Korean J Ophthalmol.  2016 Dec;30(6):451-458. 10.3341/kjo.2016.30.6.451.

Macular Ganglion Cell Layer Assessment to Detect Glaucomatous Central Visual Field Progression

• Moon H
• Lee JY
• Sung KR
• Lee JE

• KMID: 2374003
• DOI: http://doi.org/10.3341/kjo.2016.30.6.451

Abstract

PURPOSE
To investigate the use of ganglion cell inner plexiform layer (GC-IPL) thickness, as measured by spectral domain optical coherence tomography, to detect central visual field (VF) progression.
METHODS
This study included 384 eyes from 384 patients (219 preperimetric and 165 perimetric glaucomatous eyes; average follow-up, 4.3 years). Photographic assessment of retinal nerve fiber layer (RNFL) and serial VF analysis were performed to detect glaucoma progression in the central (within 10°) area. Study inclusion required at least five serial spectral domain optical coherence tomography exams at different visits. The long-term test-retest variability of average GC-IPL thicknesses was calculated in 110 stable preperimetric glaucomatous eyes. The sensitivity and specificity of GC-IPL measurements for the detection of central VF progression were calculated in an event-based analysis using the calculated variability as a cut-off and were compared with those of central RNFL photographic assessment.
RESULTS
The intersession test-retest variability, defined as the 95% confidence interval, was 1.76 µm for average GC-IPL thickness. The sensitivity and specificity of the average GC-IPL thickness for detecting central VF progression were 60.7% and 78.9%, respectively. Among six sectors, the inferonasal GC-IPL sector showed the highest sensitivity (53.6%). The sensitivity of the ≥1 sector GC-IPL to detect central VF progression was significantly higher than that of central RNFL photographic progression (p = 0.013). Other GC-IPL parameters showed comparable sensitivity and specificity to detect central VF progression compared with RNFL photographic progression.
CONCLUSIONS
Serial GC-IPL measurements show comparable performance in the detection of central glaucomatous VF progression to RNFL photographic assessment.

Keyword

Central visual field; Glaucoma; Optical coherence tomography; Retinal ganglion cell

MeSH Terms

Disease Progression
Female
Follow-Up Studies
Glaucoma/*diagnosis/physiopathology
Humans
*Intraocular Pressure
Macula Lutea/*diagnostic imaging
Male
Middle Aged
ROC Curve
Retinal Ganglion Cells/*pathology
Retrospective Studies
Time Factors
Tomography, Optical Coherence/*methods
*Visual Fields

Figure

• 

  Fig. 1 The central circle (6-mm diameter) corresponds to the ganglion cell inner plexiform layer map size overlapping the redfree retinal nerve fiber layer photograph to determine central retinal nerve fiber layer progression.

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