Evaluation of ganglion cell complex and retinal nerve fiber layer thinning in epilepsy patients

Purpose: This study aimed to compare the perimacular ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thickness measurements of epileptic and healthy individuals. Methods: The right eyes of 38 epileptic and 38 healthy individuals who had been using antiepileptic drugs (AEDs) for at least 1 year were included in the study. Central macular thickness, perimacular GCC thickness and volume, and peripapillary retinal nerve fiber layers were measured by optical coherence tomography (OCT) device. Perimacular 1, 3, and 6 mm circle diameters of Early Treatment of Diabetic Retinopathy Study (ETDRS) were selected for GCC measurements. Results: In epilepsy patients, GCC was significantly lower in the 3 mm superior quadrant and 6 mm in all quadrants compared to the control group (P < 0.05). RNFL was significantly thinner in epilepsy patients only in the temporal?inferior quadrant (P < 0.05). There was no significant difference between the patients who received AEDs as monotherapy and polytherapy (P > 0.05). Conclusion: We found that epilepsy patients had significant thinning in the GCC layers and temporal?inferior quadrant of RNFL compared to the control group. Our findings from the study show that early retinal changes in epilepsy patients, especially perimacular GCC layers, can be followed up with OCT.

Changes of ganglion cell complex and retinal nerve fiber layer thickness in different degrees of myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the changes in retinal nerve fiber layer(RNFL)and macular ganglion cell complex(GCC)measured by spectral domain optical coherence tomography(SD-OCT)in non-glaucoma subjects with low, moderate, and high myopia.METHODS: A total of 400 subjects(400 eyes)with myopia who attended our hospital from December 2019 to November 2022 were selected to participate in this study, and the subjects were divided into the following groups according to their degree of myopia: low myopia group(142 cases, 142 eyes, 35.5%), moderate myopia group(139 cases, 139 eyes, 34.8%)and high myopia group(119 cases, 119 eyes, 29.8%). RNFL thickness profiles were measured, including mean, superior, inferior, nasal, and temporal RNFL thickness. GCC parameters were measured, including mean, superior, superior temporal, inferior, inferior temporal, superior nasal, and inferior nasal. Correlation between RNFL thickness measured by OCT, mean GCC parameters, and axial length was evaluated.RESULTS: The mean RNFL thickness above, below and nasal side was significantly higher in the low and moderate myopia groups and the temporal RNFL thickness was significantly lower than the high myopia group(all P&#x003C;0.05); the mean GCC thickness above, above temporal, below, below temporal, above nasal, below nasal and mean GCC thickness were significantly higher in the low and moderate myopia groups than in the high myopia group(all P&#x003C;0.05); In the moderate myopia group, the mean RNFL and GCC thickness were both negatively correlated with axial length(r=-0.387, -0.309, all P&#x003C;0.05). In the high myopia group, both RNFL and GCC thickness means were negatively correlated with eye axis length(r=-0.499, -0.503, all P&#x003C;0.01).CONCLUSION:RNFL and GCC thicknesses tend to be thinner in subjects with high myopia than in subjects with low and moderate myopia.

Retinal nerve fiber layer and ganglion cell complex thickness analysis in patients having relative afferent pupillary defect

Purpose: To determine the retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) thickness in patients having relative afferent pupillary defect (RAPD) measured by optical coherence tomography (OCT). Methods: This cross?sectional study was conducted on 30 patients with posterior segment disease and glaucoma presenting with RAPD. The control group comprised 30 patients with the aforementioned diseases without RAPD. RAPD was graded using neutral density filters placed over the unaffected eye. Peripapillary RNFL thickness and macular GCC were measured using the Cirrus HD?OCT machine. Results: There were 45 males and 15 females. There was a statistically significant (P < 0.05) difference in the mean of average RNFL thickness in patients having RAPD (64.73 ± 15.16 ?m in the affected eyes) as compared to sick control (82.73 ± 11.33 ?m in the affected eyes). It was further observed that there was a decrease in RNFL thickness with advancing grades of RAPD. There was a statistically significant (P < 0.05) difference in the mean of average GCC thickness in patients having RAPD (51.57 ± 14.96 ?m in the affected eyes) as compared to sick control (76.36 ± 8.06 ?m in the affected eyes). Conclusion: Our study suggests that there is a significant reduction in RNFL thickness and GCC thickness in RAPD patients as compared to the sick control group

Fellow-eye asymmetry on optical coherence tomography angiography and thickness parameters in unilateral pseudoexfoliation syndrome / Assimetria do olho oposto na angiografia por tomografia de coerência óptica e parâmetros de espessura na síndrome de pseudoexfoliação unilateral

ABSTRACT Purpose: To investigate inter-eye retinal vessel density and thickness asymmetry in unilateral pseudoexfoliation syndrome and understand its use for the early detection of glaucoma. Methods: Thirty patients with unilateral pseudoexfoliation syndrome were enrolled in our study. Optical coherence tomography angiography macular scans were used measure the retinal vessel density, and optical coherence tomography scans were used to assess the thickness parameters of the peripapillary retinal nerve fiber layer and the macular ganglion cell complex. Inter-eye asymmetry was determined by taking the absolute value of the difference in the vessel density and thickness parameters between the pseudoexfoliation syndrome eye and fellow eye. Results: The mean patient age was 64.20 ± 7.05 y in the study group. Inter-eye asymmetry in the peripapillary retinal nerve fiber layer thickness and macular ganglion cell complex measurements were significant in the study group (p=0.03 and p=0.001, respectively). The vessel density of the macular superficial inner region was significantly lower in eyes with pseudoexfoliation syndrome than in fellow eyes (p=0.035). However, there was no inter-eye asymmetry in the central and full region macular superficial vessel density of eyes with pseudoexfoliation syndrome and fellow eyes (p>0.05). Conclusion: Retinal vessel density can be evaluated using optical coherence tomography angiography measurements. There was inter-eye asymmetry in the inner region macular superficial vessel density, peripapillary retinal nerve fiber layer, and macular ganglion cell complex thickness of the unilateral pseudoexfoliation syndrome eyes and fellow eyes. Further studies on a larger number of subjects might provide more clarity regarding the relationship between the inter-eye asymmetry of the retinal vessel density and thickness parameters with early detection of glaucomatous damage.

RESUMO Objetivo: Investigar a densidade dos vasos interoculares da retina e assimetria na espessura na síndrome de pseudoexfoliação unilateral e o seu uso para a detecção precoce de glaucoma. Métodos: Trinta pacientes com síndrome de pseudoexfoliação unilateral foram incluídos no estudo. As varreduras maculares de angiografia por tomografia de coerência óptica mediram a densidade dos vasos da retina, e as varreduras por tomografia de coerência óptica obtiveram parâmetros de espessura da camada de fibras nervosas da retina peripapilar e do complexo macular de célula ganglionar. A assimetria interocular foi determinada tomando o valor absoluto da diferença entre o olho da síndrome de pseudoexfoliação e o olho oposto nos parâmetros de densidade e espessura dos vasos. Resultados: A média de idade foi 64,20 ± 7,05 anos no grupo de estudo. A assimetria interocular na espessura da camada de fibra nervosa da retina peripapilar e as medidas do complexo macular de célula ganglionar foram estatisticamente significativas no grupo de estudo (p=0,03 e p=0,001, respectivamente). Para os olhos com síndrome de pseudoexfoliação, a densidade do vaso da região macular superficial interna foi significativamente menor do que em olhos opostos (p=0,035). No entanto, não houve assimetria interocular estatisticamente significativa na densidade macular dos vasos superficiais da região central e completa entre os olhos da síndrome de pseudoexfoliação e os olhos opostos (p>0,05). Conclusões: A densidade dos vasos da retina pode ser avaliada por medidas de angiografia por tomografia de coerência óptica. Houve assimetria interocular na densidade macular do vaso superficial da região interna, camada de fibra nervosa da retina peripapilar e espessura do complexo macular de célula ganglionar entre olhos com síndrome de pseudoexfoliação unilateral e olhos opostos. Novos estudos com um número maior de indivíduos podem fornecer a relação entre a assimetria interocular da densidade do vaso da retina e os parâmetros de espessura com detecção precoce de dano glaucomatoso.

Rare Case of Misdiagnosed Rathke Pouch Cleft Leading to Severe Visual Loss

A rare case of symptomatic Rathke cleft cyst resulting in severe visual compromise in a young 45 yr/f who presented with gradual progressive painless diminution of vision in both eyes. Patient noticed diminution of vision in the Left eye an year ago and later on in the Right eye for which she consulted ophthalmologists. She was diagnosed as optic neuritis and underwent treatment for the same, but vision didn’t improve. At presentation,vision in Both eyes was same, counting fingers at 2 meters. Pupillary reactions were normal, however there was bilateral disc pallor and rest fundus was normal. On systemic evaluation patient gave history of irregular menstrual periods since 3-4 months. on further investigation her S. Prolactin levels were markedly raised(59.99ng/ml). Radiology showed well defined hyperintense suprasellar lesion. Patient was operated for right frontotemporal craniotomy with decompression of RCCs by a neurosurgeon. 2 months post surgery visual acuity in RE 4/60 and LE is counting finger close to face.

Research on diagnostic value of OCT measurement of optic disc and macular parameters in early primary open angle glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To analyze the diagnostic value of optical coherence tomography(OCT)for early primary open angle glaucoma(POAG)by measuring the thickness of macular ganglion cell complex(mGCC), peripapillary retinal nerve fiber layer(pRNFL), macular retinal nerve fiber layer(mRNFL)and retinal ganglion cell layer+inner plexiform layer(GCIP)in the macular region.METHODS:A case-control study design was used to collect 82 patients(82 eyes)with early POAG who admitted to our hospital from January 2019 to January 2020. There were 40 healthy volunteers(40 eyes)in the same period selected as the control group(20 eyes for left and right eyes, respectively). All subjects underwent tests of uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA)and equivalent spherical power. The upper, lower, nasal, temporal and average pRNFL thickness, the upper, lower and average mGCC, mRNFL and GCIP thickness in the macular region were analyzed. Spearman was used to analyze the correlation among the average thickness of eachindices, and ROC curve was used to analyze the value of mGCC, pRNFL, mRNF and GCIP thickness parameters in diagnosing early POAG.RESULTS:In the early POAG group, the thickness of upper, nasal, lower, temporal, average pRNFL and the thickness of upper, lower and average mGCC, mRNFL and GCIP were lower than those in the control group(all P&#x003C;0.05). Average thickness of pRNFL was positively correlated with average thickness of mGCC, average mRNFL and average GCIP(rs=0.582, 0.632, 0.456, all P&#x003C;0.05); average thickness of mGCC was positively correlated with average thickness of mRNFL and average GCIP(rs=0.583, 0.851, all P&#x003C;0.05); Average thickness of mRNFL was positively correlated with average thickness of GCIP(rs=0.528, all P&#x003C;0.01). ROC curve analysis shows that the AUC value of mGCC thickness and average value in early diagnosis of POAG were all above 0.8, and the diagnostic efficiency was the highest.CONCLUSION: OCT measurement of mGCC has certain value in diagnosing early POAG.

Alterations of macular ganglion cell complex thickness in obstructive appea / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the changes of macular ganglion cell complex(GCC)thickness in patients with obstructive sleep apnea(OSA)and discuss the relativity between thickness of GCC and OSA.<p>METHODS: Fifty-eight patients with OSA whose Apnea-Hypopnea Index ≥5 and fifty healthy people whose Apnea-Hypopnea Index <5 were enrolled in this study. OSA patients were further divided into mild, moderate, and severe OSA groups according to their Apnea-Hypopnea Inde. RTVUE 100-2 optical coherence tomography was used to measure the GCC thickness. The examination included average thickness of GCC(GCC-Avg), superior(GCC-Sup)and inferior thickness of GCC(GCC-Inf), focal loss of volume(FLV)and general loss of volume(GLV). The difference in GCC thickness was analyzed among four groups. <p>RESULTS: The thickness of GCC of the OSA groups was thinner than that of the normal control group(<i>P</i><0.05), and FLV in the OSA groups was higher than that in the normal control group(<i>P</i><0.05), but there was no significant difference in FLV between OSA groups(<i>P</i>>0.05). GLV increased in the OSA groups compared with the control group.<p>CONCLUSION:The macular GCC thickness decreased in OSA patients, and the thickness of GCC decreased with the increase of OSA patients' severity(AHI).

Value of OCT in the diagnosis of primary open angle glaucoma optic nerve injury / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the value of frequency threshold optical coherence tomography(OCT)in the diagnosis of primary open angle glaucoma optic nerve injury. <p>METHODS: Eighty patients with early primary glaucoma who were admitted to the hospital between January 2018 and March 2020 and 100 healthy subjects were selected as the study subjects. Patients with primary open angle glaucoma were divided into early group, middle group and late group. OCT was used to measure the thicknesses of upper, lower, nasal, bitemporal peri-papillary retinal nerve fiber layer(pRNFL)and upper and lower macular ganglion cell complex(mGCC)in each group. The mean deviation(MD)of visual field was determined through perimetry. The OCT parameters and perimetry parameters were compared among groups. Spearman correlation analysis was performed to analyze the correlation between OCT parameters and visual field defects, and the receiver operating characteristic(ROC)curve was used to calculate the value of OCT parameters in diagnosing primary open angle glaucoma. <p>RESULTS: There were 24 cases, 39 cases and 17 cases in the early group, middle group and late group, respectively. There were statistically significant differences in pRNFL and mGCC among 3 groups(<i>P</i><0.05).The upper, lower, average pRNEL and the upper, lower, and average mGCC of patients in the early group of a third-class hospital were significantly lower than those of the control group, and the parameters of pRNFL and mGCC in each position of the mid-stage and late group were significantly lower than those of the control group. The upper, lower, nasal pRNFL, average pRNFL, upper, lower and average mGCC of the late group of glaucoma patients were significantly lower than those of the early group and the middle group. The indicators of the middle group were significantly lower than those of the early group(<i>P</i><0.05). Spearman correlation analysis showed that pRNFL and mGCC parameters were negatively correlated with glaucoma severity(<i>P</i><0.05)ROC curve analysis showed that the areas under the curves of the upper, lower, nasal, bitamporal and average pRNFL for diagnosis of primary open angle glaucoma optic nerve injury were 0.693, 0.846, 0.676, 0.579 and 0.844, respectively. The areas under the curves of upper, lower and average mGCC for diagnosis of primary open angle glaucoma optic nerve injury were 0.542, 0.677 and 0.676 respectively. The area under the curve of average pRNFL combined with average mGCC for the diagnosis of primary open angle glaucoma optic nerve injury was 0.883. <p>CONCLUSION:The pRNFL and mGCC measured by OCT are closely related to the degree of primary open angle glaucoma optic nerve injury. Both have high diagnostic value for glaucoma and can be used clinically for diagnosis and condition assessment.

Changes in the ganglion cell complex thickness after anti-VEGF treatment for diabetic macular edema / Alterações na espessura do complexo de células ganglionares após tratamento anti-VEGF para edema macular diabético

ABSTRACT Purpose: To assess tomographic ganglion cell complex changes in patients with diabetic macular edema treated with intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF). Methods: We analyzed data from 35 eyes of 35 previously untreated patients in whom diabetic macular edema improved after three loading doses of anti-VEGF injection and who did not receive repeated injections. We recorded spectral domain-optical coherence tomography assessments of ganglion cell complex and central macular thickness at baseline and monthly for three months, and on the sixth and ninth month after treatment. We compared the results with those of the unaffected eyes in the same patients and with those in a control group of patients with diabetic macular edema who were untreated. Results: The mean age of the patients in the treatment group was 60 ± 4.38 years. The foveal thicknesses measured using optical coherence tomography decreased significantly from baseline to the third month post-injection (p<0.05). The mean ganglion cell complex thickness was 115.08 ± 16.72 µm before the first injection and 101.05 ± 12.67 µm after the third injection (p<0.05). The mean ganglion cell complex was 110.04 ± 15.07 µm on the sixth month (p>0.05) and 113.12 ± 11.15 µm on the ninth month (p>0.05). We found a significant difference between the patients and the control group in terms of mean ganglion cell complex thickness on the second- and third-months post-injection (p<0.05). Conclusion: Our study showed that the ganglion cell complex thickness in patients with diabetic macular edema decreased after the anti-VEGF injections. We cannot ascertain whether the ganglion cell complex thickness decreases were due to effects of the anti-VEGF agents or to the natural disease course.

RESUMO Objetivo: Avaliar as alterações do complexo tomográfico das células ganglionares em pacientes com edema macular diabético tratados com injeções intravítreas do fator de crescimento endotelial anti-vascular (anti-VEGF). Métodos: Analisamos dados de 35 olhos de 35 pacientes previamente não tratados nos quais o edema macular diabético melhorou após três doses de injeção de anti-VEGF e que não receberam injeções repetidas. Registramos avaliações da tomografia de coerência óptica de domínio espectral do complexo de células ganglionares e da espessura macular central na linha de base e mensalmente por três meses e, também no sexto e nono mês após o tratamento. Comparamos os resultados com os olhos não afetados nos mesmos pacientes e com os de um grupo controle de pacientes com edema macular diabético que não foram tratados. Resultados: A média da idade dos pacientes no grupo de tratamento foi de 60 ± 4,38 anos. As espessuras foveais medidas pela tomografia de coerência óptica diminuiram significativamente desde o início até o terceiro mês após a injeção (p<0,05). A espessura média do complexo de células ganglionares foi de 115,08 ± 16,72 µm antes da primeira injeção e 101,05 ± 12,67 µm após a terceira injeção (p<0,05). A média do complexo de célula ganglionar foi de 110,04 ± 15,07 µm no sexto mês (p>0,05) e 113,12 ± 11,15 µm no nono mês (p>0,05). Encontramos uma diferença significativa entre os pacientes e o grupo controle quanto à média da espessura do complexo de células ganglionares no segundo e terceiro meses após a injeção (p<0,05). Conclusão: Nosso estudo mostrou que a espessura do complexo de células ganglionares em pacientes com edema macular diabético diminuiu após as injeções de anti-VEGF. Não podemos determinar se a diminuição da espessura do complexo de células ganglionares ocorreu devido aos efeitos dos agentes anti-VEGF ou ao curso natural da doença.

Linear discriminant score for differentiating early primary open angle glaucoma from glaucoma suspects

Purpose: To determine the diagnostic accuracy of a linear discriminant function (LDF) based on macular ganglion cell complex (GCC), optic nerve head (ONH) and retinal nerve fibre layer (RNFL) for differentiating early primary open-angle glaucoma (POAG) from glaucoma suspects. Methods: In this cross-sectional study, data from consecutive 127 glaucoma suspects and 74 early POAG eyes were analysed. Each patient underwent detailed ocular examination, standard automated perimetry, GCC and ONH and RNFL analysis. After adjusting for age, gender and signal strength using the analysis of covariance; Benjamin–Hochberg multiple testing correction was performed to detect truly significant parameters to calculate the LDF. Subsequently, diagnostic accuracy of GCC and ONH and RNFL were determined. The obtained LDF score was evaluated for diagnostic accuracy in another test set of 32 suspect and 19 glaucomatous eyes. Data were analysed with the R-3.2.1 (R Core Team 2015), analysis of variance, t-test, Chi-square test and receiver operating curve. Results: Among all GCC parameters, infero temporal had the best discriminating power and average RNFL thickness and vertical CDR among ONH and RNFL parameters. LDF scores for GCC had AUROC of 0.809 for a cut-off value 0.07, while scores for ONH and RNFL had AUROC of 0.903 for a cut-off value ? 0.24. Analysis on combined parametric space resulted in avg RNFL thickness, vertical CDR, min GCC + IPL and superior GCC + IPL as key parameters. LDF scores obtained had AUROC of 0.924 for a cut-off value 0.1. The LDF was applied to a test set with an accuracy of 84.31%. Conclusion: The LDF had a better accuracy than individual GCC and ONH and RNFL parameters and can be used for diagnosis of glaucoma.

The time relationship of retinal light threshold fluctuations and retinal nerve fiber layer and ganglion cell complex thickness changes on high-risk primary open-angle glaucoma / 中华眼底病杂志

Objective To investigate the time relationship of the change,and diagnostic accuracy and sensitivity between retinal light threshold fluctuations (LTF) and retinal nerve fiber layer (RNFL) and ganglion cell complex(GCC) thickness on high-risk primary open-angle glaucoma (POAG).Methods Totally 319 patients (319 eyes) with high-risk in POAG from the First Affiliated Hospital of Kunming Medical Universityand during December 2009 and December 2017,50 healthy individuals (50 eyes) as control were collected in this longitudinal cohort study.Visual field and OCT were reviewed every 6 months on the high-risk group and every 12 months on the control group.High-risk groups inclusion criteria:vertical C/D≥0.6;early visual field defect (according to glaucoma visual field damage GSS2 quantitative grading standards,mean deviation and pattern standard deviation of central field exceeds the border as an early visual field defect);continuous repeatable results.The first field and OCT results in the absence of visual field defects and C/D≥0.6,which were conformed reliability indicators and removed learning effects as a baseline.When patients achieve POAG diagnosis criteria first time which was recorded as a turning point.And they were divided into early group meanwhile were ended of follow-up.After the last follow-up,the inspection data was segmented counted in yearly interval.The changes of LTF,thickness of RNFL and GCC during the follow-up period in the early POAG group and the control group were observed.The loss rate and change rate in each period were compared for the assessment of their trends with time.Followed by calculation of the area under receiver operating curves (AUC) to compare the predicted value of POAG and the sensitivity at 95％ specificity in each period.Results After last follow-up,totally 67 patients 67 eyes (early POAG group,37 males and 30 females) were entered the turning point.The mean follow-up of the early POAG group and the control group were 6.6 and 6.4 years.The average RNFL thickness was 79.05± 8.09 μm,GCC thickness was 71.58 ± 8.41 μm,LTF was -6.05 ± 7.02 dB in early POAG group.The average RNFL thickness was 93.49± 6.24 μrm,GCC thickness was 79.72± 6.32 μm,LTF was-0.31 ± 0.58 dB in the control group.The differences of LTF and the thickness of RNFL and GCC were statistically significant (t=-5.97,-10.42,-5.60;P＜0.001).The AUC of RNFL,GCC thickness and LTF increased with time in the early POAG group.The sensitivity was gradually increased at 95％ specificity:5th year before to at turning point,RNFL thickness AUC was 0.15,0.65,0.71,0.77,0.85,0.92,and sensitivity was 20％,56％,61％,65％,70％,76％,respectively;GCC thickness AUC was 0.12,0.53,0.69,0.74,0.82,0.90,and sensitivity was 14％,53％,69％,74％,82％,90％,respectively;the AUC of LTF was 0.10,0.21,0.33,0.75,0.86,0.91,and sensitivity was 7％,17％,44％,65％,78％,87％,respectively.Conclusions The earliest time of structural functional damage of POAG is at the 4th year before confirmed,simultaneous RNFL diagnosis accuracy and sensitivity are better than GCC and LTF.The earliest time of visual functional damage of POAG is at the 2th year before confirmed,simultaneous LTF diagnosis accuracy and sensitivity are better than RNFL and GCC.

Interocular symmetry of ganglion cell complex thickness in normal healthy subjects / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate interocular differences in macular ganglion cell complex(mGCC)thickness in normal healthy subjects, and to determine cutoffs for interocular differences in mGCC thickness in normal healthy subjects.<p>METHODS: This was a cross-sectional study. mGCC thickness were measured in 236 healthy volunteers(472 eyes)using optical coherence tomography(OCT). The differences and the relationships of mGCC thickness between right and left eyes were analyzed. <p>RESULTS: For the right eyes, the mean average mGCC thickness was 91.99±6.61μm, and for the left, 91.75±9.93μm, with no significant difference. The mean mGCC thickness among superior and inferior in the right eye were 92.32±6.66μm and 91.27±8.87μm, respectively. The mean mGCC thickness among superior and inferior in the left eye were 92.05±6.55 and 91.51±6.76μm, respectively. It is comparable between the two eyes at different area. The P2.5 and P97.5 percentiles of interocular difference for mean average mGCC thickness were -4.82μm and 4.36μm, for superior mGCC thickness, -5.79μm and 6.42μm, and for inferior mGCC thickness, -7.21μm and 6.28μm. There was a strong correlation in the corresponding area between the right and left eyes for the mGCC thickness.<p>CONCLUSION: mGCC thickness shows significant interocular symmetry in normal subjects. Interocular difference exceeding the normal limits should be considered significantly asymmetrical, and may be indicative of glaucoma.

Study of peripapillary vessel density in primary open angle glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate peripapillary vessel density(VD)in primary open angle glaucoma(POAG)eyes and to compare them with normal control eyes, and to evaluate the diagnostic ability of peripapillary VD in POAG.<p>METHODS: Sixty consecutive POAG patients from March 2018 to December 2018 were enrolled in this study. Sixty age- and sex-matched healthy volunteer were also enrolled as a control group. Using RTVue-100 optical coherence tomography(OCT), the peripapillary VD of POAG eyes and normal control eyes were measured and compared. To assess the diagnostic ability of peripapillary VD in POAG, receiver operating characteristic curves(ROC)and areas under the ROC(AUC)were used. <p>RESULTS: The POAG eyes had a smaller peripapillary VD than the control eyes overall(<i>P</i><0.001). The mean superior and inferior peripapillary VD of the POAG patients were 52.38%±5.31% and 52.58%±5.32%, respectively. The mean superior and inferior peripapillary VD in control eyes were 58.43%±4.11% and 58.36%±3.40%, respectively. Compared to the normal control subjects, the POAG eyes had a smaller superior and inferior peripapillary VD with a significant difference(<i>P</i><0.001). Multivariable linear regression analysis showed that cup/disc ratio and the peripapillary VD were significantly thinner in association with the POAG diagnosis. The ROC and AUC analyses showed that the AUC value of peripapillary VD is 0.808(95% <i>CI</i>:0.730-0.887)with a good diagnostic value. <p>CONCLUSION:The peripapillary VD in POAG eyes was smaller than that of normal control eyes. Decreased peripapillary VD might therefore be associated with POAG. The peripapillary VD had a good diagnostic value.

Discriminating ability of Cirrus and RTVue optical coherence tomography in different stages of glaucoma

Purpose: The aim of this study is to determine which parameter of Cirrus and RTVue optical coherence tomography (OCT) has the highest ability to discriminate between early, moderate, and advanced glaucoma. Simultaneously, to compare the performance of the two OCT devices in terms of their ability to differentiate the three stages of glaucoma. Further, to analyze the macular parameters of both devices and compare them with the conventional retinal nerve fiber layer (RNFL) parameters. Methods: One hundred and twenty eyes (30 healthy and 90 glaucomatous [30 mild, 30 moderate, and 30 advanced glaucoma]) of 65 participants (15 healthy, 50 glaucomatous [15 mild, 15 moderate, and 20 advanced glaucoma]) underwent Cirrus and RTVue OCT scanning on a single visit. Results: Average RNFL thickness and superior RNFL thickness of both the devices and inferior (ganglion cell complex [GCC] of RTVue device best differentiated normals from all stage glaucomatous eyes (P > 0.05). Cirrus average RNFL thickness and superior RNFL thickness performed better than other parameters (P < 0.05) in differentiating early glaucoma from moderate and advanced. In differentiating advanced from early and moderate glaucoma, RTVue average, superior, and inferior RNFL thickness and inferior GCC parameters had the highest discriminating ability (P < 0.05). Conclusion: Overall, average RNFL thickness had the highest ability to distinguish different stages of the disease. No significant difference was found between RTVue and Cirrus OCT device in different severity levels. No significant difference was observed between RNFL and macular parameters in different stages of glaucoma.

Research progress of measurement of retinal ganglion cell complex using optical coherence tomography in glaucoma / 中华实验眼科杂志

Glaucoma mainly affects the axon and cell body of retinal ganglion cells (RGCs).Optical coherence tomography (OCT) is a kind of imaging machine with noncontact,high scanning speed and high resolution,can be used for quantitative measurement of retinal ganglion cell complex (GCC) thickness or ganglion cell-inner layer (GCIPL) thickness.GCC includes nerve fiber layer,ganglion cell layer and inner cluster layer,GCIPL only includes ganglion cell layer and inner cluster layer time domain OCT (TD-OCT) can only measure the total thickness of the macular region,in fact,some levels are not involved in the progress of glaucoma,which leads to a decrease in specificity and sensitivity.At present,spectral domain OCT (SD-OCT) is used for measuring GCC and GCIPL.It gains faster scanning speed than traditional TD-OCT,and can scan more locations and form 3D images in macular region.Therefore,it is helpful to improve the sensitivity and specificity of detecting the damage of glaucoma by refining the stratification of the macular retina and making the qualitative measurement of the inner layer of retina.Three scanning modes and methods are commonly used,RTVue-100 OCT,Cirrus HD-OCT,3D OCT,and the three methods have their own advantages.Measurement of the thickness of GCC by OCT may be influenced by factors such as age,sex,axial length,race and signal intensity.In recent years,many studies have indicated that GCC or GCIPL has a good consistency with the visual field,and can be used in early diagnose and regular follow-up of glaucoma.The future research should be devoted to normal database establishment of GCC and GCIPL thickness parameters with different age and different ethnic and clinical trials and follow-up study should be performed to explore the change rules of those paremeters.

Effects of different surgical methods in open angle glaucoma patients with cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To explore the effects of EX-PRESS glaucoma drainage device implantation and trabectome on visual acuity, intraocular pressure, central anterior chamber depth(ACD)and postoperative complications in patients with primary open angle glaucoma(POAG)complicated with cataract. <p>METHODS: The clinical data of 64 patients(64 eyes)with POAG complicated with cataract in our hospital from March 2015 to January 2017 were retrospectively analyzed. Among them, 34 patients(34 eyes)were given EX-PRESS glaucoma drainage device implantation and cataract phacoemulsification(the Group A)and another 30 cases(30 eyes)were given trabectome combined with cataract phacoemulsification(the Group B). The visual acuity \〖best corrected visual acuity(BCVA)\〗, intraocular pressure, ACD and the thickness of macular ganglion cell complex(GCC)were compared between the two groups before operation and at 5mo after operation, and the differences of postoperative complications were also recorded between the two groups. <p>RESULTS: At 5mo after operation, the BCVA, intraocular pressure(IOP)was lower than that before operation(<i>t</i> _{Group A}=39.359, 21.045; <i>t</i> _{Group B}=23.126, 16.863; <i>P</i><0.01), and the Group A was lower than that in the Group B(<i>t</i>=9.452, 2.761; <i>P</i><0.01). There was no significant difference in the ACD level before and after operation between-groups and within-groups(<i>P</i>>0.05). At 5mo after operation, there was no significant difference in the thickness of macular GCC in the Group A compared with that before operation(<i>P</i>>0.05), but the thickness of macular GCC in the Group B was lower than that before operation(<i>t</i>=3.851, <i>P</i><0.05)and was lower than that in the Group A(<i>t</i>=2.269, <i>P</i><0.05). The incidence rate of postoperative complications in the Group A was significantly lower than that in the Group B(<i>χ</i>²=7.883, <i>P</i><0.05). <p>CONCLUSION: EX-PRESS glaucoma drainage device implantation or trabectome combined with cataract phacoemulsification can receive good treatment effects in treating POAG patients with cataract, but the former one has better effects on reducing IOP and improving visual acuity than those in the latter one. And EX-PRESS glaucoma drainage device implantation can reduce the incidence rate of postoperative complications, and it is also beneficial to the reduction of retinal ganglion cells(RGCs)damage and the disease prognosis.

Diagnostic value of mGCC in primary glaucoma and its correlation with pRNFL and visual fields / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the diagnostic value of macular ganglion cell complex(mGCC)in primary glaucoma and explore the correlation between mGCC and peripapillary retinal nerve fiber layer(pRNFL)and visual field, in order to provide scientific reference for the diagnosis and treatment of primary glaucoma. <p>METHODS: Eighty eyes in 67 primary glaucoma patients admitted to our hospital from January 2015 to December 2016 were included in the observation group. Another 80 eyes in 40 healthy subjects in our hospital were included in the control group during the same period. The mGCC and pRNFL thicknesses of two groups were measured with an optical coherence tomography(OCT). The thickness of mGCC and pRNFL and visual field were compared between the two groups. The diagnostic value of mGCC for primary glaucoma was analyzed. The correlation between mGCC and pRNFL and visual field mean defect was detected. <p>RESULTS: The superior, inferior and average mGCC thickness in the observation group was significantly lower than that in the control group(<i>P</i><0.05). The superior, inferior and average pRNFL thickness in the observation group were significantly lower than those in the control group, the difference was statistically significant(<i>P</i><0.05). The visual field mean defect in the observation group was significantly higher than that in the control group, the difference was statistically significant(<i>P</i><0.05). Pearson correlation analysis showed that there was a significant positive correlation between mGCC and pRNFL(<i>r</i>=0.58, <i>P</i><0.01)and there was a significant negative correlation between mGCC and the average visual field defect(<i>r</i>=-0.69,<i> P</i><0.01)in the observation group. ROC curve analysis showed that the intercept point value of mGCC in the diagnosis of primary glaucoma was 86.39μm. The sensitivity was 82.5% and the specificity was 76.25%. <p>CONCLUSION: The mGCC has a certain diagnostic value for primary glaucoma. There is positive correlation between mGCC and pRNFL and negative correlation between that and visual field mean defect.

Application of Ic-VEP in diagnosis of early and middle stage glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To study the sensitivity and specificity of Ic-VEP in diagnose of early and middle stage glaucoma. <p>METHODS: All the participants included glaucoma patients and normal people came from Beijing Aier-Intech Eye Hospital from October 2014 to October 2016. All the participants performed slit lamp examination, fundus examination, Goldmann applanation tonometer, Humphery visual field examination, retinal nerve fiber layer(RNFL)thickness and macular ganglion cell complex(GCC)thickness examination and Ic-VEP. The sensitivity and specificity of Ic-VEP in diagnose of glaucoma were main results. <p>RESULTS: The sensitivity and specificity of Ic-VEP in diagnose of glaucoma is 82% and 92% respectively. The area under ROC curve was 0.872. Consistency of Ic-VEP and GCC thickness in moderate glaucoma was good(<i>Kappa</i> value=0.75). <p>CONCLUSION: Ic-VEP is a useful new method for the diagnosis of early and middle stage glaucoma.

Association between Alzheimer's disease and glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the correlation between Alzheimer's disease(AD)and the pathogenesis of glaucoma.<p>METHODS: Prospective observational study. Totally 24 AD subjects and 30 age- and sex-matched controls were enrolled. All of the subjects had a cup-to-disc ratio(CDR)less than 0.6 and asymmetry of less than 0.2 between right and left eyes. Retinal nerve fiber layer(RNFL)thickness and macular ganglion cell complex(mGCC)thickness were obtained using Fourier domain optical coherence tomography. The intraocular pressure(IOP)was also measured.<p>RESULTS: Mini-mental state examination(MMSE)scores were significantly higher in the AD group compared with controls(<i>P</i><0.01). AD patients also showed lower IOP(12.7±2.8mmHg <i>vs</i> 14.36±3.3mmHg; <i>P</i><0.05). However, these was no significant difference in RNFL thickness and mGCC thickness between the two groups(<i>P</i>>0.05).<p>CONCLUSION: Patients with AD have lower IOP, which suggesting a protection mechanism of optic nerve damage in AD patients.

Research progress of the spectral-domain optical coherence tomography for glaucoma diagnosis / 中华实验眼科杂志

Optical coherence tomography (OCT) has the advantage of non-contact,good repeatability and quick to obtain retinal image.With the rapid development of resolution and scanning speed,OCT has been more widely used in the field of ophthalmology.OCT has developed from time-domain OCT (TD-OCT) to spectral-domain OCT (SD-OCT).OCT can diagnose glaucoma without visual field damage and play an important role in monitoring and diagnosing the progression of primary open angle glaucoma.In recent years,SD-OCT has made an enoumous contribution to the detection and diagnosis of glaucoma,by detecting retinal nerve fiber layer (RNFL) thickness,structural parameters of optic disc as well as the macular ganglion cell complex (mGCC) thickness.This paper reviewed the relevant researches of the three parameters obtained from SD-OCT on the diagnosis of primary glaucoma.