Free
Eye Movements, Strabismus, Amblyopia and Neuro-ophthalmology  |   July 2014
The Detection of Macular Analysis by SD-OCT for Optic Chiasmal Compression Neuropathy and Nasotemporal Overlap
Author Notes
  • Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan 
  • Correspondence: Akiyasu Kanamori, Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, Japan, 650-0017; kanaaki@med.kobe-u.ac.jp
Investigative Ophthalmology & Visual Science July 2014, Vol.55, 4667-4672. doi:10.1167/iovs.14-14766
  • Views
  • PDF
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Azusa Akashi, Akiyasu Kanamori, Kaori Ueda, Yoshiko Matsumoto, Yuko Yamada, Makoto Nakamura; The Detection of Macular Analysis by SD-OCT for Optic Chiasmal Compression Neuropathy and Nasotemporal Overlap. Invest. Ophthalmol. Vis. Sci. 2014;55(7):4667-4672. doi: 10.1167/iovs.14-14766.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose.: To assess the diagnostic performance of the macular parameters detected by spectral-domain optical coherence tomography (SD-OCT) in band atrophy (BA) eyes.

Methods.: Forty-nine BA eyes with permanent temporal hemianopia and 89 normal eyes were enrolled. Any patients who had nasal visual field loss were excluded. Each participant was imaged by three-dimensional (3D) OCT-2000, and 10 × 10 grids in the macula were automatically allocated. The thickness of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL)+ (GCL+inner plexiform layer [IPL]), and GCL++ (RNFL+GCL+IPL) in both nasal and temporal hemiretina was calculated and compared between the BA and normal eyes. The areas under the receiver operating characteristic curves (AUCs) in these parameters were compared between the nasal hemiretina and the temporal hemiretina.

Results.: All the parameters in the BA eyes were significantly thinner than those in the normal eyes. The AUCs for the mRNFL, GCL+, and GCL++ thickness in the nasal hemiretina were 0.890, 0.988, and 0.981, respectively. The parameters in the nasal hemiretina showed significantly higher AUCs than those parameters in the temporal hemiretina. In the temporal hemiretina, the damaged grids in the mRNFL were located in the arcuate areas in each hemifield.

Conclusions.: The inner macular parameters in the nasal hemiretina exhibited high diagnostic abilities to detect BA. The GCL+ was more affected than mRNFL. The characteristic pattern of mRNFL and GCL+ thinning was implicated in the anatomical architecture regarding the nasotemporal overlap of the crossed and uncrossed fibers around the fovea. (www.umin.ac.jp/ctr number, UMIN000006900.)

Introduction
Chiasmal compression predominantly affects the crossed nerve fibers subserving the nasal hemiretina compared with the effect on the uncrossed fibers originating from the temporal hemiretina, which results in bitemporal hemianopia. Treatment delay leads to preferential atrophy of the temporal and nasal sectors of the neuroretinal rim in the optic disc, which is denoted as band atrophy (BA). 1 Optical coherence tomography (OCT), which uses near-infrared light to provide cross-sectional images of the retinal architecture, enables physicians to noninvasively and objectively quantify the reduction in the circumpapillary retinal nerve fiber layer (cpRNFL) caused by glaucomatous and nonglaucomatous optic neuropathy. Our previous studies 2 and those of others 35 demonstrated that the earlier version of time-domain (TD) OCT could detect the characteristic cpRNFL loss in eyes with BA. 
Additionally, the macular thickness obtained by OCT was reduced in the eyes with BA. 58 Numerous studies have shown that the macular ganglion cell complex (GCC) had a good glaucoma-discriminating power that was comparable to that of RNFL. 913 Additionally, GCC thickness showed the structural damage in the nasal hemiretina caused by chiasmal compression. 14 Recent advances in OCT technology have enabled an automatic segmentation between the RNFL and the ganglion cell layer (GCL) in the macula. 1518 No studies have evaluated these macular parameters in eyes with BA, to the best of our knowledge. 
In this study, the thickness of the macular RNFL (mRNFL), ganglion cell layer (GCL)+ composed of GCL and an inner plexiform layer (IPL), and GCL++ composed of mRNFL and GCL+ in the nasal and temporal hemiretina was measured by SD-OCT and compared between the BA and normal eyes. The diagnostic performances of these parameters were evaluated. The grid patterns of the deviation plots compared with the normative database were illustrated for each parameter to further elucidate the anatomical architecture regarding the crossed and uncrossed fibers around the fovea. 
Materials and Methods
Japanese subjects were recruited at the Kobe University Hospital (Kobe, Japan) for this observational cross-sectional study. The institutional review board of Kobe University approved the study protocol, which adhered to the tenets of the Declaration of Helsinki. Written informed consent was obtained from each subject after an explanation of the study protocol. 
An eye with temporal hemianopia because of a chiasmal lesion was included in this study after obtaining informed consent from the patient. All the eyes had a best-corrected visual acuity of at least 20/40, with a refractive error of <4 dioptric astigmatism. The axial length was acquired with an IOL Master (Carl Zeiss Meditec, Inc., Dublin, CA, USA). The intraocular pressure measurements were <21 mm Hg. All the subjects had a negative medical history of diabetes mellitus. Temporal hemianopia was defined as the presence of at least two nonedge points with P < 0.5% and one point with P < 2% by a Humphrey Field Analyzer 30-2 Swedish Interactive Thresholding Algorithm (SITA) standard program (HFA; Carl Zeiss Meditec, Inc.); test points directly above and below the blind spot were excluded. 8,19 The eyes with glaucomatous visual field damage in the nasal hemivisual field detected by HFA and those with glaucomatous optic disc changes (notching, excavation, or optic disc hemorrhage) were excluded. In addition, the eyes with retinal diseases, obvious glaucomatous optic neuropathy, and severe cataract or vitreous opacity were excluded from the study. 
Self-reported healthy subjects at least 20 years of age were invited to participate in the study. The following exclusion criteria were used for the normal eyes: intraocular pressure > 21 mm Hg; unreliable HFA results (fixation loss, false positive or false negative > 33%); abnormal findings in HFA suggestive of glaucoma ([1] two or more contiguous points of P < 0.01 with three or more contiguous points of P < 0.05 in either horizontal hemifield or [2] two or more adjacent points with a 10-dB difference across the horizontal midline on the pattern standard deviation plots); vitreoretinal diseases; and optic nerve disorders. Only one eye per subject was randomly included in the normal group. 
Macular Inner Retinal Layer Thickness Measurements
Optical coherence tomography examination using three-dimensional (3D) OCT-2000 software (version 8.00; Topcon, Inc., Tokyo, Japan) was performed within 1 month from the last visual field examination. The 3D OCT-2000 uses a raster scanning of a 7-mm2 area centered on the fovea with a scan density of 512 (vertical) × 128 (horizontal) scans. The 3D OCT measured a 6- × 6-mm area that was centered on the fovea using built-in software. The magnification effect in each eye was automatically corrected according to the formula (the modified Littman's method) provided by the manufacturer, which was based on the refraction, corneal radius, and axial length, to obtain more accurate circle sizes during the measurements. 
The analyzing macular loci were automatically allocated to 10 × 10 grids. The grids located on the top and bottom rows were excluded because of an artifact effect from the existing arcade vessels, and thus the remaining 8 × 10 grids were used for the further analyses by grouping into the nasal and temporal hemiretina (Fig. 1). The average mRNFL, GCL+, and GCL++ thickness in the nasal and temporal hemiretina was calculated and compared between the BA and the normal groups. The number of abnormal grids that were color coded in yellow (P < 0.05) or in red (P < 0.01) on the deviation map was sampled, from which the damaged composite grid areas of each OCT parameter in BA eyes were illustrated. 
Figure 1
 
A printout of the macular analysis using 3D OCT. The built-in viewer shows the macular RNFL thickness, the ganglion cell layer+inner plexiform layer (GCL+) thickness, and the RNFL+GCL+IPL (GCL++) thickness. Upper: A pseudo-colored map of the measured thickness. Lower: Each grid in the 10 × 10 grid was color coded with no color (within the normal limit), yellow (outside of the 95% normal limit), or red (outside of the 99% normal limit). The grids in the two dashed bars were excluded from the analyses.
Figure 1
 
A printout of the macular analysis using 3D OCT. The built-in viewer shows the macular RNFL thickness, the ganglion cell layer+inner plexiform layer (GCL+) thickness, and the RNFL+GCL+IPL (GCL++) thickness. Upper: A pseudo-colored map of the measured thickness. Lower: Each grid in the 10 × 10 grid was color coded with no color (within the normal limit), yellow (outside of the 95% normal limit), or red (outside of the 99% normal limit). The grids in the two dashed bars were excluded from the analyses.
Statistical Analysis
All the numerical data had normal distributions confirmed by the Kolmogorov-Smirnov test. Comparison of age, axial length, refraction, and mean deviation between the groups was performed using unpaired t-test. Sex differences were assessed with χ2 test. Bilateral eyes were included in the analyses if they matched the inclusion criteria. Because measurements from both eyes of the same subject were likely to be correlated, to investigate differences in OCT measurements between the groups, generalized estimation equation models (GEE) with working correlation matrix “exchangeable” were used, accounting for within-patient intereye dependencies. In all GEE models, diagnosis was used as independent variable and OCT measurements as dependent variable. 
Receiver operating characteristic (ROC) curves were depicted for the average thickness of mRNFL, GCL+, and GCL++ to investigate the ability of the devices to differentiate the eyes with BA from normal eyes. The ROC curves were adjusted for the differences in age using covariate-adjusted ROC curves, as demonstrated by Pepe. 20 A bootstrap resampling procedure was used (n = 1000 resamples). A pairwise comparison of the areas under the curve (AUCs) was performed using a method proposed by Dodd and Pepe. 21 The sample size calculation approved the statistical power to compare the two AUCs. When the estimated correlation between the two instruments in normal eyes and eyes with BA was set at 0.7, a minimum of 27 subjects in each group was required to detect a 0.15 difference in the AUCs at values of more than 0.9, with a statistical power of 80% and a type I error of 5%. The sensitivity of the detection of the eyes with BA in each OCT parameter was determined, with a target specificity of 95%. The statistical analyses were performed using computer programs (Stata ver. 12.0, StataCorp., College Station, TX, USA; SPSS ver. 21.0, Japan IBM, Tokyo, Japan; and Medcalc ver. 11.6.1.0, Medcalc, Mariakerke, Belgium). A P value less than 0.05 was considered statistically significant. 
Results
A total of 49 eyes of 32 Japanese patients (12 males and 20 females) with BA and 89 normal eyes were enrolled. Of the patients with BA, 23 patients had pituitary adenoma, 5 had craniopharyngioma, and 4 had Rathke's cleft cyst. 
Figure 1 shows the OCT measurements of a representative case with BA. Three-dimensional OCT provided color-coded thickness deviation maps of the mRNFL, GCL+, and GCL++ thicknesses. Whereas grids with normal-range thickness are represented in green, the grids that had thickness with a probability less than 5% on the normal distribution in the normative database are represented in yellow, and those that had thickness with P ≤ 1% are represented in red. All the OCT measurements showed multiple abnormal grids in the nasal hemiretina. Notably, in the GCL+ and GCL++ measurements, the abnormally deviated grids clearly respected the vertical meridian crossing the fovea, which corresponded to the temporal hemianopia caused by chiasmal compression. However, several clusters of grids in the mRNFL parameter were unexpectedly abnormal, even in the temporal hemiretina, and are expressed in red and yellow. 
Table 1 presents the demographics and ocular characteristics of the subjects. The refraction, sex, and axial length were not significantly different between the two groups. However, there were significant differences in age, so the AUCs were adjusted by age for the subsequent analyses. 
Table 1
 
Characteristics of the Studied Eyes (Mean ± Standard Deviation)
Table 1
 
Characteristics of the Studied Eyes (Mean ± Standard Deviation)
BA, n = 49 Normal Eyes, n = 89 P Value
Age, y 50 ± 17.3 47.2 ± 10.3 <0.01*
Sex, % female 53.1 57.8 0.64†
Ratio of laterality, % right 49.0 49.4 0.94
Refraction, spherical equivalent, D −2.52 ± 2.34 −1.89 ± 2.84 0.117*
Axial length, mm 24.4 ± 1.34 24.8 ± 1.16 0.256*
Mean deviation, dB −4.62 ± 5.57 −0.28 ± 1.38 <0.0001*
Table 2 summarizes the mean thicknesses of the macular parameters in the two groups. All the parameters in the BA eyes were significantly thinner than those in the normal eyes. 
Table 2
 
Thickness of the Inner Retinal Layer Parameters by 3D OCT Instruments (μm, Mean ± SD)
Table 2
 
Thickness of the Inner Retinal Layer Parameters by 3D OCT Instruments (μm, Mean ± SD)
Macular Parameters Band Atrophy Normal P Value
mRNFL Nasal 33.2 ± 5.3 41.8 ± 5.1 0.003
Temporal 21.7 ± 1.7 22.6 ± 1.6 <0.001
GCL+ Nasal 55.1 ± 8.0 73.4 ± 5.0 <0.001
Temporal 67.4 ± 6.9 73.9 ± 5.2 <0.001
GCL++ Nasal 88.4 ± 12.3 115.2 ± 7.5 <0.001
Temporal 89.0 ± 7.2 96.4 ± 6.4 <0.001
Table 3 demonstrates the age-adjusted AUCs of the parameters to distinguish BA eyes from normal eyes. The AUCs for the average thickness of the nasal hemiretina were 0.890, 0.988, and 0.981 for the mRNFL, GCL+, and GCL++, respectively. All these were significantly higher than those of the temporal hemiretina. Figure 2 illustrates the ROC curves for detecting the BA eyes from the normal eyes. The sensitivities calculated with target specificities at 95% were 55.1% (n = 27/49), 93.9% (n = 46/49), and 93.8% (n = 46/49) for the mRNFL, GCL+, and GCL++, respectively, in the average thickness of nasal hemiretina. In the temporal hemiretina, the sensitivities were 14.3% (n = 7/49), 34.7% (n = 17/49), and 34.7% (n = 17/49), respectively. 
Figure 2
 
The receiver operating characteristic (ROC) curves of the macular retinal nerve fiber layer (mRNFL) thickness (A), the ganglion cell layer+inner plexiform layer (GCL+) thickness (B), and the RNFL+GCL+IPL (GCL++) thickness (C) of the nasal hemiretina (red lines) and the temporal hemiretina (blue lines) for discriminating eyes with band atrophy from the normal eyes.
Figure 2
 
The receiver operating characteristic (ROC) curves of the macular retinal nerve fiber layer (mRNFL) thickness (A), the ganglion cell layer+inner plexiform layer (GCL+) thickness (B), and the RNFL+GCL+IPL (GCL++) thickness (C) of the nasal hemiretina (red lines) and the temporal hemiretina (blue lines) for discriminating eyes with band atrophy from the normal eyes.
Table 3
 
Area Under the Receiver Operating Characteristic Curve Analysis Using 3D OCT for Eyes With Band Atrophy (Means ± Standard Error)
Table 3
 
Area Under the Receiver Operating Characteristic Curve Analysis Using 3D OCT for Eyes With Band Atrophy (Means ± Standard Error)
Macular Parameters Nasal Temporal P Value
mRNFL 0.890 ± 0.002 0.619 ± 0.06 <0.001
GCL+ 0.988 ± 0.102 0.789 ± 0.05 <0.001
GCL++ 0.981 ± 0.103 0.768 ± 0.052 <0.001
Given the temporal hemianopia, the temporal hemiretina should theoretically be unaffected. However, previous studies demonstrated that chiasmal compression damages the uncrossing nerve fibers and thus yields a degree of sensitivity decline in the nasal visual field. To elucidate the pattern and location of the structural damage in the temporal hemiretina, the number and loci of the abnormal grids in the mRNFL and GCL+ were sampled. Figure 3 illustrates the percentage of abnormality on each grid of the mRNFL and GCL+ in the temporal hemiretina. In the mRNFL measurements, the abnormal grids were located along the arcuate areas in each upper and lower hemifield to the periphery. In a clear contrast, in the GCL+ measurements, the abnormal grids in the temporal hemiretina were exclusively concentrated around the foveal loci adjacent to the nasal hemiretina. 
Figure 3
 
(A) A printout in 3D OCT of a representative case shows the reduction of the mRNFL and GCL+ thickness in the temporal hemiretina. The percentages of the BA eyes that had abnormal grids of mRNFL (B) and GCL+ (C) thickness are shown in the temporal hemiretina. Based on the internal normative data in 3D OCT, the eyes color coded with yellow or red were counted in each grid. The grids were applied to the grayscale in which the darker shades indicate higher percentages. These schemas were overlapped with the projection pattern of the retinal nerve fibers. Reprinted with permission from Hogan MJ, Alvarado JA, Weddell JE. Optic Nerve. In: Histology of the Human Eye. Philadelphia, PA: Saunders; 1971. Copyright Elsevier.
Figure 3
 
(A) A printout in 3D OCT of a representative case shows the reduction of the mRNFL and GCL+ thickness in the temporal hemiretina. The percentages of the BA eyes that had abnormal grids of mRNFL (B) and GCL+ (C) thickness are shown in the temporal hemiretina. Based on the internal normative data in 3D OCT, the eyes color coded with yellow or red were counted in each grid. The grids were applied to the grayscale in which the darker shades indicate higher percentages. These schemas were overlapped with the projection pattern of the retinal nerve fibers. Reprinted with permission from Hogan MJ, Alvarado JA, Weddell JE. Optic Nerve. In: Histology of the Human Eye. Philadelphia, PA: Saunders; 1971. Copyright Elsevier.
Discussion
In this study, we demonstrated that the three inner retinal parameters obtained by 3D OCT in eyes with BA were significantly lower than those in healthy control eyes. As expected, the macular parameters in the nasal hemiretina had a higher ability to detect damage in the eyes with BA than those in the temporal hemiretina. Given that the crossed fibers are damaged because of chiasmal compression, it is not surprising that the retrogradely damaged retinal ganglion cells were lost, resulting in inner retina thinning in the nasal macular region. Our results were in accordance with previous reports, in which the reduction of nasal macular thickness and the average GCC thickness were demonstrated. 58,14 This study is the first to show that, in addition to GCC, mRNFL and GCL+ might be good candidates for diagnosing BA. This specific pattern of OCT macular damage might be helpful in differentiating BA from diseases with a different pattern of ganglion cell loss, such as glaucoma. 
We noted the reduction of thickness in the GCC++ and GCL+ in the temporal hemiretina. These findings were in agreement with previous studies that reported the total macular thickness reduction measured by TD- and SD-OCT. 58 However, this study demonstrated that the pattern of reduction in the mRNFL and GCL+ thickness in the temporal hemiretina was distinct. The uncrossed fibers from the temporal hemiretina should theoretically be preserved because no eyes showed significant visual field loss in the nasal hemifield in this study. This result prompted us to further investigate the pattern of inner retina damage in the temporal hemiretina. We counted the number of abnormal grids in the BA eyes that were color coded in yellow (outside of the 95% normal limit) or red (outside of the 99% normal limit). In the mRNFL measurements, the abnormal grids were located along the arcuate areas in the upper and lower hemifield that were split by the horizontal meridian. Many eyes showed reduced mRNFL thickness at the parafoveal grids (particularly rows 3 and 8), as shown in Figure 3. The patterns appeared to be as if the abnormally thin mRNFL respected the horizontal midline rather than the vertical meridian crossing the fovea. We previously reported the usefulness of cluster analysis of mRNFL to diagnose glaucoma. 22 In this definition, if an eye showed at least four contiguous, horizontally located grids and an additional two grids adjacent to these grids that were displayed in red in the mRNFL measurements of the same horizontal hemiretina, the eye was considered to be abnormal. This method reflected the projection pattern of mRNFL around the fovea. When this criterion was adapted, 26 eyes (53%) were defined as abnormal. None of the normal eyes showed such abnormality. Hence, a substantial loss of RNFL thickness with the projection pattern of fibers likely decreased in the temporal hemiretina of the BA eyes, although no obvious visual field loss in the nasal hemifield was observed. 
In a clear contrast, in the GCL+ measurements, the abnormal grids in the temporal hemiretina were exclusively concentrated around the foveal loci adjacent to the nasal hemiretina, which were comparable to those in the temporal hemianopia with macular sparing. As shown in Figure 3C, many eyes lost their GCL+ thickness in the grids near the fovea. Some histologic studies have demonstrated that the parafoveal area had a nasotemporal overlap zone in which cells with crossed and uncrossed fibers are intermixed in nonprimate mammals. 2327 In 1973, Stone et al. 28 first demonstrated in the Nissl-stained retina of a rhesus monkey model that the overlap zone was approximately 1° in width around the fovea. Subsequently, Bunt et al. 29 and Leventhal et al. 30 showed that the overlap zone was up to 3° in a macaque monkey model in which horseradish peroxidase was injected into the lateral geniculate nucleus. Furthermore, Fukuda et al. 31 demonstrated that the width of the overlap zone became greater, up to 5°, in the central retina of a Japanese monkey model with an injection of HRP and fluorescent dyes. Given that the width of one grid in 3D OCT is 600 μm (10 × 10 grids being 6 × 6 mm2), which is equivalent to 2° of visual field, the distribution of the abnormal grids of the GCL+ was in good agreement with these histologic studies. Additionally, the analysis of the mRNFL grids suggested wider spreading of the uncrossed fibers into the temporal hemiretina. Our study might be the first to demonstrate the overlap zone in human eyes in vivo. 
In conclusion, the mRNFL, GCL+, and GCL++ thickness in the nasal hemiretina measured by 3D OCT had significantly higher diagnostic ability for BA eyes than those in the temporal hemiretina. Although the BA eyes in the study had theoretically preserved uncrossed fibers, the macular OCT parameters in the temporal hemiretina were lost to some degree, with a distinct mechanism of the damages in the mRNFL and GCL+. This finding might provide new insights into the anatomical architecture regarding the nasotemporal overlap in human eyes. 
Acknowledgments
Presented at the annual meeting of the Association for Research in Vision and Ophthalmology, Orlando, Florida, United States, May 2014. 
Supported by Grants-in-Aid for Scientific Research (25462715) from the Japan Society for the Promotion of Science from the Japanese government (AK), the Santan Pharmaceutical Founder Commemoration Ophthalmic Research Fund (AK), and the Uehara Memorial Foundation (AK). 
Disclosure: A. Akashi, None; A. Kanamori, None; K. Ueda, None; Y. Matsumoto, None; Y. Yamada, None; M. Nakamura, None 
References
Unsold R Hoyt WF. Band atrophy of the optic nerve. The histology of temporal hemianopsia. Arch Ophthalmol . 1980; 98: 1637–1638. [CrossRef] [PubMed]
Kanamori A Nakamura M Matsui N Optical coherence tomography detects characteristic retinal nerve fiber layer thickness corresponding to band atrophy of the optic discs. Ophthalmology . 2004; 111: 2278–2283. [CrossRef] [PubMed]
Monteiro ML Leal BC Rosa AA Bronstein MD. Optical coherence tomography analysis of axonal loss in band atrophy of the optic nerve. Br J Ophthalmol . 2004; 88: 896–899. [CrossRef] [PubMed]
Monteiro ML Moura FC Medeiros FA. Diagnostic ability of optical coherence tomography with a normative database to detect band atrophy of the optic nerve. Am J Ophthalmol . 2007; 143: 896–899. [CrossRef] [PubMed]
Moura FC Medeiros FA Monteiro ML. Evaluation of macular thickness measurements for detection of band atrophy of the optic nerve using optical coherence tomography. Ophthalmology . 2007; 114: 175–181. [CrossRef] [PubMed]
Monteiro ML Cunha LP Costa-Cunha LV Maia OO Jr Oyamada MK. Relationship between optical coherence tomography, pattern electroretinogram and automated perimetry in eyes with temporal hemianopia from chiasmal compression. Invest Ophthalmol Vis Sci . 2009; 50: 3535–3541. [CrossRef] [PubMed]
Costa-Cunha LV Cunha LP Malta RF Monteiro ML. Comparison of Fourier-domain and time-domain optical coherence tomography in the detection of band atrophy of the optic nerve. Am J Ophthalmol . 2009; 147: 56–63, e2. [CrossRef] [PubMed]
Monteiro ML Costa-Cunha LV Cunha LP Malta RF. Correlation between macular and retinal nerve fibre layer Fourier-domain OCT measurements and visual field loss in chiasmal compression. Eye (Lond) . 2010; 24: 1382–1390. [CrossRef] [PubMed]
Tan O Chopra V Lu AT Detection of macular ganglion cell loss in glaucoma by Fourier-domain optical coherence tomography. Ophthalmology . 2009; 116: 2305–2314, e1–e2. [CrossRef] [PubMed]
Garas A Vargha P Hollo 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) . 2011; 25: 57–65. [CrossRef] [PubMed]
Kim NR Hong S Kim JH Rho SS Seong GJ Kim CY. Comparison of macular ganglion cell complex thickness by Fourier-domain OCT in normal tension glaucoma and primary open-angle glaucoma. J Glaucoma . 2011; 22: 133–9. [CrossRef]
Schulze A Lamparter J Pfeiffer N Berisha F Schmidtmann I Hoffmann EM. 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: 1039–1045. [CrossRef] [PubMed]
Rao HL Babu JG Addepalli UK Senthil S Garudadri CS. Retinal nerve fiber layer and macular inner retina measurements by spectral domain optical coherence tomograph in Indian eyes with early glaucoma. Eye (Lond) . 2012; 26: 133–139. [CrossRef] [PubMed]
Ohkubo S Higashide T Takeda H Murotani E Hayashi Y Sugiyama K. Relationship between macular ganglion cell complex parameters and visual field parameters after tumor resection in chiasmal compression. Jpn J Ophthalmol . 2012; 56: 68–75. [CrossRef] [PubMed]
Ishikawa H Stein DM Wollstein G Beaton S Fujimoto JG Schuman JS. Macular segmentation with optical coherence tomography. Invest Ophthalmol Vis Sci . 2005; 46: 2012–2017. [CrossRef] [PubMed]
Mwanza JC Durbin MK Budenz DL Profile and predictors of normal ganglion cell-inner plexiform layer thickness measured with frequency-domain optical coherence tomography. Invest Ophthalmol Vis Sci . 2011; 52: 7872–7879. [CrossRef] [PubMed]
Mwanza JC Oakley JD Budenz DL Chang RT Knight OJ Feuer WJ. Macular ganglion cell-inner plexiform layer: automated detection and thickness reproducibility with spectral domain-optical coherence tomography in glaucoma. Invest Ophthalmol Vis Sci . 2011; 52: 8323–8329. [CrossRef] [PubMed]
Kotera Y Hangai M Hirose F Mori S Yoshimura N. Three-dimensional imaging of macular inner structures in glaucoma by using spectral-domain optical coherence tomography. Invest Ophthalmol Vis Sci . 2011; 52: 1412–1421. [CrossRef] [PubMed]
Nakamura M Ishikawa-Tabuchi K Kanamori A Yamada Y Negi A. Better performance of RTVue than Cirrus spectral-domain optical coherence tomography in detecting band atrophy of the optic nerve. Graefes Arch Clin Exp Ophthalmol . 2012; 250: 1499–1507. [CrossRef] [PubMed]
Pepe MS. The Statistical Evaluation of Medical Tests for Classification and Prediction . Oxford, New York: Oxford University Press; 2004: xvi, 302.
Dodd LE Pepe MS. Partial AUC estimation and regression. Biometrics . 2003; 59: 614–623. [CrossRef] [PubMed]
Kanamori A Naka M Akashi A Fujihara M Yamada Y Nakamura M. Cluster analyses of grid-pattern display in macular parameters using optical coherence tomography for glaucoma diagnosis. Invest Ophthalmol Vis Sci . 2013; 54: 6401–6408. [CrossRef] [PubMed]
Stone J. The naso-temporal division of the cat's retina. J Comp Neurol . 1966; 126: 585–600. [PubMed]
Wassle H Illing RB. The retinal projection to the superior colliculus in the cat: a quantitative study with HRP. J Comp Neurol . 1980; 190: 333–356. [CrossRef] [PubMed]
Provis JM Watson CR. The distribution of ipsilaterally and contralaterally projecting ganglion cells in the retina of the pigmented rabbit. Exp Brain Res . 1981; 44: 82–92. [CrossRef] [PubMed]
Wakakuwa K Washida A Fukuda Y. Ipsilaterally projecting retinal ganglion cells in the eastern chipmunk (Tamias sibiricus asiaticus). Neurosci Lett . 1985; 55: 219–224. [CrossRef] [PubMed]
Reese BE Cowey A. The crossed projection from the temporal retina to the dorsal lateral geniculate nucleus in the rat. Neuroscience . 1987; 20: 951–959. [CrossRef] [PubMed]
Stone J Leicester J Sherman SM. The naso-temporal division of the monkey's retina. J Comp Neurol . 1973; 150: 333–348. [CrossRef] [PubMed]
Bunt AH Minckler DS Johanson GW. Demonstration of bilateral projection of the central retina of the monkey with horseradish peroxidase neuronography. J Comp Neurol . 1977; 171: 619–630. [CrossRef] [PubMed]
Leventhal AG Ault SJ Vitek DJ. The nasotemporal division in primate retina: the neural bases of macular sparing and splitting. Science . 1988; 240: 66–67. [CrossRef] [PubMed]
Fukuda Y Sawai H Watanabe M Wakakuwa K Morigiwa K. Nasotemporal overlap of crossed and uncrossed retinal ganglion cell projections in the Japanese monkey (Macaca fuscata). J Neurosci . 1989; 9: 2353–2373. [PubMed]
Figure 1
 
A printout of the macular analysis using 3D OCT. The built-in viewer shows the macular RNFL thickness, the ganglion cell layer+inner plexiform layer (GCL+) thickness, and the RNFL+GCL+IPL (GCL++) thickness. Upper: A pseudo-colored map of the measured thickness. Lower: Each grid in the 10 × 10 grid was color coded with no color (within the normal limit), yellow (outside of the 95% normal limit), or red (outside of the 99% normal limit). The grids in the two dashed bars were excluded from the analyses.
Figure 1
 
A printout of the macular analysis using 3D OCT. The built-in viewer shows the macular RNFL thickness, the ganglion cell layer+inner plexiform layer (GCL+) thickness, and the RNFL+GCL+IPL (GCL++) thickness. Upper: A pseudo-colored map of the measured thickness. Lower: Each grid in the 10 × 10 grid was color coded with no color (within the normal limit), yellow (outside of the 95% normal limit), or red (outside of the 99% normal limit). The grids in the two dashed bars were excluded from the analyses.
Figure 2
 
The receiver operating characteristic (ROC) curves of the macular retinal nerve fiber layer (mRNFL) thickness (A), the ganglion cell layer+inner plexiform layer (GCL+) thickness (B), and the RNFL+GCL+IPL (GCL++) thickness (C) of the nasal hemiretina (red lines) and the temporal hemiretina (blue lines) for discriminating eyes with band atrophy from the normal eyes.
Figure 2
 
The receiver operating characteristic (ROC) curves of the macular retinal nerve fiber layer (mRNFL) thickness (A), the ganglion cell layer+inner plexiform layer (GCL+) thickness (B), and the RNFL+GCL+IPL (GCL++) thickness (C) of the nasal hemiretina (red lines) and the temporal hemiretina (blue lines) for discriminating eyes with band atrophy from the normal eyes.
Figure 3
 
(A) A printout in 3D OCT of a representative case shows the reduction of the mRNFL and GCL+ thickness in the temporal hemiretina. The percentages of the BA eyes that had abnormal grids of mRNFL (B) and GCL+ (C) thickness are shown in the temporal hemiretina. Based on the internal normative data in 3D OCT, the eyes color coded with yellow or red were counted in each grid. The grids were applied to the grayscale in which the darker shades indicate higher percentages. These schemas were overlapped with the projection pattern of the retinal nerve fibers. Reprinted with permission from Hogan MJ, Alvarado JA, Weddell JE. Optic Nerve. In: Histology of the Human Eye. Philadelphia, PA: Saunders; 1971. Copyright Elsevier.
Figure 3
 
(A) A printout in 3D OCT of a representative case shows the reduction of the mRNFL and GCL+ thickness in the temporal hemiretina. The percentages of the BA eyes that had abnormal grids of mRNFL (B) and GCL+ (C) thickness are shown in the temporal hemiretina. Based on the internal normative data in 3D OCT, the eyes color coded with yellow or red were counted in each grid. The grids were applied to the grayscale in which the darker shades indicate higher percentages. These schemas were overlapped with the projection pattern of the retinal nerve fibers. Reprinted with permission from Hogan MJ, Alvarado JA, Weddell JE. Optic Nerve. In: Histology of the Human Eye. Philadelphia, PA: Saunders; 1971. Copyright Elsevier.
Table 1
 
Characteristics of the Studied Eyes (Mean ± Standard Deviation)
Table 1
 
Characteristics of the Studied Eyes (Mean ± Standard Deviation)
BA, n = 49 Normal Eyes, n = 89 P Value
Age, y 50 ± 17.3 47.2 ± 10.3 <0.01*
Sex, % female 53.1 57.8 0.64†
Ratio of laterality, % right 49.0 49.4 0.94
Refraction, spherical equivalent, D −2.52 ± 2.34 −1.89 ± 2.84 0.117*
Axial length, mm 24.4 ± 1.34 24.8 ± 1.16 0.256*
Mean deviation, dB −4.62 ± 5.57 −0.28 ± 1.38 <0.0001*
Table 2
 
Thickness of the Inner Retinal Layer Parameters by 3D OCT Instruments (μm, Mean ± SD)
Table 2
 
Thickness of the Inner Retinal Layer Parameters by 3D OCT Instruments (μm, Mean ± SD)
Macular Parameters Band Atrophy Normal P Value
mRNFL Nasal 33.2 ± 5.3 41.8 ± 5.1 0.003
Temporal 21.7 ± 1.7 22.6 ± 1.6 <0.001
GCL+ Nasal 55.1 ± 8.0 73.4 ± 5.0 <0.001
Temporal 67.4 ± 6.9 73.9 ± 5.2 <0.001
GCL++ Nasal 88.4 ± 12.3 115.2 ± 7.5 <0.001
Temporal 89.0 ± 7.2 96.4 ± 6.4 <0.001
Table 3
 
Area Under the Receiver Operating Characteristic Curve Analysis Using 3D OCT for Eyes With Band Atrophy (Means ± Standard Error)
Table 3
 
Area Under the Receiver Operating Characteristic Curve Analysis Using 3D OCT for Eyes With Band Atrophy (Means ± Standard Error)
Macular Parameters Nasal Temporal P Value
mRNFL 0.890 ± 0.002 0.619 ± 0.06 <0.001
GCL+ 0.988 ± 0.102 0.789 ± 0.05 <0.001
GCL++ 0.981 ± 0.103 0.768 ± 0.052 <0.001
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×