Eye and Brain (Jan 2020)
Ganglion Cell Complex Analysis in Glaucoma Patients: What Can It Tell Us?
Abstract
Gianluca Scuderi,1 Serena Fragiotta,1 Luca Scuderi,2 Clemente Maria Iodice,3 Andrea Perdicchi1 1NESMOS Department, Ophthalmology Unit, S. Andrea Hospital, University of Rome “La Sapienza”, Rome, Italy; 2Ophthalmology Unit, Department of Sense Organs, Azienda Policlinico Umberto I, University of Rome “La Sapienza”, Rome, Italy; 3Faculty of Medicine and Dentistry, University of Rome “La Sapienza”, Rome, ItalyCorrespondence: Serena FragiottaNESMOS Department, S. Andrea Hospital, Via di Grottarossa 1035-1039, Rome 00189, ItalyTel +39 3293276433Fax +39 0633776628Email [email protected]: Glaucoma is a group of optic neuropathies characterized by a progressive degeneration of retina ganglion cells (RGCs) and their axons that precedes functional changes detected on the visual field. The macular ganglion cell complex (GCC), available in commercial Fourier-domain optical coherence tomography, allows the quantification of the innermost retinal layers that are potentially involved in the glaucomatous damage, including the retinal nerve fiber (RNFL), ganglion cell and inner plexiform layers. The average GCC thickness and its related parameters represent a reliable biomarker in detecting preperimetric glaucomatous damage. The most accurate GCC parameters are represented by average and inferior GCC thicknesses, and they can be associated with progressive visual field loss. Although the diagnostic accuracy increases with more severe glaucomatous damage and higher signal strength values, it is not affected by increasing axial length, resulting in a more accurate discrimination of glaucomatous damage in myopic eyes with respect to the traditional RNFL thickness. The analysis of the structure-function relationship revealed a good agreement between the loss in retinal sensitivity and GCC thickness. The use of a 10-2° visual field grid, adjusted for the anatomical RGCs displacement, describes more accurately the relationship between RGCs thickness and visual field sensitivity loss.Keywords: retinal ganglion cells, spectral-domain optical coherence tomography, standard automated perimetry, retinal nerve fiber layer
