Macular imaging by optical coherence tomography in the diagnosis and management of glaucoma

Abstract

The macular area is important to the detection of glaucomatous retinal ganglion cell (RGC) damage. Macular thickness complementary to peripapillary retinal nerve fibre layer (RNFL) thickness can well reflect glaucomatous damage, given that the macula contains more than 50% of the RGCs in a multilayered pattern and larger RGC bodies compared with their axons. Thus, macular ganglion cell thickness parameters recently have been considered to be an effective glaucoma-diagnostic tool comparable to RNFL thickness parameters. Furthermore, spectral-domain optical coherence tomography ganglion cell-inner plexiform layer thickness and deviation maps can provide additional information essential for distinguishing glaucomatous changes from other, myopia-associated or macular disease-associated changes. Therefore, our aim with this study was to review the clinical application of macular imaging by optical coherence tomography and to provide essential clinical tips for its use in the diagnosis and management of glaucoma.

<p>Peripapillary Vessel Density In Unilateral Preperimetric Glaucoma</p>

“…Examination of optic disc and visual field has traditionally been used in glaucoma diagnosis. 35 Measurement of peripapillary RNFL and macular GCC 32,36 by means of OCT improved the diagnostic ability to identify early-stage disease. Recently, the VD of RPC obtained by OCTA has emerged as a marker of microvascular disturbances associated with optic nerve damage.…”

“…49,50 Measurements of RNFL and GCC thickness have a high diagnostic ability to detect the glaucomatous damage, but sometimes longitudinal follow-up is needed to establish the PPG diagnosis. 32,36,51 Statistical evaluation of OCT parameters may often mislead into green or red disease. 43,52 Macular comorbidities may also complicate GCC assessment.…”

Peer Review #1 of "Pathway analysis identifies altered mitochondrial metabolism, neurotransmission, structural pathways and complement cascade in retina/RPE/ choroid in chick model of form-deprivation myopia (v0.1)"

“…2017), CNV (Ohno-Matsui et al 2017) and glaucoma (Kim & Park 2017). These morphological changes occur concomitantly with elemental microanalytical evidence of hyperosmotic changes in ion distribution patterns across the retina, RPE and choroid (Brocker et al 2012;Crewther et al 2006;Grubman et al 2016;Hollborn et al 2017;Junghans et al 1999;Liang et al 1995;Liang et al 2004) and reminiscent of physiologically induced hyperosmotic and oxidative stress elsewhere in the brain (Brocker et al 2012;Morland et al 2016;Veltmann et al 2016).…”

Deep learning in glaucoma: progress, but still lots to do

“…SDOCT devices can image not only the optic nerve, but also areas such as the macula, which is also important in glaucoma. 8 Deeplearning algorithms could be used to integrate the vast information derived from imaging multiple regions of the eye to improve detection of glaucomatous damage. It will also be important to assess whether deep-learning algorithms can help to detect progressive glaucomatous changes over time-a task that has proven a lot harder than discrimination of glaucomatous eyes from healthy eyes.…”