September 2004, healthy Chinese subjects (age range, 21-50 years), underwent measurements of visual acuity, refractive error, intraocular pressure, and posterior pole retinal thickness with the RTA, as well as ophthalmoscopy and slit lamp examinations. Eleven retinal thickness parameters were directly derived from the reports of the RTA measurement. The average value of each parameter was compared between the male and female groups, the emmetropia and low-myopia groups, and the three age groups (21-30, 31-40, and 41-50 years). Linear regression analysis was also applied to determine the effect of age on 11 parameters. Some participants were also enrolled in the reproducibility assessment procedure. The 272 eyes of 272 subjects (mean age, 34.4 years) were included. The intraclass correlation coefficients of intravisit and intervisit reproducibility were 0.95 and 0.88, respectively. The average retinal thicknesses at the foveola and fovea are 147.6 and 160.0 microm, respectively. No significant difference was found in any of the parameters between the different gender groups, emmetropia and low-myopia groups, or age groups. Regression analysis revealed no significant negative linear correlation between any of the parameter values and age. The retinal thickness of macular region in the Chinese is a little lower than in Westerners, but not statistically significant. The Chinese retinal thickness was not gender or refractive error related.

Posterior Pole Retinal Thickness in Ocular Hypertension and Glaucoma

To evaluate retinal thickness at the posterior pole of the fundus in ocular hypertension (OHT) and open-angle glaucoma (OAG), and to correlate morphometric findings with visual sensitivity as determined by automated perimetry. One randomly selected eye from 41 patients with clinical diagnosis of OHT (n = 25) or early to moderate OAG (n = 16) and 16 age-matched normal controls was examined. Retinal thickness was measured by Retinal Thickness Analyzer (RTA), acquiring 5 pre-defined scans covering the central 20 degrees of the fundus. RTA average thickness and thickness profile data, including hemispheric asymmetries calculated as relative (superior/inferior and nasal/temporal) or absolute (vertical and horizontal, ie, independent of which hemisphere was thinner) parameters, were calculated. For each eye, white-on-white Humphrey 30-2 visual field results were analyzed, in addition to standard global indices, by quantifying perimetric sensitivities for regions of the posterior pole corresponding to those sampled by the RTA. On average, central retinal thickness was reduced (P < 0.05) in OAG compared with OHT or normal control eyes. Vertical hemispheric absolute thickness asymmetry was increased (P < or = 0.01) in OAG eyes compared with the other groups. Horizontal hemispheric absolute thickness asymmetry was increased (P < 0.01) in both OHT and OAG eyes, compared with control eyes. At least one of the RTA parameters was altered in 13 of 25 OHT (52%) and 12 of 16 OAG eyes (75%), most frequently involving thickness asymmetries. In OAG, but not OHT eyes, superior/inferior asymmetry was positively (r = 0.69, P < 0.01) correlated with the corresponding asymmetry in perimetric sensitivity. The RTA can reveal increased hemispheric thickness asymmetries in both OHT and OAG eyes. In OAG eyes thickness asymmetries are associated with corresponding perimetric asymmetries. The findings in OHT eyes suggest that localized anatomic and functional damage to inner retina may not develop in parallel early in the disease process.

Reduction of posterior pole retinal thickness in glaucoma detected using the Retinal Thickness Analyzer

Objectives To report evidence of changes in posterior pole retinal thickness in glaucoma and preperimetric glaucoma. Design Cross-sectional study. Participants One hundred forty participants (140 eyes): 31 normal subjects, 33 with ocular hypertension, 43 with primary open-angle glaucoma (POAG), and 33 with preperimetric glaucoma. Intervention Posterior pole retinal thickness measurements using the Retinal Thickness Analyzer (RTA; Talia Technology Ltd., Neve-Ilan, Israel). Main outcome measures The mean foveola average thickness (VAV), foveola minimum thickness (VMI), perifoveal average thickness (PFAV), perifoveal minimum thickness (PFMI), posterior pole average thickness (PPAV), and posterior pole minimum thickness (PPMI) were compared among the groups. The correlation between RTA values and visual field values was evaluated. The area under the receiver operator characteristic (AROC) curve, the optimal cut values, and the predictability values were estimated statistically between normal and the other groups using RTA values. Results Results from 91 eyes (65%) were included. Perifoveal average thickness values in preperimetric glaucoma (190.4±15.6 μm; mean±standard deviation) and POAG (185.7±16.8 μm) were significantly less than in normal controls (211.4±16.8 μm) and in eyes with ocular hypertension (211.6±15.9 μm). Perifoveal minimum thickness, PPAV, and PPMI were significantly less in preperimetric glaucoma and in POAG than in normal controls; VAV and VMI were not significantly different among groups. Perifoveal average thickness, PFMI, PPAV, and PPMI significantly correlated with visual field mean defect ( R = −0.38, −0.42, −0.36, and −0.41, respectively) and loss of variance ( R = −0.29, −0.30, −0.26, and −0.17, respectively). The AROC using PFAV, PFMI, PPAV, and PPMI was significantly larger than 0.5 between normal and preperimetric glaucoma (0.83, 0.92, 0.82, and 0.87, respectively) and between normal and POAG eyes (0.86, 0.97, 0.83, and 0.93, respectively). When using the PFMI, the sensitivities at the minimum specificity cutoffs of 90% were highest in comparisons between normal and preperimetric glaucoma (sensitivity, 75%) and between normal and POAG eyes (sensitivity, 95%). By the logistic regression analysis, PFAV, PFMI, PPAV, and PPMI distinguished between normal and preperimetric glaucoma ( R 2 = 0.30, 0.49, 0.27, and 0.37, respectively) and between normal and POAG ( R 2 = 0.37, 0.59, 0.31, and 0.51, respectively). Conclusions Posterior pole retinal thickness decreases in early- and moderate-stage glaucoma. Reduction of perifoveal retinal thickness is correlated with visual field loss. In vivo measurements of posterior pole retinal thickness may help distinguish between normal and glaucomatous eyes.

Quantitative mapping of the retinal thickness at the posterior pole in chronic open angle glaucoma.

The sensitivity of a new device, which is able to measure the thickness of the retina at the posterior pole (Retinal Thickness Analyzer), was assessed in a group of 21 glaucomatous patients, and in 24 patients with ocular hypertension. The specificity of RTA was evaluated in a control group of normal eyes. Of the glaucomatous eyes, 57.6% had a significant reduction in retinal thickness, while another 30.3% were borderline. In the ocular hypertension group, 37.5% of eyes were abnormal, and 45.8% were borderline. In the control group, no eye was abnormal, though 42.9% had borderline alterations. In many glaucomatous eyes (81.8%) there was a relationship between retinal thickness loss and visual field defects.