Glaucoma-Diagnostic Ability of Ganglion Cell-Inner Plexiform Layer Thickness Difference Across Temporal Raphe in Highly Myopic Eyes.
OBJECTIVE
To evaluate the glaucoma-diagnostic ability of the ganglion cell-inner plexiform layer (GCIPL) thickness difference across the temporal raphe in highly myopic eyes.


METHODS
We consecutively enrolled a total of 195 highly myopic eyes (axial length [AL] >26.5 mm) of 195 subjects: 93 glaucoma patients along with and 102 nonglaucomatous subjects. Cirrus high-definition optical coherence tomography (OCT) was employed to scan all of the subjects' macular and optic discs. Using a MATLAB-based customized program (the GCIPL hemifield test), a positive test result was automatically declared if the following two conditions were met: (1) the horizontal line is detected for longer than one-half of the distance from the temporal inner elliptical annulus to the outer elliptical annulus, and (2) the average GCIPL thickness difference within 10 pixels of the reference line, both above and below, is 5 μm or more. The glaucoma-diagnostic ability was computed using the area under the receiver operating characteristic curve (AUC).


RESULTS
Among the glaucomatous eyes, GCIPL hemifield test positivity was shown in 92.5% (86 of 93), significantly higher than that for the nonglaucomatous eyes (4.90%, 5 of 102; P <0.001). The value of AUC for the GCIPL hemifield test was excellent (0.938; sensitivity 92.50%, specificity 95.10%) and was the best compared with those for any of OCT parameters.


CONCLUSIONS
In highly myopic eyes, determination of the presence or absence of GCIPL thickness difference across the temporal raphe via OCT macula scan can be a useful means of distinguishing the glaucomatous damage.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea 2Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Young Kook
YK
Kim
Bioengineering Major, Graduate School, Seoul National University, Seoul, Korea.
Byeong Wook
BW
Yoo
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea 2Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Jin Wook
JW
Jeoung
Department of Biomedical Engineering, College of Medicine and Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea.
Hee Chan
HC
Kim
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea 2Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Hae Jin
HJ
Kim
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea 2Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Ki Ho
KH
Park
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D016022:Case-Control Studies; D005260:Female; D005901:Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000473:pathology*; D009412:Nerve Fibers; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000473:pathology*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods; D014794:Visual Fields / Q000502:physiology