Diagnostic ability of macular ganglion cell asymmetry for glaucoma.
BACKGROUND
Using spectral-domain optical coherence tomography (OCT), this study aims to investigate the glaucoma diagnostic ability of macular ganglion cell asymmetry analysis.


METHODS
A cross-sectional study was conducted. This study was performed to investigate glaucoma diagnostic ability of macular ganglion cell asymmetry analysis in eyes with various degrees of glaucoma.


METHODS
We enrolled 181 healthy eyes and 265 glaucomatous eyes.


METHODS
Glaucomatous eyes were subdivided into pre-perimetric, early, moderate and advanced-to-severe glaucoma based on visual field test results. For each eye, macular ganglion cell-inner plexiform layer (GCIPL) thickness was measured using OCT. Average GCIPL thickness, GCIPL thicknesses in superior and inferior hemispheres, absolute difference in GCIPL thickness between superior and inferior hemispheres and GCIPL asymmetry index calculated as the absolute value of log10 (inferior hemisphere thickness/superior hemisphere thickness) were analysed.


METHODS
Areas under the receiver operating characteristics curves (AUCs) of GCIPL parameter were calculated and compared.


RESULTS
All of the GCIPL parameters showed good glaucoma diagnostic ability (AUCs ≥ 0.817, P < 0.01). AUCs of average, superior and inferior GCIPL thickness increased as the severity of glaucoma increased. GCIPL thickness difference and asymmetry index showed the highest AUCs in early and moderate glaucoma and lower AUCs in pre-perimetric and advanced-to-severe glaucoma. GCIPL thickness difference and asymmetry index showed better glaucoma diagnostic ability than other GCIPL parameters only in early stage of glaucoma (P < 0.05); in other stages, these parameters had similar to or worse glaucoma diagnostic ability than other GCIPL parameters.


CONCLUSIONS
Macular ganglion cell asymmetry analysis showed good glaucoma diagnostic ability, especially in early-stage glaucoma. However, it has limited usefulness in other stages of glaucoma.
Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Seoul, Korea.
Young Hoon
YH
Hwang
Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Seoul, Korea.
Sang Il
SI
Ahn
Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Seoul, Korea.
Sung Ju
SJ
Ko
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D012372:ROC Curve; D012029:Refraction, Ocular / Q000502:physiology; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology
ganglion cell; glaucoma; macula; optical coherence tomography