Ghita Aurelian Mihai, Iliescu Daniela Adriana, Ghita Ana Cristina, Ilie Larisa Adriana, Otobic Alexandru
Ophthalmology Department, Bucharest University Emergency Hospital, 169 Splaiul Independenței Street, 050098 Bucharest, Romania.
Department of Physiology, "Carol Davila" University of Medicine and Pharmacy, 8 Eroii Sanitari Bld., 050474 Bucharest, Romania.
Diagnostics (Basel). 2023 Jan 11;13(2):266. doi: 10.3390/diagnostics13020266.
The aim of this review is to analyze the correlations between the changes in the ganglion cell complex (GCC) and the retinal nerve fiber layer (RNFL) on optical coherence tomography in different possible situations, especially in eyes with glaucoma. For glaucoma evaluation, several studies have suggested that in the early stages, GCC analysis, especially the thickness of the infero and that of the inferotemporal GCC layers, is a more sensitive examination than circumpapillary RNFL (pRNFL). In the moderate stages of glaucoma, inferior pRNFL thinning is better correlated with the disease than in advanced cases. Another strategy for glaucoma detection is to find any asymmetry of the ganglion cell-inner plexiform layers (GCIPL) between the two macular hemifields, because this finding is a valuable indicator for preperimetric glaucoma, better than the RNFL thickness or the absolute thickness parameters of GCIPL. In preperimetric and suspected glaucoma, GCC and pRNFL have better specificity and are superior to the visual field. In advanced stages, pRNFL and later, GCC reach the floor effect. Therefore, in this stage, it is more useful to evaluate the visual field for monitoring the progression of glaucoma. In conclusion, GCC and pRNFL are parameters that can be used for glaucoma diagnosis and monitoring of the progression of the disease, with each having a higher accuracy depending on the stage of the disease.
本综述的目的是分析在不同可能情况下，尤其是青光眼患者眼中，光学相干断层扫描中神经节细胞复合体（GCC）和视网膜神经纤维层（RNFL）变化之间的相关性。对于青光眼评估，多项研究表明，在早期阶段，GCC分析，尤其是下方和颞下GCC层的厚度，比视盘周围RNFL（pRNFL）检查更为敏感。在青光眼的中度阶段，下方pRNFL变薄与疾病的相关性比晚期病例更好。青光眼检测的另一种策略是发现两个黄斑半视野之间神经节细胞-内丛状层（GCIPL）的任何不对称性，因为这一发现是视野前青光眼的一个有价值指标，优于RNFL厚度或GCIPL的绝对厚度参数。在视野前和疑似青光眼阶段，GCC和pRNFL具有更好的特异性，且优于视野检查。在晚期，pRNFL以及随后的GCC会出现下限效应。因此，在这个阶段，评估视野对于监测青光眼的进展更有用。总之，GCC和pRNFL是可用于青光眼诊断和疾病进展监测的参数，根据疾病阶段的不同，各自具有更高的准确性。
