Macular Ganglion Cell Layer Assessment to Detect Glaucomatous Central Visual Field Progression.
10.3341/kjo.2016.30.6.451
- Author:
Haein MOON
1
;
Jin Young LEE
;
Kyung Rim SUNG
;
Jong Eun LEE
Author Information
1. Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sungeye@gmail.com
- Publication Type:Original Article
- Keywords:
Central visual field;
Glaucoma;
Optical coherence tomography;
Retinal ganglion cell
- MeSH:
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
- From:Korean Journal of Ophthalmology
2016;30(6):451-458
- CountryRepublic of Korea
- Language:English
-
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.
