San Pedro Marie Jeremy B, Sosuan George Michael N, Yap-Veloso Maria Imelda R
Asian Eye Institute, PHINMA Plaza, Rockwell Center, Makati, Philippines.
University of the Philippines Manila-Philippine General Hospital, Department of Ophthalmology and Visual Sciences, Metro Manila, Philippines.
Clin Ophthalmol. 2024 Aug 20;18:2313-2325. doi: 10.2147/OPTH.S439501. eCollection 2024.
The study aimed to correlate macular ganglion cell layer + inner plexiform layer (GCL + IPL) thickness and circumpapillary retinal nerve fiber layer (cRNFL) thickness and to determine the validity of GCL + IPL in the evaluation of glaucoma across different stages using the area under the curve (AUC) analysis in comparison to cRNFL.
The charts of 260 adult glaucoma suspect and glaucoma patients having macular ganglion cell analysis, optical coherence tomography (OCT) of the cRNFL and automated visual field (AVF) were reviewed. GCL + IPL thickness (average, minimum and sectoral) and sectoral cRNFL thickness were obtained. Glaucomatous eyes were further classified into stages based on the Hodapp-Anderson-Parrish Visual Field Criteria of Glaucoma Severity. AUC analysis was used to compare GCL + IPL parameters with cRNFL in glaucoma suspects and glaucoma patients.
A total of 122 eyes were included in the study and were grouped into glaucoma suspects (n = 43), early or mild glaucoma (n = 40), and moderate-to-severe glaucoma (n = 39). Both GCL + IPL and cRNFL thickness parameters showed a significant decline with greater glaucoma severity. In the determination of visual field defects across all glaucoma stages, the highest AUC was obtained by minimum GCL + IPL (AUC = 0.859) with cut-off value at ≤70 µm. Average GCL + IPL had the highest AUC (0.835) in detecting progression from glaucoma suspect to mild glaucoma, while the inferior sector of the cRNFL had the highest AUC (0.937) in discerning mild from moderate-to-severe glaucoma.
The results of this study highlight the significance of macular ganglion cell analysis in the screening, detection and staging of glaucoma. Compared to cRNFL, macular ganglion analysis may be more beneficial in glaucoma screening and detecting progression from glaucoma suspect to mild glaucoma.
本研究旨在关联黄斑神经节细胞层+内丛状层（GCL+IPL）厚度与视盘周围视网膜神经纤维层（cRNFL）厚度，并通过曲线下面积（AUC）分析，与cRNFL相比，确定GCL+IPL在评估不同阶段青光眼时的有效性。
回顾了260例成年青光眼可疑患者和青光眼患者的病历，这些患者均进行了黄斑神经节细胞分析、cRNFL光学相干断层扫描（OCT）和自动视野检查（AVF）。获取了GCL+IPL厚度（平均值、最小值和扇形）以及扇形cRNFL厚度。根据青光眼严重程度的霍达普-安德森-帕里什视野标准，将青光眼患眼进一步分为不同阶段。采用AUC分析比较青光眼可疑患者和青光眼患者中GCL+IPL参数与cRNFL参数。
本研究共纳入122只眼，分为青光眼可疑组（n=43）、早期或轻度青光眼组（n=40）和中度至重度青光眼组（n=39）。随着青光眼严重程度的增加，GCL+IPL和cRNFL厚度参数均显著下降。在确定所有青光眼阶段的视野缺损时，最小GCL+IPL获得的AUC最高（AUC=0.859），截断值≤70µm。平均GCL+IPL在检测从青光眼可疑患者进展为轻度青光眼时AUC最高（0.835），而cRNFL的下方扇形区域在区分轻度与中度至重度青光眼时AUC最高（0.937）。
本研究结果突出了黄斑神经节细胞分析在青光眼筛查及检测和分期中的重要性。与cRNFL相比，黄斑神经节细胞分析在青光眼筛查以及检测从青光眼可疑患者进展为轻度青光眼方面可能更具优势。
