Analysis of Ganglion Cell Complex and Retinal Nerve Fiber Layer Thickness in Glaucoma Diagnosis

Abstract

The aim was to compare retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thicknesses in patients with primary open angle glaucoma (POAG), ocular hypertension (OH) and healthy subjects, and to investigate the role of GCC parameters in glaucoma diagnosis. Eighty-one patients were divided into four groups according to Hodapp-Parrish-Anderson classification: 26 OH, 22 early POAG, 10 moderate to advanced POAG, and 23 healthy subjects. All patients underwent RNFL and GCC thickness measurement using SOCT Copernicus HR. All RNFL and GCC parameters were significantly lower in POAG than in OH and healthy subjects, especially Average RNFL, RNFL Superior and Inferior, GCC Average, and GGC Inferior. Of all RNFL parameters, the highest area under the receiver operating characteristic curve (AUC) was recorded for Average RNFL, 0.906. GCC Average, and GCC Superior and Inferior had the overall highest AUCs (0.957, 0.955 and 0.946, respectively) with 100% specificity. The RNFL Average and Inferior and GCC Average, Superior and Inferior were identified as the main predictors for development of glaucoma (p=0.015 and p=0.014 vs. p=0.002, p=0.002 and p=0.003, respectively). In conclusion, GCC parameters showed a slightly better glaucoma discriminating ability and were found to be better predictors for development of glaucoma as compared with RNFL.

Diagnostic evaluation of optical coherence tomography parameters in normal, preperimetric and perimetric glaucoma patients

“…GCL parameters however perform poorly in differentiating glaucomatous from non-glaucomatous eyes and between normal and PPG in our cohort of patients. This is in contrast with previous studies which reported that GCL parameters have a better diagnostic ability compared to RNFL parameters [27] . Nevertheless, there were an abundant body of evidence reporting otherwise, agreeing with our results.…”

The Comparison of Age-related Change in Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses between Glaucoma Suspects and Healthy Individuals

“…In the present study, overall GCC thickness in the control group was measured as 111.3 µm, which was higher than a previous study by Aydogan et al (100.7 µm) 21 ; however, it was found lower than the value found in Vidas et al's study (119.61 µm). 22 Thus, the overall GCC thickness was 104.67 µm in the present study, which was in the middle of the values found by Aydogan et al (100.5 µm) 21 and Vidas et al (112.58 µm) study 22 in the glaucoma suspect group. In overall GCC thickness, age-related decay was present in both control (0.23 µm) and glaucoma suspect (0.11 µm) groups; however, these decays between groups were not found to be statistically significant.…”

Screening for Glaucoma in Adults

“…Across all key questions, 83 studies (reported in 96 publications, total 75 887 participants) were included (30 trials and 53 diagnostic accuracy studies) (Figure 2). Sixteen studies were carried forward from the 2013 reviews, and 67 studies were new.…”

“…Fifty-three studies evaluated the diagnostic accuracy of screening tests (reported in 59 publications, n = 65 464) (eTables 3-4 in the Supplement). Most studies evaluated spectral-domain OCT (29 studies, n = 11 434), tonometry (17 studies, n = 49 742), and visual field assessment (10 studies, n = 11 633). No study evaluated the diagnostic accuracy of a comprehensive ophthalmological examination.…”