<p>Individual Macular Layer Evaluation with Spectral Domain Optical Coherence Tomography in Normal and Glaucomatous Eyes</p>

Abstract

Purpose: To evaluate differences in the thickness of the individual macular layers between early, moderate, and severe glaucomatous eyes and compare them with healthy controls. Patients and Methods: Subjects with glaucoma presenting typical optic nerve head findings, high intraocular pressure with or without visual field (VF) damage and normal controls were included. All participants underwent 24-2 perimetry and spectral-domain OCT. Patients were divided into three groups (early, moderate, and severe) based on the mean deviation of the VF and a healthy control group. The device segmented the layers automatically, and their measurements were plotted using the means of the sectors of the inner (3mm) and outer (6mm) circles of the ETDRS grid. Results: A total of 109 eyes qualified for the study: 14 in the control group and 52, 18 and 25 in the early, moderate and severe groups, respectively. Mean age was 66.13 (SD=12.38). The mean thickness of the circumpapillary retinal nerve fiber layer (RNFL), total macular thickness (TMT), macular RNFL, ganglion cell layer (GCL) and inner plexiform layer (IPL) were significantly different between the 4 groups, with progressive decrease in thickness. Significant overall difference was found for the inner nuclear layer (INL), and the severe glaucoma group presented thicker measurements than controls and early glaucoma. Outer nuclear layer (ONL) was thinner in severe glaucoma group compared with early glaucoma group. Conclusion: Individual macular layer measurement using the inner and outer circles of the ETDRS grid is useful to evaluate different stages of glaucoma. The INL thickening and ONL thinning in advanced glaucoma should be explored in the future studies.

High sampling resolution optical coherence tomography reveals potential concurrent reductions in ganglion cell‐inner plexiform and inner nuclear layer thickness but not in outer retinal thickness in glaucoma

“…Previous studies investigating macular retinal layer thickness measurements in glaucoma have variably reported no significant differences in INL and outer retinal thicknesses between glaucoma and comparative cohorts [10][11][12][13][14][15] and increased INL thickness with increasing glaucoma severity. 13,[16][17][18] Conversely, this study observed colocalised reductions in INL and GCIPL thickness, and two key points have likely contributed to these differences between study findings.…”

“…8 Whether retinal layers outside of the inner retina are affected in glaucoma is not well-established, with OCTbased studies in glaucomatous eyes variably reporting no changes in outer retinal thickness measurements and apparent thickening of outer retinal measurements with increasing glaucoma severity. [9][10][11][12][13][14][15][16][17][18] The myriad of presentations consistent with glaucoma has likely contributed to widely variable thickness measurements between individual eyes with glaucoma and between cohorts in different studies, 19,20 and likewise it is well-documented that retinal thickness measurements in normal eyes are highly variable. [21][22][23][24][25] Subsequently, when not accounting for variations across individuals, significant overlap in thickness measurement distributions could occur depending on effect size.…”

Retinal Sublayer Thickness Analysis of The Macula of Symptomatic and Asymptomatic Carriers of G11778A Mutations with Leber's Hereditary Optic Neuropathy

“…(22) Until now, no studies have described the ONL layer in symptomatic carriers with LHON. Recently, Fujihara et al (23) published a study on glaucoma that found signi cant thinning of the ONL in advanced open-angle glaucoma. It has also been reported that macular ONL thickness increases in the early stages of glaucoma, then gradually thins in the later stages until the thickness approached that of normal subjects.…”

Retinal Glaucoma Public Datasets: What Do We Have and What Is Missing?

“…It makes it possible to diagnose and monitor glaucoma through the evolution of macular thickness. Although central vision is often preserved in late glaucoma, the thinning of the macular area is a parameter found in the early stages of the disease and precedes visual field defects [18]. Figure 1 exemplifies an OCT diagram (left part) correlating with a papilla (right part).…”