Superior Ganglion Cell Complex Research Articles

Correlation between glycemic control and retinal nerve fiber layer parameters in type 2 diabetics without retinopathy: a case control study

Background Retinal neurodegenerative changes were found to develop in patients with diabetes mellitus (DM) before the onset of microvascular changes of diabetic retinopathy (DR). Such changes usually affect inner retinal layers in the form of retinal nerve fiber layer (RNFL) thinning. Aim To correlate the degree of glycemic control [in the form of hemoglobin A1c (HBA1c) levels] with changes in peripapillary RNFL thickness in patients with type 2 DM without DR using optical coherence tomography (OCT). Patients and methods Participants are divided into three groups each including 28 eyes: group 1: uncontrolled type 2 DM without DR (HBA1c≥7%), group 2: controlled type 2 DM without DR (HBA1c<7%), group 3: healthy age and sex-matched controls. Peripapillary RNFL and macular ganglion cell complex (GCC) thickness were evaluated in all participants using RTVue spectral domain OCT device (Optovue, Fremont, USA). Results Peripapillary RNFL and macular GCC were significantly thinner in the uncontrolled type 2 DM group in comparison to both the controlled type 2 DM group and the healthy control group. No significant difference in OCT parameters between the controlled type 2 DM group and the healthy control group. HBA1c shows a statistically significant negative correlation with average, superior and inferior RNFL thickness as well as average, superior, and inferior GCC thickness. Conclusion Early and adequate glycemic control, indicated by HBA1c less than 7%, is of critical importance in delaying and reducing early neurodegenerative changes in the form of RNFL and GCC thinning in patients with type 2 DM without DR.

Role of optical coherence tomography as a diagnostic marker for neurodegeneration in epilepsy: a cross-sectional analytical study

BackgroundProgressive neurodegeneration is a common consequence of epilepsy, which has a negative impact on the patient’s quality of life. This study aimed to predict neurodegeneration in patients with epilepsy (PwE) through assessment of the retinal nerve fiber layer (RNFL), ganglion cell complex (GCC) thickness, and central macular thickness (CMT) using optical coherence tomography (OCT).ResultsA cross-sectional study was done on 60 patients with idiopathic epilepsy and 30 healthy volunteers. They were subjected to a full neurological examination, ophthalmological assessment, and OCT for assessment of retinal layers, and cognitive examination using Addenbrooke’s scale. PwE had lower cognitive scores, including memory (13.97 ± 2.52), attention (15.95 ± 1.85), language (24.08 ± 1.71), and fluency (6.10 ± 2.05), compared to controls (20.53 ± 3.5), (17.13 ± 1.53), (24.83 ± 0.99), and (8.87 ± 2.39), respectively. There was a significant thinning in average RNFL thickness (84.27 ± 7.66), inferior RNFL thickness (99.33 ± 10.19), average GCC thickness (83.17 ± 9.76), and superior GCC thickness (84.83 ± 7.27) in the epilepsy group compared to controls (105.70 ± 8.73), (104.93 ± 9.75), (101.50 ± 4.84), and (100.53 ± 4.09), respectively. PwE had significantly higher focal macular volume loss (1.17 ± 1.22) versus (0.11 ± 0.21) and a higher insignificant global macular volume loss (1.88 ± 2.32) versus (1.37 ± 0.65) in controls, respectively. Superior GCC thickness was significantly lower in the uncontrolled patients (82.53 ± 6.23) compared to the controlled patients (87.13 ± 7.60), while CMT was significantly lower in the polytherapy group compared to the monotherapy group. There was a significant positive correlation between the age of epilepsy onset and verbal fluency (r = 0.382, p = 0.003). Epilepsy duration had significant negative correlations with memory (r = − 0.364, p = 0.004), inferior RNFL thickness (r = − 0.324, p = 0.012), perifoveal thickness (r = − 0.353, p = 0.006), and inferior (perifoveal) thickness (r = − 0.365, p = 0.004).ConclusionPwE receiving anti-seizure medications (ASMs) have reduced GCC, RNFL, and CMT and lower cognitive functions compared to controls. OCT may be a useful tool for detection of neurodegeneration in PwE.

Evaluation of optical coherence tomography findings in patients with multiple sclerosis and glaucoma.

Glaucoma and multiple sclerosis (MS) can cause optic disc pathology and, in this way, affect optical coherence tomography (OCT) data. In this context, the objective of this study is to investigate the changes in the mean, quadrant, and sector data measured by OCT in glaucoma and MS patients. The sample of this prospective cohort study consisted of 42 MS patients (84 eyes), 34 Primary open-angle glaucomas patients (67 eyes), and 24 healthy control subjects (48 eyes). The MS group was divided into two groups according to the presence of a history of optic neuritis. Accordingly, those with a history of optic neuritis were included in the MS ON group, and those without a history of optic neuritis were included in the MS NON group. The differences between these groups in the mean, quadrant, and sector data related to the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) were evaluated. Superior nasal (SN), superior temporal (ST), inferior nasal (IN), and superior quadrant (SUP) values were significantly lower in the glaucoma group than in the MS group (p < 0.05). The mean superior GCC (GCC SUP) value was significantly lower in the MS ON group than in the glaucoma group (p < 0.05). On the other hand, SN, ST, inferior temporal (IT), IN, average RNFL (AVE RNFL), semi-average superior RNFL (SUP AVE RNFL), semi-average inferior RNFL (INF AVE RNFL), SUP, and inferior quadrant RNFL (INF) values were significantly lower in the glaucoma group than in the MS NON group (p < 0.05). RNFL and GCC parameters get thinner in MS and glaucoma patients. While the inferior and superior RNFL quadrants are more frequently affected in glaucoma patients, the affected quadrants vary according to the presence of a history of optic neuritis in MS patients. It is noteworthy that the GCC superior quadrant was thin in MS ON patients. The findings of this study indicate that OCT data may be valuable in the differential diagnosis of glaucoma and MS.

Predictive visual field outcomes after optic chiasm decompressive surgery by retinal vessels parameters using optical coherence tomography angiography.

To evaluate the predictive value of superficial retinal capillary plexus (SRCP) and radial peripapillary capillary (RPC) for visual field recovery after optic cross decompression and compare them with peripapillary nerve fiber layer (pRNFL) and ganglion cell complex (GCC). This prospective longitudinal observational study included patients with chiasmal compression due to sellar region mass scheduled for decompressive surgery. Generalized estimating equations were used to compare retinal vessel density and retinal layer thickness pre- and post-operatively and with healthy controls. Logistic regression models were used to assess the relationship between preoperative GCC, pRNFL, SRCP, and RPC parameters and visual field recovery after surgery. The study included 43 eyes of 24 patients and 48 eyes of 24 healthy controls. Preoperative RPC and SRCP vessel density and pRNFL and GCC thickness were lower than healthy controls and higher than postoperative values. The best predictive GCC and pRNFL models were based on the superior GCC [area under the curve (AUC)=0.866] and the tempo-inferior pRNFL (AUC=0.824), and the best predictive SRCP and RPC models were based on the nasal SRCP (AUC=0.718) and tempo-inferior RPC (AUC=0.825). There was no statistical difference in the predictive value of the superior GCC, tempo-inferior pRNFL, and tempo-inferior RPC (all P>0.05). Compression of the optic chiasm by tumors in the saddle area can reduce retinal thickness and blood perfusion. This reduction persists despite the recovery of the visual field after decompression surgery. GCC, pRNFL, and RPC can be used as sensitive predictors of visual field recovery after decompression surgery.

Quantitative analysis of related parameters of retinal nerve fiber layer and ganglion cell complex thickness in patients with different degrees of Parkinson's disease.

A quantitative analysis was performed to evaluate the morphologic changes of the retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC) in patients with Parkinson's disease (PD). Thirty PD patients were enrolled, and they were allocated to the mild-to-moderate PD group (n = 15) or severe PD group (n = 15) according to the severity of PD. Twenty healthy volunteers (20 eyes) were included as controls. Optical coherence tomography (OCT) was used to measure the thickness of mean RNFL and each of the sectors: temporal-upper (TU), superior-temporal (ST), superior-nasal (SN), nasal-upper (NU), nasal-lower (NL), inferior-nasal (IN), inferior-temporal (IT), temporal-lower (TL). The thickness of macular GCC, superior GCC, and inferior GCC was also measured. No difference was found between the three groups with respect to age, sex and disease course (p > 0.05). The mean RNFL thickness was 118.15 ± 10.25µm in the control group, 96.12 ± 9.45µm in the mild-to-moderate PD group, and 80.48 ± 10.35µm in the severe PD group. Significant differences were found in the mean RNFL thickness and thickness of TU, IN, IT and TL sectors among the three groups (p < 0.05). These values, mean RNFL, TU, IN, IT, and TL, were lower in both the PD groups than those in the control, among them the severe PD group had the lowest values. A quantitative analysis of the macula GCC was also performed. Overall, there were significant differences in mean macula, superior, and inferior GCC thickness among the three groups (p < 0.05). The two PD groups had lower values of mean macula, superior, and inferior GCC thickness than that in the controls (p < 0.05); and the severe PD group had lowest values of these parameters. In this study, significant thinning of RNFL and macular GCC was found in PD patients. The more serious the illness, the more the thickness becomes thinner. The OCT measurement was found useful in detecting the structural alterations in the retina of PD. The technique may be useful in follow-up of the disease progression after further validation.

Decreased Vessel Density in Retinal Capillary Plexus and Thinner Ganglion Cell Complex Associated With Cognitive Impairment.

BackgroundTo determine the association of the retinal capillary plexus (RCP) and ganglion cell complex (GCC) with cognitive impairment using optical coherence tomography angiography (OCTA).MethodsA cross-sectional, community-based study utilizing data from the participants enrolled between August 2019 and January 2020 in the Jidong Eye Cohort Study. We assessed the vessel density in RCP and GCC thickness using OCTA, and cognitive testing using the Montreal Cognitive Assessment (MoCA). Cognitive impairment in this study was defined as MoCA score < 24. We used multivariable analysis to evaluate the association of RCP and GCC with cognitive impairment after adjusting for confounders.ResultsThis study analyzed 1555 participants. The mean age of participants was 52.3 (8.4) years, and 861 (55.4%) were women. Cognitive impairment was observed in 268 (17.2%) participants. The adjusted odds ratio (OR) with 95% confidence interval (95% CI) for parafovea vessel density in the deep RCP with cognitive impairment was 1.20 (1.03–1.39). For vessel area and length density surrounding foveal avascular zone with cognitive impairment, the ORs with 95% CIs were 1.23 (1.07–1.41) and 1.30 (1.13–1.49), respectively. For thickness in the superior GCC with cognitive impairment, the OR with 95% CI was 1.16 (1.01–1.32).ConclusionLower vessel density in the RCP and thinner GCC were associated with cognitive impairment. Our results suggest that alterations in the RCP and GCC could provide further evidence when assessing the cognitive function and may even be potentially useful biomarkers in the detection of cognitive impairment.

The Diagnostic Value of Pulsar Perimetry, Optical Coherence Tomography, and Optical Coherence Tomography Angiography in Pre-Perimetric and Perimetric Glaucoma.

The purpose of this article is to investigate the diagnostic value of Pulsar perimetry (PP), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) in pre-perimetric glaucoma (PPG) and perimetric glaucoma (PG). This retrospective cross-sectional study included 202 eyes (145 eyes in the control group, 40 eyes in the PPG group, and 17 eyes in the PG group) from 105 subjects. The results were analyzed by paired t-tests and Wilcoxon signed-rank test. The area under the curve (AUC), sensitivity, and specificity were used to evaluate the diagnostic accuracy. Pearson correlation was used to investigate the relationships of each parameter. The most sensitive parameters for differentiating the control group from the PPG group by using Pulsar, OCT, and OCTA were square loss variance of PP (AUC = 0.673, p < 0.001), superior ganglion cell complex thickness (AUC = 0.860, p < 0.001), and superior-hemi retina thickness (AUC = 0.817, p < 0.001). In the PG group, the most sensitive parameters were mean defect of PP (AUC = 0.885, p < 0.001), whole image of ganglion cell complex thickness (AUC = 0.847, p < 0.001), and perifoveal retina thickness (AUC = 0.833, p < 0.001). The mean defect of PP was significantly correlated with vascular parameters (radial peripapillary capillary (RPC), p = 0.008; vessel density of macular superficial vascular complex (VDms), p = 0.001; vessel density of macular deep vascular complex (VDmd), p = 0.002). In conclusion, structural measurements using OCT were more sensitive than vascular measurements of OCTA and functional measurements of PP for PPG, while PP was more sensitive than the structural and vascular measurements for PG. The mean defect of PP was also shown to be highly correlated with the reduction of vessel density.

Optical Coherence Tomography Angiography Findings in Polycystic Ovary Syndrome.

To evaluate microstructure and vascularity of macula and optic disc in polycystic ovary syndrome (PCOS) by optical coherence tomography (OCT) and OCT angiography (OCTA). Descriptive study. Department of Ophthalmology and Department of Obstetrics and Gynecology, University of Health Sciences, Yüksek lhtisas Training and Research Hospital, Bursa, Turkey between January and June 2019. Fifty-nine patients with PCOS and 35 healthy controls were enrolled in the study. Foveal avascular zone (FAZ), the capillary density assessed in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in the macula and was also measured in optic disc using the OCTA. The thicknesses of the retinal nerve fiber (RNFL), ganglion cell complex (GCC), and macula were measured by OCT. The capillary density in the macula and optic disc region were not a significant difference between the PCOS patients and healthy controls.The parafoveal superior, inferior, and temporal quadrant thickness was significantly higher in the study group compared to control group (p=0.047, p=0.033,and p=0.033, respectively). In patients with PCOS, there were negative correlations between IR and inferior RNFL, total and superior GCC thickness (r=-0.29 p= 0.027, r=-0.27 p=0.050, r=-0.31 p=0.029, respectively). Although no microvascular macular abnormalities were seen in PCOS patients, the parafoveal thickness significantly increased in all quadrants, except the nasal quadrant. In patients with PCOS, IR, dyslipidemia may affect the structural integrity of the retina. Further longitudinal follow-up studies are needed to determine whether PCOS has any effect on OCTA findings. Key Words: Polycystic ovary syndrome, Retina, Optical coherence tomography, Optical coherence tomography angiography.

The effect of multiple sclerosis on retinal nerve fiber layer in eyes without history of optic neuritis

Background Multiple sclerosis (MS) is a disabling disease that is characterized by an axonal damage in the central nervous system, leading to progressive neurologic deficits. Evidence indicates that axonal damage occurs already in the early stages of the disease. Objective To discover the ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL) changes using optical coherence tomography in patients with early relapsing-remitting MS [expanded disability status scale (EDSS)&lt;3] and their relation to the degree of disability and duration of the disease. Patients and methods Overall, 48 eyes of 24 patients with relapsing-remitting MS [31 eyes without history of optic neuritis (ON) and 17 with history of ON] were scanned by using optical coherence tomography and compared with 12 eyes of six age-matched and sex-matched healthy participants. Full history taking and neurological and ophthalmological examination was done. In addition, assessment of disability by EDSS was done for patients. Results Both total and sectorial RNFL thickness were significantly decreased in affected eyes (with ON) and nonaffected eyes in comparison with control eyes; however, RNFL thickness (average and sectorial) was not significantly correlated with duration of the disease or disability assessed by EDSS. In contrast, superior and inferior GCC thickness was significantly correlated with EDSS, although they were not significantly decreased in nonaffected eyes in comparison with control eyes. Conclusion RNFL thinning takes place without a historical record of ON and may be considered as a chronic optic neuropathy in patients with MS. GCC thickness is perhaps a reliable marker for indicating progression of disease.

Correlation of retinal nerve fiber layer and ganglion cell complex thickness with glycosylated hemoglobin in diabetic patients

Aim The aim of this study was to correlate the retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness with glycosylated hemoglobin (HbA1c) in diabetic patients.Setting and design This is a comparative case series study that was conducted on 58 eyes of 30 diabetic patients attending the Outpatient Clinics of the Ophthalmology Department, Beni-Suef University Hospital, Beni-Suef, Egypt, between June and August 2019.Patients and methods The 30 cases were divided into two equal groups: uncontrolled diabetic group (group 1), with HbA1c more than or equal to 7%, and controlled group (group 2), with HbA1c less than 7%. Both eyes in each patient were scanned using optical coherence tomography, ‘Optovue.’ Blood samples for HbA1c testing were collected as well.Results There was a significant negative correlation between average, superior, inferior, and nasal RNFL quadrant thickness and HbA1c in group 1, which was found with HbA1c level more than 9%. In group 2, there was no statistically significant correlation of HbA1c and all RNFL parameters in both eyes. In addition, in group 1, there was a significant negative correlation of average, superior, and inferior GCC quadrant thickness and a positive correlation of focal loss volume with Hb1Ac level more than 9%. In group 2, the average and inferior GCC thickness showed a positive correlation with HbA1c. Furthermore, focal loss volume and global loss volume were negatively correlated with HbA1c.Conclusion There was a statistically significant correlation between thinning of most of RNFL and GCC quadrants and uncontrolled HbA1c more than 9%.

Ganglion Cell Complex Parameters in Primary Angle Closure Suspects

Introduction: This study aimed to investigate the ganglion cell complex (GCC) parameters in primary angle closure suspects (PACS) and identify the related factors. Methods: A total of 731 subjects, including 289 subjects with PACS and 442 subjects without PACS, underwent RTVue XR OCT. GCC parameters were compared between the two groups. The linear mixed-effects model was performed to evaluate the relationships between the GCC parameters and related factors. Results: Significant differences were found in gender, age, spherical refractive error, height, waist, anterior chamber depth, lens thickness, axial length, superior GCC thickness, ganglion cell complex focal loss volume, ganglion cell complex global loss volume, and ganglion cell complex root mean square between PACS and normal controls. The linear mixed-effects model showed that age (p = 0.008) and blood glucose (p = 0.001) were negatively correlated with average GCC thickness in PACS subjects, and PACS (p = 0.036) and age (p < 0.001) were the key influencing factors for average GCC thickness. Conclusion: GCC parameters in PACS subjects are different from those in normal controls. Careful explanation should be considered when evaluating changes of GCC parameters in patients with PACD.

Optical coherence tomography indices in the diagnosis and discrimination of stages of primary open-angle glaucoma in an African population.

The objective of this study was to determine the structure-function association of the optical coherence tomography (OCT) indices (retinal nerve fibre layer (RNFL), ganglion cell complex (GCC) and optic nerve head (ONH) parameters) with the visual field sensitivity and their diagnostic ability at different stages of primary open-angle glaucoma (POAG) among a population West-African descent. The study was a clinic-based prospective study which employed purposive sampling in the recruitment of clinically diagnosed POAG and non-glaucoma patients. OCT and visual field test (VFT) results were collated. Classification of the POAG cases was done using the Hodapp-Parrish-Anderson criteria. ROC was used for assessing the diagnostic ability of OCT indices. Pearson's correlation was used to assess the structure-function association. P value < 0.05 was considered statistically significant. Of the 497 subjects (497 eyes), 301 (60.6%) were males and 196 (39.4%) were females. The average, superior and inferior RNFL and GCC showed a strong positive correlation with the visual field sensitivity, but the average RNFL had the highest correlation (r = 0.673, p < 0.001). The parameters of the ONH showed a moderate-to-weak correlation with the visual field sensitivity. However, there was no significant correlation between structure and function in early POAG (p > 0.05). Superior GCC showed the highest diagnostic ability for POAG (AUC = 0.655; p < 0.001) comparable to the RNFL. Macula (GCC) and (RNFL) have a comparable ability to diagnose POAG at all the stages of POAG and can be used complimentarily for glaucoma assessment and diagnosis.

The Role of Optical Coherence Tomography in Differential Diagnosis of Multiple Sclerosis and Autoimmune Connective Tissue Diseases with CNS Involvement.

The purpose of this study was to examine whether application of optical coherence tomography (OCT) measurements can provide a useful biomarker for distinguishing central nervous system (CNS) involvement in autoimmune connective tissue diseases (CTD) from multiple sclerosis (MS). An observational study included non-optic neuritis eyes of 121 individuals: 59 patients with MS, 30 patients with CNS involvement in CTD, and 32 healthy controls. OCT examination was performed in all subjects to measure retinal nerve fiber layer (RNFL) thickness, ganglion cell complex (GCC) thickness, ganglion cell layer-inner plexiform layer (GCIPL) thickness, and volume of the macula. There was a significant group effect with regard to superior optic disc RNFL, macular RNFL, GCC, and GCIPL thickness, and macular volume. Post-hoc analysis revealed that MS patients have significantly smaller macular volume and thinner superior optic disc RNFL, macular RNFL, GCC, and GCIPL compared to healthy controls. CTD patients have significantly smaller superior optic disc RNFL, GCIPL, and GCC thickness compared to healthy controls. However, no significant group differences were observed between the patient groups (MS vs. CTD) on any outcome. Although a prominent retinal thinning may be a useful biomarker in MS patients, in a general population of individuals with a confirmed CNS involvement the use of OCT is not specific enough to discriminate between MS and autoimmune CTD.

Effect of Obstructive Sleep Apnea Syndrome on Retinal Nerve Fiber Layer and Ganglion Cell Complex

In this study, we aimed to identify the effect of oxygen desaturation due to comparing ganglion cell complex (GCC), retinal nerve fiber layer (RNFL) between patients with obstructive sleep apnea syndrome (OSAS), simple snoring and healthy individuals.132 total patients with OSAS and simple snoring who were diagnosed with polysomnography between 2016 -2018 and 88 healthy individuals were included in the prospective-case control study. The patients were grouped according to the Apnea Hypopnea Index (AHI). Healthy volunteers and the patients with simple snoring (the AHI index value lower than 5) were grouped as respectively Group 1(G1) and Group 2 (G2). Groups 3 to 5 were separated according to the AHI index as mild OSAS (Group 3 (G3); AHI=5-15), moderate OSAS (Group 4(G4);AHI=16-30), and severe OSAS (Group 5(G5); AHI&gt;30). All study participants underwent an examination of both eyes including corrected visual acuity, intraocular pressure measurement, dilated-pupil fundus examination, with RNFL and GCC thickness which were measured with optical coherence tomography (OCT). Of the 132 patients included in the study, 29 had simple snoring, 22 mild, 22 moderate, and 57 severe OSAS. When bilateral mean, superior, inferior, temporal, and nasal RNFL thickness and mean, superior and inferior GCC values were compared among the study groups; no statistically significant difference was found (p&gt;0.005). No significant difference was evaluated between mean RNFL thickness, four quadrants RNFL thicknesses, mean GCC thickness, two quadrants GCC thickness with OCT in the study patients. Indeed, because the patients with diagnosed OSAS could more likely to develop glaucoma, it would be appropriate for these patients to have a regular optic examination.

Comparison of the retinal nerve fiber layer and ganglion cell complex thickness in Korean patients with unilateral exfoliation syndrome and healthy subjects.

PurposeTo compare retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness in patients with unilateral exfoliation syndrome (XFS) and age-matched controls using spectral domain-optical coherence tomography (SD-OCT).Materials and methodsThis prospective case–control study included 54 eyes (the XFS-affected and the fellow eyes) of 27 unilateral XFS patients and 27 eyes of 27 age-matched control subjects. The RNFL and GCC thicknesses were measured using SD-OCT (RT-Vue 100, Optovue, Fremont, CA) after pupillary dilation. RNFL and GCC thicknesses were compared between case and control groups.ResultsThe mean age of XFS patients was 73.3 years and that of age-matched controls was 74.3 years. Both groups demonstrated a male preponderance. Superior RNFL thickness of XFS-affected eyes were significantly thinner than those of the healthy age-matched controls (P = 0.002 by ANOVA). There were no statistically significant differences in the RNFL thickness between both eyes of unilateral XFS patients. Moreover, superior GCC thickness of both eyes in unilateral XFS patients were thinner than those in controls (P = 0.002 by ANOVA).ConclusionsThinner RNFL and GCC thicknesses were observed in unilateral XFS patients without visual field defects. These findings imply that XFS itself might be a risk factor for development of glaucomatous optic disc and RNFL damage.

Short-term variations of optic coherence tomography findings in mild and severe chronic obstructive pulmonary disease.

To evaluate the short-term changes in subfoveal choroidal thickness (SFCT), ganglion cell complex (GCC) analysis, and retinal nerve fiber length (RNFL) of patients with chronic obstructive pulmonary disease (COPD) in a 3-month follow-up. Forty-eight patients with COPD (96 eyes) and 40 control subjects (80 eyes) were enrolled in our study. COPD patients were grouped according to disease severity as Group 1 (mild-moderate) and Group 2 (advanced). GCC, RNFL, and SFCT analysis by Cirrus SD-OCT were obtained for all eyes, in two consecutive examinations with a 3-month interval. SFCT in Group 2 was lower than Group 1 and control group in the initial and 3rd month examination (p < 0.001, respectively). Inferior RNFL in Group 2 were lower than control group in the initial and 3rd month examination (p = 0.002, p < 0.001, respectively) Temporal RNFL were lower in Group 2 than Group 1 in 3rd month examination (p = 0.009). Average, superior, superotemporal, inferior, and inferonasal GCC analyses of the Group 2 were lower than control group both in the initial and 3rd month examination (p = 0.001, p < 0.001, respectively) SFCT, average, and superior GCC of Group 2 were significantly reduced during the 3-month follow-up (p < 0.001). Hypoxia is thought to be the underlying mechanism in COPD, which may influence retinal and choroidal OCT parameters. Decrease in blood flow of optic nerve head, increased vascular resistance, and reduced blood flow in choroid may affect the visual ability in these patients, which should be kept in mind during their follow-up.

Linear discriminant score for differentiating early primary open angle glaucoma from glaucoma suspects.

Purpose:To determine the diagnostic accuracy of a linear discriminant function (LDF) based on macular ganglion cell complex (GCC), optic nerve head (ONH) and retinal nerve fibre layer (RNFL) for differentiating early primary open-angle glaucoma (POAG) from glaucoma suspects.Methods:In this cross-sectional study, data from consecutive 127 glaucoma suspects and 74 early POAG eyes were analysed. Each patient underwent detailed ocular examination, standard automated perimetry, GCC and ONH and RNFL analysis. After adjusting for age, gender and signal strength using the analysis of covariance; Benjamin–Hochberg multiple testing correction was performed to detect truly significant parameters to calculate the LDF. Subsequently, diagnostic accuracy of GCC and ONH and RNFL were determined. The obtained LDF score was evaluated for diagnostic accuracy in another test set of 32 suspect and 19 glaucomatous eyes. Data were analysed with the R-3.2.1 (R Core Team 2015), analysis of variance, t-test, Chi-square test and receiver operating curve.Results:Among all GCC parameters, infero temporal had the best discriminating power and average RNFL thickness and vertical CDR among ONH and RNFL parameters. LDF scores for GCC had AUROC of 0.809 for a cut-off value 0.07, while scores for ONH and RNFL had AUROC of 0.903 for a cut-off value − 0.24. Analysis on combined parametric space resulted in avg RNFL thickness, vertical CDR, min GCC + IPL and superior GCC + IPL as key parameters. LDF scores obtained had AUROC of 0.924 for a cut-off value 0.1. The LDF was applied to a test set with an accuracy of 84.31%.Conclusion:The LDF had a better accuracy than individual GCC and ONH and RNFL parameters and can be used for diagnosis of glaucoma.

Do you have restless leg syndrome? I understood from your eyes.

According to many studies in the literature, there is a strong association between restless leg syndrome and dopaminergic dysfunction. Dopamine is also the major catecholamine in the retina and is also a possible transmitter of the amacrine and interplexiform cells. The aim of this study is to investigate the possible association between RLS and retinal thickness. In this study, we included 33 patients who were diagnosed with idiopathic RLS according to the "International RLS Study Group" criteria and 31 healthy subjects. All the patients and controls underwent routine ophthalmologic examination and had spectral-domain optical coherence tomography (OCT) performed. We compared the retinal thickness of the patients and control subjects. In the RLS group, foveal thickness was thinner then controls. Also, only inferior, superior, and temporal quadrant retina nerve fiber layer (RNFL) thickness were significantly thinner in the RLS group. The parafoveal ganglion cell complex (GCC) in the superior temporal, inferior temporal, inferior nasal quadrant, and perifoveal superior nasal thickness was also significantly thinner in the patient group. Pearson correlation analyses showed that there were statistically significant negative correlations between disease duration and macular GCC and RNFL thickness. Negative correlations were also detected between parafoveal superior, temporal, inferior and nasal macular thickness, parafoveal superior nasal, inferior temporal GCC thickness, and perifoveal superior nasal GCC thickness and disease duration. According to our results; most retinal layers are thinner in RLS patients, so it can be considered that OCT has a predictive value for progression of RLS.

The characteristics of multifocal microperimetry and its relationship with visual acuity and multifocal ganglion cell complex in nonarteritic anterior ischemic optic neuropathy

Objective To observe the characteristics of multifocal microperimetry and its relationship with visual acuity and multifocal ganglion cell complex (GCC) in nonarteritic anterior ischemic optic neuropathy (NAION). Methods A retrospective case study. A total of 38 patients (54 eyes) with NAION were enrolled in this study. 25 NAION eyes (25 patients) and 29 contralateral health eyes (29 patients) were randomly selected into case group and control group respectively. All eyes underwent best corrected visual acuity (BCVA), slit lamp microscope, indirect ophthalmoscope, color fundus photography, optical coherence tomography (OCT), visual field and multifocal microperimetry. Logarithm of the minimum angle of resolution (logMAR) was used to calculate BCVA. There were no significantly differences on age (t=−0.647), gender, dominant eyes ( χ2=0.128, 0.099), intraocular pressure (t=0.376) between two groups (P>0.05). Macular GCC thickness, superior and inferior GCC thickness were measured by OCT, focal loss volume (FLV) and global loss volume (GLV) were obtained at the same time. Microperimetry were measured by macular integrity assessment instrument (MAIA microperimetry), and mean retinal sensitivities (MS) in macular area 10° and fixation rate in the macular central 2° and 4° were determined. The relationship between MS, macular GCC and BCVA were analyzed by Spearman correlation analysis. Results The mean logMAR BCVA of case group and control group were 0.68±0.79 and 0.07±0.06, respectively. There was significantly statistical difference in MS between two groups (t=−2.507, P=0.037). There were no significantly statistical difference in mean GCC (t=−1.245, P=0.259), superior and inferior GCC (t=−1.336, −1.024; P=0.230, 0.346), FLV (t=1.058, P=0.331) and GLV (P=0.182) between two groups. The correlation between BCVA and MS (r=−0.809, P=−0.005) was observed. However, there were no correlation between BCVA and GCC, superior and inferior GCC, FLV, GLV (r=−0.98, −0.466, −0.061, 0.442, 0.442; P=0.817, −0.244, 0.885, 0.273, 0.273). And also, there were no correlation between MS and GCC, superior and inferior GCC, FLV, GLV (r=0.238, 0.524, 0.286, 0.643, −0.619; P=0.570, 0.183, 0.493, 0.086, 0.102). Conclusions MS reduced in early stage NAION eyes, which did not correlate with macular GCC. Key words: Optic neuropathy, ischemic; Visual fields; Tomography, optical coherence

Diagnostic value of thickness of macular ganglion cell complex and retinal nerve fiber layer measured by optical coherence tomography in patients with anterior ischemic optic neuropathy

Background Anterior ischemic optic neuropathy (AION) is a common eye disease, and early diagnosis is very important for reserving useful vision.Frequency-domain optical coherence tomography (FD-OCT) can display retinal microstructure in vivo and quantify the thickness of macular ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL). Previous study on assessing retinal ganglion cell loss is assessed by measuring the RNFL thickness, while recent researches showed that GCC thickness measurement can reveal the retinal structure change in AION patients.However, there is few comparative studies on the diagnostic efficiency of RNFL thickness versus GCC thickness for AION. Objective This study was to evaluate and analyze the diagnostic value of GCC thickness and RNFL thickness measured by FD-OCT in patients with AION. Methods Fifteen eyes of 15 patients with AION and 14 normal eyes of 14 normal persons were enrolled in Eye Hospital of Tianjin Medical University from December 2013 to July 2014.Macular GCC thickness and disc RNFL thickness were measured by FD-OCT, and macular GCC thickness included superior, inferior and average GCC thickness around 6 mm×6 mm of macula, and focal loss volume (FLV) and global loss volume (GLV) were calculated.The disc RNFL thickness included superior, inferior and mean RNFL thickness around disc.The measuring outcomes between AION group and normal control group were compared.The diagnostic efficiency of GCC thickness and RNFL thickness was evaluated by the area under the receiver operating characteristic (ROC) curve. Results Compared with normal control group, the GCC thickness at superior, inferior and average GCC thickness at macula were thinner, with significant differences between them (t=-3.402, P=0.002; t=2.690, P=0.012; t=2.913, P=0.007). The FLV and GLV values were (8.39±4.54)μm3 and (19.57±10.66)μm3 in the AION group, which were significantly lower than (0.64±0.48)μm3 and (1.14±0.91)μm3 in the normal control group (t=5.036, 6.732; both at P<0.01). The disc RNFL thicknesses of superior, inferior and average RNFL were thinner in the AION group than those in the normal control group, with significant differences between them (t=2.815, P=0.009; t=2.392, P=0.024; t=2.863, P=0.008). The AUC of FLV and GLV for AION were both 1.000, and that of superior GCC thickness, inferior GCC thickness and average GCC thickness at macula was 0.871, 0.819 and 0.795, respectively.The AUC of average RNFL thickness and disc superior, inferior RNFL thicknesses for AION were 0.814, 0.809 and 0.762, respectively. Conclusions The diagnosis ability of GCC and RNFL thickness for AION is comparable.FLV and GLV appear to have the strongest efficiency in the evaluation of GCL in AION patients.Macular GCC measurement may provide a good alternative or a complementary practice to RNFL scans for the diagnosis of AION. Key words: Optic neuropathy, ischemic/diagnosis; Tomography, optical coherence; Retinal ganglion cells; Retina; Nerve fibers