Structural changes of macular inner retinal layers in early normal-tension and high-tension glaucoma by spectral-domain optical coherence tomography

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 256; no. 7; pp. 1245 - 1256
• Main Authors: Edlinger, Florian S. M., Schrems-Hoesl, Laura M., Mardin, Christian Y., Laemmer, Robert, Kruse, Friedrich E., Schrems, Wolfgang A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2018; Springer Nature B.V
• Subjects: Glaucoma; Medicine; Medicine & Public Health; Ophthalmology; Retina; Supplements; Tomography; Peripapillary retinal nerve fiber layer; Macular inner retinal layers; Open angle glaucoma; Spectral-domain optical coherence tomography; Normal-tension and high-tension glaucoma
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-018-3944-6

Purpose Assessment of the diagnostic ability of segmented macular inner retinal layer thickness and peripapillary retinal nerve fiber layer (pRNFL) measured by spectral-domain optical coherence tomography (SD-OCT) in patients with normal-tension (NT) and high-tension (HT) perimetric and preperimetric glaucoma. Methods The 212 participants included 45 healthy subjects, 55 patients with ocular hypertension, 56 patients with preperimetric glaucoma, and 56 patients with perimetric glaucoma. The preperimetric and perimetric groups were further subdivided into NT and HT groups. Sectoral and global thickness of macular retinal nerve fiber layer (mRNFL), ganglion cell layer (mGCL), inner plexiform layer (mIPL), ganglion cell complex (mGCC), and pRNFL were measured using SD-OCT (Spectralis, Heidelberg Engineering, Germany). Diagnostic performance was ascertained by sectoral and global comparison of the sensitivities at specificity ≥ 95%. Results For all layers, the largest thickness decrease was reported in the HT perimetric group. In all groups, the sensitivities of mGCL showed a comparable diagnostic value to pRNFL in order to distinguish between healthy subjects and glaucoma patients. In the perimetric group, mGCL (85.7%) exhibited higher sensitivities than mRNFL (78.6%) and mGCC (78.6%). Both mRNFL and pRNFL demonstrated equal diagnostic performance in the HT perimetric group (88.5 and 96.2%), in the NT groups, mRNFL was inferior to all other layers. Conclusion The sensitivities of mGCL and mRNFL were comparable to the sensitivities of pRNFL. In clinical application, mGCL and mRNFL, with a focus on the temporal and inferior sectors, may provide a convincing supplementation to pRNFL. Clinical Trial Registration Erlangen Glaucoma Registry www.clinicaltrials.gov ID: NCT00494923