Severity-dependent association between ganglion cell inner plexiform layer thickness and macular mean sensitivity in open-angle glaucoma.
OBJECTIVE
To evaluate the structure-function relationship between macular mean sensitivity (mMS) and ganglion cell inner plexiform layer thickness (GCIPLT) according to glaucoma severity and to compare it with that between mMS and peripapillary retinal nerve fibre layer thickness (pRNFLT), using spectral-domain (Cirrus) optical coherence tomography (OCT).


METHODS
Three hundred and sixty-two eyes of 362 patients with open-angle glaucoma of differing severity (preperimetric, early, moderate, and advanced) together with 130 eyes of 130 healthy controls, all of whom underwent Cirrus OCT imaging and 30-2 standard automated perimetry (SAP), were included in the study. The mMS was assessed by calculating the average of sensitivities at 12 central SAP points. The relationships between mMS and the various GCIPLT (average, minimum, superior, and inferior) parameters obtained by Cirrus OCT were evaluated according to disease severity using a linear regression model and were then compared with those between pRNFLT parameters and mMS.


RESULTS
The mMS and GCIPLT showed stronger relationships with the increase in glaucoma severity, but this was not the case with the pRNFLT parameters. In preperimetric glaucoma, the associations between mMS and both GCIPLT and pRNFLT were not significant. In moderate and advanced glaucoma, all GCIPLT parameters showed a statistically significant relationship with mMS. However, pRNFLT showed a moderate association in early and moderate glaucoma and none at all in advanced glaucoma.


CONCLUSIONS
GCIPLT showed a stronger structure-function relationship with mMS in more advanced stages of glaucoma compared to pRNFLT. GCIPLT reflected macular functional damage better than pRNFLT in advanced glaucoma.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Ko Eun
KE
Kim
Ki Ho
KH
Park
Jin Wook
JW
Jeoung
Seok Hwan
SH
Kim
Dong Myung
DM
Kim
D000328:Adult; D000368:Aged; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D012160:Retina / Q000502:physiology*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology
cirrus optical coherence tomography; ganglion cell inner plexiform layer; macular mean sensitivity; peripapillary retinal nerve fibre layer