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Ganglion Cell Complex Analysis in Glaucoma Patients: What Can It Tell Us?

Authors Scuderi G, Fragiotta S, Scuderi L, Iodice CM, Perdicchi A

Received 8 August 2019

Accepted for publication 15 January 2020

Published 31 January 2020 Volume 2020:12 Pages 33—44


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Margaret Wong-Riley

Gianluca Scuderi,1 Serena Fragiotta,1 Luca Scuderi,2 Clemente Maria Iodice,3 Andrea Perdicchi1

1NESMOS Department, Ophthalmology Unit, S. Andrea Hospital, University of Rome “La Sapienza”, Rome, Italy; 2Ophthalmology Unit, Department of Sense Organs, Azienda Policlinico Umberto I, University of Rome “La Sapienza”, Rome, Italy; 3Faculty of Medicine and Dentistry, University of Rome “La Sapienza”, Rome, Italy

Correspondence: Serena Fragiotta
NESMOS Department, S. Andrea Hospital, Via di Grottarossa 1035-1039, Rome 00189, Italy
Tel +39 3293276433
Fax +39 0633776628

Abstract: Glaucoma is a group of optic neuropathies characterized by a progressive degeneration of retina ganglion cells (RGCs) and their axons that precedes functional changes detected on the visual field. The macular ganglion cell complex (GCC), available in commercial Fourier-domain optical coherence tomography, allows the quantification of the innermost retinal layers that are potentially involved in the glaucomatous damage, including the retinal nerve fiber (RNFL), ganglion cell and inner plexiform layers. The average GCC thickness and its related parameters represent a reliable biomarker in detecting preperimetric glaucomatous damage. The most accurate GCC parameters are represented by average and inferior GCC thicknesses, and they can be associated with progressive visual field loss. Although the diagnostic accuracy increases with more severe glaucomatous damage and higher signal strength values, it is not affected by increasing axial length, resulting in a more accurate discrimination of glaucomatous damage in myopic eyes with respect to the traditional RNFL thickness. The analysis of the structure-function relationship revealed a good agreement between the loss in retinal sensitivity and GCC thickness. The use of a 10-2° visual field grid, adjusted for the anatomical RGCs displacement, describes more accurately the relationship between RGCs thickness and visual field sensitivity loss.

Keywords: retinal ganglion cells, spectral-domain optical coherence tomography, standard automated perimetry, retinal nerve fiber layer

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