scholarly journals Structural and functional correlations in the pre-perimetric and the initial stages of glaucomatous optic neuropathy

2021 ◽  
Vol 14 (2) ◽  
pp. 14-22
Author(s):  
M. O. Kirillova ◽  
A. N. Zhuravleva ◽  
M. V. Zueva ◽  
I. V. Tsapenko
Keyword(s):  
Ganglion Cell ◽  
Comparison Group ◽  
Structural Parameters ◽  
Nerve Fibers ◽  
Glaucomatous Optic Neuropathy ◽  
Ganglion Cell Complex ◽  
Inner Plexiform Layer ◽  
Pattern Erg ◽  
Functional Relationships ◽  
Preclinical Diagnosis

Purpose:to study morphological and functional relationships in the early and preclinical diagnosis of glaucomatous optical neuropathy based on optical coherence tomography (OCT) of the retina and the data of electrophysiological research. Material and methods. Two clinical groups: (I) 35 patients (60 eyes) aged 49–70 (ave. 58.0 ± 5.3 yrs) with suspected glaucoma and (II) 21 patients (30 eyes) aged 46-68 (ave. 61.0 ± 4.8 yrs) with initial primary open-angle glaucoma (POAG), and a comparison group consisting of 36 relativelyhealthy subjects (41 eyes) aged 54–70 (ave. 62.0 ± 4.5 yrs), were subjected to spectral OCT by OСT Spectralis (Heidelberg Engineering, Germany). The thickness of the peripapillary layer of retinal nerve fibers (pRNFL), the minimum rim width (MRW), and the thickness of theretinal layers in the macular region that make up the ganglion cell complex (GCC) were evaluated. Spearman correlation analysis was used to identify correlations between OCT and electroretinography (ERG) data. Results.In patients with suspected glaucoma, changes in the parameters of transient pattern-ERG correlated with RNFL thinning in the macular region, inner plexiform layer (IPL), and ganglion cell layer(GCL) in the parafoveal area. In patients with initial glaucoma, changes in the retinal GCL were detected for the upper, lower, and temporal quadrants, while the nasal and central quadrants remained intact in all three GCC layers (RNFL, GCL, and IPL). In patients with suspected glaucoma, no statistically significant changes in the thickness of the pRNFL as compared with the norm were detected. Yet the MRW differed significantly from the comparison group. The highest number of correlations was found between the parameters of the ERGs and the thickness of the pRNFL. In patients with the initial stage of POAG, there was a significant increase in the thickness of RNFL in the temporal quadrant of the paramacular region. In our opinion, this phenomenon may be associated with the development of reactive gliosis being thereaction of neuroglia in response to changes in vascular and/or dystrophic homeostasis. Conclusion.Specific combinations of changes in the structural parameters of the retina and optic nerve head and the temporal and amplitude indices of the PERG and phototopic negative response have been found, justifying their use as combined markers of early and preclinical diagnosis of POAG.

scholarly journals Structural and Functional Correlations in Patients with Advanced Stages of Primary Open-Angle Glaucoma

2021 ◽  
Vol 18 (2) ◽  
pp. 266-275
Author(s):  
V. I. Kotelin ◽  
S. Yu. Petrov ◽  
A. N. Zhuravleva ◽  
M. V. Zueva ◽  
I. V. Tsapenko
Keyword(s):  
Ganglion Cell ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Photopic Negative Response ◽  
Inner Plexiform Layer ◽  
Pattern Erg ◽  
Open Angle ◽  
Functional Relationships ◽  
Rnfl Thickness ◽  
Advanced Stages

Purpose: To study the correlations in the diagnosis of patients with advanced stages of primary open-angle glaucoma (POAG) using data from electroretinography and optical coherence tomography (OCT) of the retina.Methods. The study was performed in two clinical subgroups of patients (35 people, 55 eyes) with stages II and III POAG and the age-matched control group (28 healthy people, 32 eyes). The thickness of the ganglion cell complex (GCC), including the retinal nerve fiber layer (RNFL), the retinal ganglion cell layer (RGC), and the inner plexiform layer (INL) in the macular region, was assessed in nine segments. Correlation analysis of morphometric parameters of GCC in advanced POAG was performed with data from previously performed electroretinography: the transient pattern-ERG (T-PERG), stationary pattern-ERG (S-PERG), and photopic negative response (PhNR).Results. Statistically significant (p < 0.01) thinning of all layers of the GCC was revealed in all studied sectors. Significant (p < 0.05) differences in all morphometric characteristics were recorded between the two subgroups. In patients of the 1st subgroup, the greatest differences in morphological parameters from the control group’s values were noted in the lower, upper parafoveal sectors of the RGC layer, as well as in the temporal perifoveolar quadrant. In the 2nd subgroup, significant changes in the thickness of the inner retina layers were recorded for the upper and lower peripheral sectors of the RNFL and the temporal para- and peripheral quadrants of the RGC layer. In the study of morphological-functional relationships, the most significant correlations were revealed for the parameters of S-PERG. The amplitude of S-PERG directly correlated with the thickness of RNFL in the nasal sector of the perifovea (r = 0.86; p < 0.01) in the 1st subgroup of patients and the thickness of the RGC in the nasal sector of the perifovea in the 2nd subgroup (r = 0.84; p < 0.01). Moderate relationships were revealed between the N95/P50 T-PERG index and the RNFL thickness in the upper sector of the perifovea (r = 0.46; p < 0.05), the peak N95 T-PERG latency, and the RNFL thickness in the upper sector of the perifovea (r = –0.43; p < 0.05) in patients of the 1st subgroup. In patients of the 2nd subgroup, there was a correlation between the amplitude of N95 T-PERG and the thickness of the RGC in the lower sector of the perifovea (r = –0.42; p < 0.01), the peak latency of N95, and the thickness of the RNFL in the upper sector of the parafovea (r = –0.31; p < 0.05). A direct correlation was established between the PhNR amplitude from the baseline and the thickness of the RGC layer in the perifovea’s temporal sector (r = 0.72; p < 0.01) in patients with stage II POAG. The PhNR amplitude from the b-wave peak in patients with stage III POAG correlated with the RNFL thickness in the perifovea’s nasal sector (r = 0.51; p < 0.01).Conclusion. Specific patterns of morphological-functional changes in the parameters of the retina’s inner layers in patients with advanced POAG are presented, which can be used as clinical markers in determining an individual therapeutic strategy. 

scholarly journals Retinal asymmetry in multiple sclerosis

Brain ◽  
2020 ◽  
Author(s):  
Axel Petzold ◽  
Sharon Y L Chua ◽  
Anthony P Khawaja ◽  
Pearse A Keane ◽  
Peng T Khaw ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Ganglion Cell ◽  
Neuromyelitis Optica ◽  
Cell Complex ◽  
Absolute Difference ◽  
Youden Index ◽  
Ganglion Cell Complex ◽  
Potential Contribution ◽  
Inner Plexiform Layer ◽  
Co Morbidity

Abstract The diagnosis of multiple sclerosis is based on a combination of clinical and paraclinical tests. The potential contribution of retinal optical coherence tomography (OCT) has been recognized. We tested the feasibility of OCT measures of retinal asymmetry as a diagnostic test for multiple sclerosis at the community level. In this community-based study of 72 120 subjects, we examined the diagnostic potential of the inter-eye difference of inner retinal OCT data for multiple sclerosis using the UK Biobank data collected at 22 sites between 2007 and 2010. OCT reporting and quality control guidelines were followed. The inter-eye percentage difference (IEPD) and inter-eye absolute difference (IEAD) were calculated for the macular retinal nerve fibre layer (RNFL), ganglion cell inner plexiform layer (GCIPL) complex and ganglion cell complex. Area under the receiver operating characteristic curve (AUROC) comparisons were followed by univariate and multivariable comparisons accounting for a large range of diseases and co-morbidities. Cut-off levels were optimized by ROC and the Youden index. The prevalence of multiple sclerosis was 0.0023 [95% confidence interval (CI) 0.00229–0.00231]. Overall the discriminatory power of diagnosing multiple sclerosis with the IEPD AUROC curve (0.71, 95% CI 0.67–0.76) and IEAD (0.71, 95% CI 0.67–0.75) for the macular GCIPL complex were significantly higher if compared to the macular ganglion cell complex IEPD AUROC curve (0.64, 95% CI 0.59–0.69, P = 0.0017); IEAD AUROC curve (0.63, 95% CI 0.58–0.68, P &lt; 0.0001) and macular RNFL IEPD AUROC curve (0.59, 95% CI 0.54–0.63, P &lt; 0.0001); IEAD AUROC curve (0.55, 95% CI 0.50–0.59, P &lt; 0.0001). Screening sensitivity levels for the macular GCIPL complex IEPD (4% cut-off) were 51.7% and for the IEAD (4 μm cut-off) 43.5%. Specificity levels were 82.8% and 86.8%, respectively. The number of co-morbidities was important. There was a stepwise decrease of the AUROC curve from 0.72 in control subjects to 0.66 in more than nine co-morbidities or presence of neuromyelitis optica spectrum disease. In the multivariable analyses greater age, diabetes mellitus, other eye disease and a non-white ethnic background were relevant confounders. For most interactions, the effect sizes were large (partial ω2 &gt; 0.14) with narrow confidence intervals. In conclusion, the OCT macular GCIPL complex IEPD and IEAD may be considered as supportive measurements for multiple sclerosis diagnostic criteria in a young patient without relevant co-morbidity. The metric does not allow separation of multiple sclerosis from neuromyelitis optica. Retinal OCT imaging is accurate, rapid, non-invasive, widely available and may therefore help to reduce need for invasive and more costly procedures. To be viable, higher sensitivity and specificity levels are needed.

scholarly journals Repeatability of Perimacular Ganglion Cell Complex Analysis with Spectral-Domain Optical Coherence Tomography

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Dorothy S. K. Ng ◽  
Preeti Gupta ◽  
Yih Chung Tham ◽  
Chye Fong Peck ◽  
Tien Yin Wong ◽  
...  
Keyword(s):  
Ganglion Cell ◽  
Retinal Ganglion Cell ◽  
Intraclass Correlation ◽  
Plexiform Layer ◽  
Cell Complex ◽  
Ganglion Cell Complex ◽  
Inner Plexiform Layer ◽  
Retinal Ganglion ◽  
Cell Parameters ◽  
Ganglion Cell Analysis

Purpose. To assess the repeatability of spectral-domain optical coherence tomography to measure macular and perimacular ganglion cell complex thicknesses and compare retinal ganglion cell parameters between algorithms.Methods. Ninety-two nonglaucomatous eyes from 92 participants underwent macular and perimacular ganglion cell complex thickness measurement using OCT-HS100 Glaucoma 3D algorithm and these measurements were repeated for 34 subjects. All subjects also had macular ganglion cell-inner plexiform layer thickness measured by Cirrus HD-OCT Ganglion Cell Analysis algorithm. Intraclass correlation coefficient and Pearson’s correlation analyses were performed.Results. Subfields of both macular and perimacular ganglion cell complex thicknesses had high intraclass correlation coefficient values between 0.979 (95% confidence interval [CI]: 0.958–0.989) and 0.981 (95% CI: 0.963, 0.991) and between 0.70 (95% CI: 0.481–0.838) and 0.987 (95% CI: 0.956–0.989), respectively. The overall average ganglion cell complex and macular average ganglion cell-inner plexiform layer thicknesses were strongly correlated(r=0.83, P<0.001).  Conclusions. The assessment of macular and perimacular retinal ganglion cell parameters by OCT-HS100 Glaucoma 3D algorithm is highly repeatable, and strongly correlates to retinal ganglion cell parameters assessed by Ganglion Cell Analysis algorithm. A comprehensive evaluation of retinal ganglion cells may be possible with OCT-HS100.

scholarly journals Macula structural and vascular differences in glaucoma eyes with and without high axial myopia

2021 ◽  
Author(s):  
Jasmin Rezapour ◽  
Christopher Bowd ◽  
Jade Dohleman ◽  
Akram Belghith ◽  
James A. Proudfoot ◽  
...  
Keyword(s):  
Ganglion Cell ◽  
Axial Length ◽  
Plexiform Layer ◽  
Positive Association ◽  
Mean Deviation ◽  
Ganglion Cell Complex ◽  
Inner Plexiform Layer ◽  
Fiber Layer ◽  
Cross Sectional ◽  
Axial Myopia

AbstractAimsTo assess the thickness of various retinal layers, and the superficial vessel density (sVD) in the macula of glaucomatous eyes and their associations with axial length (AL) and visual field mean deviation (VFMD) to identify parameters useful for glaucoma management in myopic eyes.Methods248 glaucoma patients (401 eyes) participating in the Diagnostic Innovations in Glaucoma Study observational cohort representing 3 axial myopia groups (non-myopia: n=146 eyes; mild myopia: n=208 eyes; high myopia (AL>26 mm): n=47 eyes) who completed macular OCT and OCT-Angiography imaging were included. The cross-sectional associations of AL and VFMD with the thickness of the ganglion cell inner plexiform layer (GCIPL), macular retinal nerve fiber layer (mRNFL), ganglion cell complex (GCC), sVD and macular choroidal thickness (mCT) were evaluated.ResultsThinner Global GCIPL and GCC were significantly associated with worse VFMD (R2=35.1%; and R2=33.4%; respectively p<0.001), but not with AL (all p>0.350). Thicker mRNFL showed a weak association with increasing AL (R2=3.4%; p=0.001) and a positive association with VFMD (global R2=20.5%; p<0.001). Lower sVD was weakly associated with increasing AL (R2=2.3%; p=0.016) and more strongly associated with more severe glaucoma VFMD (R2=31.8%; p<0.001). Thinner mCT was associated with increasing AL (R2=17.3% p<0.001) and not associated with VFMD (P=0.262). mRNFL was thickest while mCT was thinnest in all sectors of high myopic eyes.ConclusionsGCIPL and GCC thinned with increasing severity of glaucoma but were not significantly associated with axial length. GCIPL and GCC thickness may be useful clinical parameters to identify glaucoma in myopic eyes.

scholarly journals Preservative free travoprost and timolol fixed combination in the initial treatment of primary glaucoma: an assessment of hypotensive efficiency and safety

2022 ◽  
Vol 14 (4) ◽  
pp. 79-84
Author(s):  
S. Yu. Petrov ◽  
L. V. Yakubova ◽  
L. V. Vasilenkova ◽  
O. M. Filippova ◽  
A. N. Zhuravleva ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Side Effects ◽  
Nerve Fibers ◽  
Term Therapy ◽  
Ganglion Cell Complex ◽  
Inner Plexiform Layer ◽  
Retinal Ganglion ◽  
Treatment Start ◽  
Primary Glaucoma ◽  
Preservative Free

Purpose. To evaluate the efficacy and safety of Travapress Duo with respect to hypotensive results, changes in functional parameters, and adverse reactions. Material and methods. 30 patients aged 65–75 (averagely 71.3 ± 3.2 years) with a newly diagnosed primary open-angle glaucoma (POAG) received Travapress Duo in the evening, once a day. Goldman tonometry was performed during the screening, then 1 week, 1 month and 3 months from the treatment start. Static perimetry and optical coherence tomography (OCT) were performed before treatment and at the end of the 3rd month since the treatment start. Adverse events were recorded at each stage of the study.Results. As a result of a 3 month long therapy with Travapress Duo, a significant decrease in IOP was noted starting from the 1st week of instillations (by 34 %), after 1 month, by 35 % and after 3 months of observation by 36 %. By the end of the 3rd month of treatment, we noted an insignificant increase in visual acuity, a positive dynamic of the standard deviation and the standard deviation pattern, as well as OCT indicators, such as average thickness of the layer of retinal nerve fibers and the layer of retinal ganglion cells in the macula, stabilization of the thickness of the retinal ganglion cell complex layer and the size of the inner plexiform layer. One patient complained of discomfort and hyperemia by the end of the 1st week of drug instillation. No systemic side effects were noted during the follow-up, and in no case drug withdrawal was require. Conclusion. The preservative-free Travapress Duo drug displayed a high hypotensive efficacy, reducing the IOP to 36% of the initial value. The hypotensive effect was accompanied by indirect neuroprotection, which manifested itself in the positive changes observable in the results of functional studies with varying degrees of reliability. Travapress Duo is characterized by a low level of local side effects and can be recommended for both for the initial and long-term therapy of primary glaucoma of developed and advanced stages.

scholarly journals Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease Patients

2021 ◽  
Vol 15 ◽  
Author(s):  
Xiaomin Zeng ◽  
Yijun Hu ◽  
Yuanhan Chen ◽  
Zhanjie Lin ◽  
Yingying Liang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Ganglion Cell ◽  
Group Versus ◽  
Plexiform Layer ◽  
Control Group ◽  
Ganglion Cell Complex ◽  
Inner Plexiform Layer ◽  
Vascular Plexus ◽  
Advanced Stages

Background: Widespread neural and microvascular injuries are common in chronic kidney disease (CKD), increasing risks of neurovascular complications and mortality. Early detection of such changes helps assess the risks of neurovascular complications for CKD patients. As an extension of central nervous system, the retina provides a characteristic window to observe neurovascular alterations in CKD. This study aimed to determine the presence of retinal neurovascular impairment in different stages of CKD.Methods: One hundred fifteen non-diabetic and non-dialytic CKD patients of all stages and a control group of 35 healthy subjects were included. Retinal neural and microvascular parameters were obtained by optical coherence tomography angiography (OCTA) examination.Results: CKD 1–2 group (versus control group) had greater odds of having decreased retinal ganglion cell-inner plexiform layer thickness (GC-IPLt) (odds ratio [OR]: 0.92; 95% confidence interval [CI]: 0.86–0.98), increased ganglion cell complex-focal loss volume (GCC-FLV) (OR: 3.51; 95% CI: 1.27–9.67), and GCC-global loss volume (GCC-GLV) (OR: 2.48; 95% CI: 1.27–4.82). The presence of advanced stages of CKD (CKD 3–5 group versus CKD 1–2 group) had greater odds of having decreased retinal vessel density in superficial vascular plexus (SVP)-WholeImage (OR: 0.77, 95% CI: 0.63–0.92), SVP-ParaFovea (OR: 0.83, 95% CI: 0.71–0.97), SVP-ParaFovea (OR: 0.76, 95% CI: 0.63–0.91), deep vascular plexus (DVP)-WholeImage (OR: 0.89, 95% CI: 0.81–0.98), DVP-ParaFovea (OR: 0.88, 95% CI: 0.78–0.99), and DVP-PeriFovea (OR: 0.90, 95% CI: 0.83–0.98). Besides, stepwise multivariate linear regression among CKD patients showed that β2-microglobulin was negatively associated with GC-IPLt (β: –0.294; 95% CI: –0.469 ∼ –0.118), and parathyroid hormone was positively associated with increased GCC-FLV (β: 0.004; 95% CI: 0.002∼0.006) and GCC-GLV (β: 0.007; 95% CI: 0.004∼0.01). Urine protein to creatinine ratio was positively associated with increased GCC-FLV (β: 0.003; 95% CI: 0.001∼0.004) and GCC-GLV (β: 0.003; 95% CI: 0.001∼0.006).Conclusion: Retinal neuronal impairment is present in early stages of CKD (stages 1–2), and it is associated with accumulation of uremic toxins and higher UACR, while retinal microvascular hypoperfusion, which is associated with worse eGFR, was only observed in relatively advanced stages of CKD (stages 3–5). The results highlight the importance of monitoring retinal neurovascular impairment in different stages of CKD.

scholarly journals Evaluation of Macular and Retinal Ganglion Cell Count Estimates for Detecting and Staging Glaucoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Yali Wu ◽  
Qing Cun ◽  
Yijin Tao ◽  
Wenyan Yang ◽  
Jia Wei ◽  
...  
Keyword(s):  
Visual Field ◽  
Ganglion Cell ◽  
Retinal Ganglion Cell ◽  
Roc Curve ◽  
Structural Parameters ◽  
Mean Deviation ◽  
Ganglion Cell Complex ◽  
Automated Perimetry ◽  
Retinal Ganglion ◽  
Fiber Layer

Purpose: To investigate the clinical significance of macular estimated retinal ganglion cell (mRGC) and estimated retinal ganglion cell (eRGC) in the diagnosis and staging of glaucoma.Methods: This is a cross-section study. All enrolled subjects underwent standard automated perimetry (SAP) and optical coherence tomography (OCT) examination. Swedish Interactive Threshold Algorithm (SITA)-FAST detection strategy and 24-2, 10-2 detection programs were employed in SAP assessment. The visual-field parameters and OCT parameters were calculated according to three formulas to obtain the eRGC and mRGC1 or mRGC2. The efficiency of eRGC, mRGC1, and mRGC2 estimates for the staging of glaucoma was compared. The sensitivity and specificity of each parameter for diagnosis of glaucoma were analyzed using the receiver operating characteristic (ROC) curve.Results: A total of 119 eyes were included in the analysis. Compared with the healthy controls, eRGC, mRGC1, and mRGC2 estimates were significantly decreased in patients with glaucoma. As glaucoma progressed, eRGC, mRGC1, and mRGC2 estimates were gradually reduced. In preperimetric glaucoma, mRGC1, mRGC2, and eRGC were reduced by 13.2, 14.5, and 18%, respectively. In the mild stage of glaucoma, mRGC1, mRGC2, and eRGC were reduced by 28, 34, and 38%, respectively. In the advanced stage of glaucoma, mRGC1, mRGC2, and eRGC were reduced by 81, 85, and 92% respectively. The proportion of retinal ganglion cell (RGC) loss in the macula was close to that outside the macula. The specificity at 95% gave a sensitivity of 95.51, 86.52, and 87.64% for eRGC, mRGC1, and mRGC2, respectively. The sensitivity of structural parameters macular ganglion cell complex thickness and retinal nerve fiber layer (RNFL) were 98.88 and 95.51%, respectively. The sensitivity of functional parameters mean deviation (24-2) and visual field index (VFI) were 80.90 and 73.03%, respectively. The area under ROC curve of mRGC1, mRGC2, and eRGC were 0.982, 0.972, and 0.995 (P &lt; 0.0001), respectively.Conclusion: Estimated retinal ganglion cell, mRGC1, and mRGC2 provide value to the staging of glaucoma and better diagnostic performance. Macular RGC estimatesthat integration of both structural and functional damages in macular may serve as a sensitive indicator for assessing macular damage in glaucoma and are of importance for the diagnosis and progression management of glaucoma.

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