DIAGNOSTIC ABILITY OF PERIMACULAR GANGLION CELL-INNER PLEXIFORM LAYER THICKNESS IN GLAUCOMA AND ITS CORRELATION WITH RETINAL NERVE FIBRE LAYER THICKNESS AND OPTIC NERVE HEAD PARAMETERS
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 49
Abstract
BACKGROUND The retinal ganglion cell layer is the first cell layer within the retina to be affected by early glaucoma. Approximately, 50% of Retinal Ganglion Cells (RGC) are located within the macula, it is well known that patients with glaucoma can suffer a 20% to 50% loss of retinal ganglion cells before a defect becomes evident in standard perimetry. Hence, macular imaging is suggested to be a valuable alternative scanning location method for glaucoma diagnosis and assessing neural damage in glaucoma. The aim of the study is to assess the diagnostic ability of perimacular Ganglion Cell Inner Plexiform Layer (GCIPL) thickness in patients with glaucoma using HD-cirrus OCT and its correlation with Retinal Nerve Fibre Layer (RNFL) thickness and other ONH parameters in different optic disc sizes in a tertiary referral eye care centre in southern India. MATERIALS AND METHODS Optic nerve head (200 x 200) and macular imaging (512 x 128) with cirrus HD-OCT was performed on 100 eyes of 66 glaucoma patients and 85 eyes of 50 control patients. Macular GCIPL thickness was assessed and correlated with peripapillary RNFL thickness and ONH parameters like disc area, rim area and cup volume. RESULTS Mean GCIPL thickness was thinner in eyes with glaucoma in comparison to controls (70.64 ± 12.24 micrometers versus 79.58 ± 0.51 micrometers). Mean RNFL thickness in eyes with glaucoma was thinner compared with controls (76.44 ± 16.36 micrometers vs. 90.62 ± 27.57 micrometers). Mean GCIPL segment thickness in all glaucomatous discs showed significant correlation (P<0.05) with corresponding mean RNFL quadrant thickness. Significant correlation was found in large discs (P<0.05), but the level of significance decreased in medium discs (P value- 0.05<P<0.10). Mean RNFL thickness showed statistically significant correlation to rim area (P<0.001) in large and medium discs, whereas mean GCIPL thickness showed significant correlation with rim area in large discs only. Other factors like disc area and cup volume did not show any correlation with mean RNFL and GCIPL thickness. CONCLUSION RNFL thickness analysis still remains the main quantitative analysis for glaucoma. GCIPL thickness analysis can also be used as a surrogate parameter to assess RNFL thickness loss in cases where RNFL analysis can be fallacious as in large peripapillary atrophy, abnormal disc vasculature and tilted disc provided macular pathology has been ruled out. RNFL thickness correlation with GCIPL thickness was not influenced by disc size. Rim area had significant positive correlation to mean RNFL thickness. Other optic nerve head parameters like disc area and cup volume did not show any correlation.
Authors and Affiliations
Jyoti Shetty, Mohan Kannam, Rachel Joseph, Fauqia Fauqia
Keywords
Related Articles
- EP ID EP220168
- DOI 10.18410/jebmh/2017/593
- Views 73
- Downloads 0
COMPARATIVE STUDY OF PARAFFIN EMBEDDED SPUTUM AND ROUTINE SPUTUM CYTOLOGY IN THE DIAGNOSIS OF BRONCHOGENIC CARCINOMA
BACKGROUND Lung cancer though known for its high mortality has a good prognosis in its early stages. 1 For early detection of lung cancer sputum cytology has been used as a screening method along with radiology. 2 But it...
STUDY OF CARBAPENEM RESISTANCE IN NON-FERMENTING GRAM NEGATIVE ISOLATES
The introduction of Carbapenems (Meropenem, Imipenem) into clinical practice represented a major advance in the treatment of serious bacterial infections caused by beta-lactam resistant bacteria. However, carbapenem resi...
A STUDY OF KIDNEY ANOMALIES - HYPO PLASTIC KIDNEY
INTRODUCTION: The subject of kidney anomalies has created much interest to the scientists in late 1950 and 1960 with the aim of prevention and curing. Etiological factors includes various genetic environmental factors, t...
A STATISTICAL ANALYSIS OF LARYNGEAL MALIGNANCIES AT OUR INSTITUTION
BACKGROUND Malignancies of larynx are an increasing global burden with a distribution of approximately 2-5% of all malignancies with an incidence of 3.6/1,00,000 for men and 1.3/1,00,000 for women with a male-to-female r...
STUDY OF INCIDENCE OF HEAD INJURIES WITH REFERENCE TO SUBDURAL HAEMORRHAGE
BACKGROUND The objective of this study was to evaluate the incidence of subdural haemorrhage among males and females. An autopsy study of subdural haemorrhage in head injuries was done. Subdural haemorrhage is a common m...