Study of the ganglion cell complex of the macula by optical coherence tomography in the diagnosis of glaucoma progression

I. Munuera , E. Gándara-Rodriguez de Campoamor , J. Moreno-Montañes
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Abstract

Introduction

The aim of this work is to evaluate the usefulness of the study of the ganglion cell complex of the macula using the OCT technique to estimate the progression of glaucoma according to its severity.

Material and methods

This is a retrospective cross-sectional study. It includes 205 eyes of 131 patients with glaucoma or ocular hypertension followed for a mean of 5.7 years. The parameters and rates of three tests have been analyzed using the progression software of each instrument: visual field, optical coherence tomography (OCT) in the ganglion cell complex of the macula and in the nerve fiber layer of the optic nerve. The results of each test, the concordance between them and how they differ according to severity stage have been evaluated.

Results

Visual field classifies more cases of progression in moderate-advanced glaucoma, while in mild glaucoma its capacity is limited. Optic nerve fiber layer OCT classifies more cases of progression in mild glaucoma than in moderate-advanced glaucoma, as it is artifacted by the floor effect. OCT of the macular ganglion cell complex is the test that classifies more cases of progression and has the highest agreement with visual field, regardless of severity.

Conclusion

In both mild and moderate-advanced glaucoma, OCT of the macula ganglion cell complex may be a better biomarker of progression than OCT of the macula ganglion cell complex.

通过光学相干断层扫描研究黄斑神经节细胞复合体在青光眼进展诊断中的作用。
导言:这项工作的目的是评估使用 OCT 技术研究黄斑部神经节细胞复合体的有用性,以便根据青光眼的严重程度估计青光眼的进展情况:这是一项回顾性横断面研究。材料:这是一项回顾性横断面研究,包括 131 名青光眼或眼压过高患者的 205 只眼睛,平均随访 5.7 年。使用每种仪器的高级软件分析了三种测试的参数和比率:视野、黄斑神经节细胞复合体和视神经神经纤维层的光学相干断层扫描(OCT)。我们对每项检测的结果、它们之间的一致性以及它们在不同严重程度阶段的差异进行了评估:结果:视野对中晚期青光眼进展病例的分类较多,而对轻度青光眼的分类能力有限。视神经纤维层 OCT 对轻度青光眼病情进展的分类能力强于中度晚期青光眼,因为它受地板效应的影响。黄斑神经节细胞复合体 OCT 是对更多进展期病例进行分类的检测方法,而且与视野的一致性最高,与严重程度无关:结论:对于轻度和中重度青光眼,黄斑神经节细胞复合体的OCT可能比黄斑神经节细胞复合体的OCT更适合作为病情进展的生物标志物。
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