Role of Macular Ganglion Cell Complex Analysis for Diagnosis of Glaucoma Using Spectral Domain Optical Coherence Tomography.

Glaucoma is chronic progressive irreversible optic neuropathy characterized by significant visual field (VF) loss. So, early diagnosis and proper treatment can preserve the useful vision in lifetime. The objective of the study was to determine the importance of ganglion cell complex (GCC) analysis as a parameter for diagnosis of glaucoma. This case control study was conducted in the Department of Ophthalmology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Bangladesh over a period of one year from July 2017 to June 2018. Twenty five (25) Type-2 Diabetes control subjects and 50 subjects with Type-2 diabetes were divided into two groups, 25 diabetic with pre perimetric and 25 diabetic with perimetric glaucoma. In this study, there was no significant difference in age (50.92±5.53 years vs. 52.44±4.75 years vs. 52.64±7.80 years), gender. Regarding Optical coherence tomography (OCT) Retinal Nerve Fiber Layer (RNFL) of right eyes of the study subjects, superior and inferior RNFL were significantly thinner in both pre-perimetric right eye (109.18±8.95 and 111.21±10.53) and perimetric right eye (90.28±8.94 and 91.51±7.87) comparing normal eyes (129.12±2.68 and 132.17±3.22). Superior and inferior RNFL were significantly lower in both pre-perimetric (110.13±11.53 and 113.75±9.61) and perimetric (95.93±15.08 and 93.29±12.68) left eyes comparing normal left eyes (129.71±5.50 and 132.57±5.22). Regarding OCT GCC layer of right eyes of the study subjects, superior and inferior GCC layer were significantly lower in both pre-perimetric (87.66±3.81 and 89.70±4.98) and perimetric (77.48±6.97 and 79.21±6.06) right eyes comparing normal eyes (104.53±2.73 and 106.88±3.29). Regarding OCT GCC layer of left eyes of the study subjects, superior and inferior GCC layer were significantly lower in both pre-perimetric (84.88±3.82 and 87.21±3.77) and perimetric (81.08±9.51 and 80.01±10.02) left eyes comparing normal eyes (102.64±2.29 and 105.20±1.27). GCC parameter is useful tool for diagnosis of Glaucoma. It has same ability to discriminate eyes with glaucoma and non glaucomatous eyes compared to RNFL. In glaucoma, GCC layer is significantly thin which correlates strongly with glaucomatous damage. According to our result GCC layer analysis is important investigation to diagnosis of Glaucoma.