title: Macular ganglion cell complex and retinal nerve fiber layer comparison in different stages of age-related macular degeneration.
abstract: OBJECTIVE
  To employ optical coherence tomography (OCT) to analyze the morphologic changes in the inner retina in different categories of age-related macular degeneration (AMD).
  
  
  METHODS
  Observational cross-sectional study.
  
  
  METHODS
  Single-center study. Inclusion criteria were age over 50, diagnosis of Age-Related Eye Disease Study (AREDS) category 2 and 3, naïve neovascular AMD, and atrophic AMD. Healthy patients of similar age acted as a control group. Primary outcome measures were the changes in ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL). Secondary outcomes included modifications of rim area and cup-to-disc ratio.
  
  
  RESULTS
  One hundred and thirty eyes of 130 patients were recruited: 26 eyes for AREDS category 2, 26 for AREDS category 3, 26 for neovascular AMD, 26 with atrophic AMD, and 26 controls. Mean peripapillary RNFL thickness was significantly lower in neovascular AMD, compared to controls (P = .004); peripapillary RNFL did not significantly vary among AREDS category 2 and 3 and atrophic AMD groups, compared to controls. Mean GCC thickness was higher in the control group, becoming progressively thinner up to neovascular and atrophic AMD groups (P < .0001). Rim area was significantly thinner in the neovascular AMD group compared with controls (P = .047); cup-to-disc ratio was higher in the neovascular AMD group compared with the control group (P = .047).
  
  
  CONCLUSIONS
  This study demonstrates that eyes with neovascular AMD display reduced RNFL and GCC thickness. RNFL is partially spared in atrophic advanced AMD. The identification of alteration in RNFL and GCC thickness may reveal useful for future therapeutic implications.
authors.affiliation: Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy. Electronic address: ilaria.zucchiatti@gmail.com.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Zucchiatti
authors.affiliation: Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Maurizio Battaglia
authors.initials: MB
authors.lastname: Parodi
authors.affiliation: Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Pierro
authors.affiliation: Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Maria Vittoria
authors.initials: MV
authors.lastname: Cicinelli
authors.affiliation: Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Gagliardi
authors.affiliation: Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Niccolò
authors.initials: N
authors.lastname: Castellino
authors.affiliation: Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bandello
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D057092:Geographic Atrophy / Q000145:classification*; D006801:Humans; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000145:classification*