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BMC Ophthalmology

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Open Access 01-12-2020 | Glaucoma | Research article

Diagnostic ability of OCT parameters and retinal ganglion cells count in identification of glaucoma in myopic preperimetric eyes

Authors: Teresa Rolle, Beatrice Bonetti, Alberto Mazzucco, Laura Dallorto

Published in: BMC Ophthalmology | Issue 1/2020

Abstract

Background

The aim of the study is to evaluate the diagnostic ability of OCT parameters and retinal ganglion cells (RGCs) count in identify glaucomatous disease in myopic preperimetric eyes.

Methods

This was a cross-sectional observational study. The study group consisted of 154 eyes: 36 controls, 64 preperimetric (PPG), and 54 primary openangle glaucoma (POAG) eyes. Each group was divided into three subgroups based on axial length: emmetropic, myopic with axial length (AL) < 25 mm, and myopic with AL > 25 mm, to analyze the effect of myopia. The RGCs count was obtained using a model described later. As regard the influence of myopia on OCT parameters and RGC count, we performed Pearson’s correlation. The Area Under Receiver Operator Characteristics Curves (AUROC curves) evaluated which parameter had the best sensitivity and specificity in identifying glaucoma in myopic eyes.

Results

In Pearson’s test, all Ganglion Cell Complex (GCC) thicknesses showed the weakest and less significant correlation with AL in all groups. All the AUROCs were statistically significant, and above 0.5. Inferior GCC and Global Loss Volume (GLV) showed the highest AUCs in all myopic group and the best diagnostic ability in distinguishing control from glaucomatous eyes. RGCcount showed good AUROC in all groups, with sensitivities of about 83% in myopic eyes, and specificity over 91% in all groups.

Conclusions

GCC is the parameter less influenced by the AL, and the inferior GCC and the GLV have the best diagnostic performance. The RGCcount has good sensitivity and specificity, so it can be used as a complementary test in the diagnosis of glaucoma in myopic preperimetric eyes.

Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036–42.PubMed

Tham Y-C, Li X, Wong TY, et al. Global prevalence of Glaucoma and projections of Glaucoma burden through 2040. Ophthalmology. 2014;121(11):2081–90.PubMed

Bourne RRA, Taylor HR, Flaxman SR, et al. Number of People Blind or Visually Impaired by Glaucoma Worldwide and in World Regions 1990–2010: A Meta-Analysis. PLoS One. 2016;11(10):e0162229.PubMedPubMedCentral

Rudnicka AR, Mt-Isa S, Owen CG, et al. Variations in primary open-angle Glaucoma prevalence by age, gender, and race: a Bayesian meta-analysis. Invest Ophthalmol Vis Sci. 2006;47(10):4254–61.PubMed

Marcus MW, de Vries MM, Montolio FGJ, et al. Myopia as a Risk Factor for Open-Angle Glaucoma: A Systematic Review and Meta-Analysis. Ophthalmology. 2011;118(10):1989–1994.e2.PubMed

Tan NYQ, Sng CCA, Jonas JB, et al. Glaucoma in myopia: diagnostic dilemmas. Br J Ophthalmol. 2019;103(10):1347–55.PubMed

Leung CK-S, Yu M, Weinreb RN, et al. Retinal nerve Fiber layer imaging with spectral-domain optical coherence tomography: interpreting the RNFL maps in healthy myopic eyes. Invest Ophthalmol Vis Sci. 2012;53(11):7194–200.PubMed

Harwerth RS, Wheat JL, Fredette MJ, et al. Linking structure and function in Glaucoma. Prog Retin Eye Res. 2010;29(4):249–71.PubMedPubMedCentral

Medeiros FA, Lisboa R, Weinreb RN, et al. A combined index of structure and function for staging glaucomatous damage. Arch Ophthalmol. 2012;130(9):1107–16.PubMedPubMedCentral

10.

Medeiros FA, Zangwill LM, Bowd C, et al. The structure and function relationship in glaucoma: implications for detection of progression and measurement of rates of change. Invest Ophthalmol Vis Sci. 2012;53(11):6939–46.PubMedPubMedCentral

11.

Medeiros FA, Zangwill LM, Anderson DR, et al. Estimating the rate of retinal ganglion cell loss in glaucoma. Am J Ophthalmol. 2012;154(5):814–824.e1.PubMedPubMedCentral

12.

Marvasti AH, Tatham AJ, Zangwill LM, et al. The Relationship between Visual Field Index and Estimated Number of Retinal Ganglion Cells in Glaucoma. PLoS One. 2013;8(10):e76590.PubMedPubMedCentral

13.

Medeiros FA, Lisboa R, Weinreb RN, et al. Retinal ganglion cell count estimates associated with early development of visual field defects in Glaucoma. Ophthalmology. 2013;120(4):736–44.PubMed

14.

Hodapp E, Parrish RK II, Anderson D. Clinical Decisions in Glaucoma. St. Louis: Mosby–Year Book Medical Publishers; 1993.

15.

Rolle T, Dallorto L, Bonetti B. Retinal and macular ganglion cell count estimated with optical coherence tomography RTVUE-100 as a candidate biomarker for Glaucoma. Invest Ophthalmol Vis Sci. 2016;57(13):5772–9.PubMed

16.

Zhang C, Tatham AJ, Weinreb RN, et al. Relationship between ganglion cell layer thickness and estimated retinal ganglion cell counts in the glaucomatous macula. Ophthalmology. 2014;121(12):2371–9.PubMedPubMedCentral

17.

DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44(3):837–45.PubMed

18.

Esporcatte BLB, Kara-José AC, Melo LAS, et al. The estimates of retinal ganglion cell counts performed better than isolated structure and functional tests for Glaucoma diagnosis. J Ophthalmol. 2017;2017:2724312.PubMedPubMedCentral

19.

Budenz DL, Anderson DR, Varma R, et al. Determinants of Normal retinal nerve Fiber layer thickness measured by stratus OCT. Ophthalmology. 2007;114(6):1046–52.PubMedPubMedCentral

20.

Pan C-W, Cheung CY, Aung T, et al. Differential associations of myopia with major age-related eye diseases. Ophthalmology. 2013;120(2):284–91.PubMed

21.

Nakanishi H, Akagi T, Hangai M, et al. Sensitivity and specificity for detecting early glaucoma in eyes with high myopia from normative database of macular ganglion cell complex thickness obtained from normal non-myopic or highly myopic Asian eyes. Graefes Arch Clin Exp Ophthalmol. 2015;253(7):1143–52.PubMed

22.

Medeiros FA, Zangwill LM, Bowd C, et al. Evaluation of retinal nerve fiber layer, optic nerve head, and macular thickness measurements for glaucoma detection using optical coherence tomography. Am J Ophthalmol. 2005;139(1):44–55.PubMed

23.

Shin H-Y, Park H-YL, Park CK. The effect of myopic optic disc tilt on measurement of spectral-domain optical coherence tomography parameters. Br J Ophthalmol. 2015;99(1):69–74.PubMed

24.

Chen HS-L, Liu C-H, Lu D-W. Comparison of glaucoma diagnostic accuracy of macular ganglion cell complex thickness based on nonhighly myopic and highly myopic normative database. Taiwan J Ophthalmol. 2016;6(1):15–20.PubMedPubMedCentral

25.

Shoji T, Sato H, Ishida M, et al. Assessment of glaucomatous changes in subjects with high myopia using spectral domain optical coherence tomography. Invest Ophthalmol Vis Sci. 2011;52(2):1098–102.PubMed

26.

Wang W-W, Wang H-Z, Liu J-R, et al. Diagnostic ability of ganglion cell complex thickness to detect glaucoma in high myopia eyes by Fourier domain optical coherence tomography. Int J Ophthalmol. 2018;11(5):791–6.PubMedPubMedCentral

27.

Scuderi G, Fragiotta S, Scuderi L, et al. Ganglion cell complex analysis in Glaucoma patients: what can it tell us? Eye Brain. 2020;12:33–44.PubMedPubMedCentral

28.

Tan O, Chopra V, Lu AT-H, et al. Detection of macular ganglion cell loss in glaucoma by Fourier-domain optical coherence tomography. Ophthalmology. 2009;116(12):2305–2314.e1–2.PubMedPubMedCentral

29.

Kim NR, Lee ES, Seong GJ, et al. Comparing the ganglion cell complex and retinal nerve fibre layer measurements by Fourier domain OCT to detect glaucoma in high myopia. Br J Ophthalmol. 2011;95(8):1115–21.PubMed

30.

Rao HL, Babu JG, Addepalli UK, et al. Retinal nerve fiber layer and macular inner retina measurements by spectral domain optical coherence tomograph in Indian eyes with early glaucoma. Eye Lond Engl. 2012;26(1):133–9.

31.

Seong M, Sung KR, Choi EH, et al. Macular and Peripapillary retinal nerve Fiber layer measurements by spectral domain optical coherence tomography in Normal-tension Glaucoma. Invest Ophthalmol Vis Sci. 2010;51(3):1446–52.PubMed

32.

Garas A, Vargha P, Holló G. Diagnostic accuracy of nerve fibre layer, macular thickness and optic disc measurements made with the RTVue-100 optical coherence tomograph to detect glaucoma. Eye Lond Engl. 2011;25(1):57–65.

33.

Schulze A, Lamparter J, Pfeiffer N, et al. Diagnostic ability of retinal ganglion cell complex, retinal nerve fiber layer, and optic nerve head measurements by Fourier-domain optical coherence tomography. Graefes Arch Clin Exp Ophthalmol. 2011;249(7):1039–45.PubMed

34.

Seol BR, Jeoung JW, Park KH. Glaucoma detection ability of macular ganglion cell-inner Plexiform layer thickness in myopic Preperimetric Glaucoma. Invest Ophthalmol Vis Sci. 2015;56(13):8306–13.PubMed

35.

Kim YC, Moon J-S, Park H-YL, et al. Three dimensional evaluation of posterior pole and optic nerve head in tilted disc. Sci Rep. 2018;8(1):1121.PubMedPubMedCentral

36.

Kim YC, Jung Y, Park HL, et al. The location of the deepest point of the eyeball determines the optic disc configuration. Sci Rep. 2017;7(1):5881.PubMedPubMedCentral

37.

Kim KE, Jeoung JW, Park KH, et al. Diagnostic classification of macular ganglion cell and retinal nerve fiber layer analysis: differentiation of false-positives from glaucoma. Ophthalmology. 2015;122(3):502–10.PubMed

38.

Song WK, Lee SC, Lee ES, et al. Macular thickness variations with sex, age, and axial length in healthy subjects: a spectral domain–optical coherence tomography study. Invest Ophthalmol Vis Sci. 2010;51(8):3913–8.PubMed

39.

Qiu K, Wang G, Zhang R, et al. Influence of optic disc-fovea distance on macular thickness measurements with OCT in healthy myopic eyes. Sci Rep. 2018;8(1):5233.PubMedPubMedCentral

40.

Benhamou N, Massin P, Haouchine B, et al. Macular retinoschisis in highly myopic eyes. Am J Ophthalmol. 2002;133(6):794–800.PubMed

41.

Xu X-Y, Xiao H, Luo J-Y, et al. Evaluation of spectral domain optical coherence tomography parameters in discriminating preperimetric glaucoma from high myopia. Int J Ophthalmol. 2019;12(1):58–65.PubMedPubMedCentral

42.

Leung CK-S, Mohamed S, Leung KS, et al. Retinal nerve Fiber layer measurements in myopia: an optical coherence tomography study. Invest Ophthalmol Vis Sci. 2006;47(12):5171–6.PubMed

43.

Medeiros FA, Ng D, Zangwill LM, et al. The effects of study design and Spectrum Bias on the evaluation of diagnostic accuracy of confocal scanning laser ophthalmoscopy in Glaucoma. Invest Ophthalmol Vis Sci. 2007;48(1):214–22.PubMed

Title: Diagnostic ability of OCT parameters and retinal ganglion cells count in identification of glaucoma in myopic preperimetric eyes
Authors: Teresa Rolle
Beatrice Bonetti
Alberto Mazzucco
Laura Dallorto
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Glaucoma
Published in: BMC Ophthalmology / Issue 1/2020
Electronic ISSN: 1471-2415
DOI: https://doi.org/10.1186/s12886-020-01616-5

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Diagnostic ability of OCT parameters and retinal ganglion cells count in identification of glaucoma in myopic preperimetric eyes

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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