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Lisa A. Kerrigan–Baumrind, Harry A. Quigley, Mary E. Pease, Danielle F. Kerrigan, Rebecca S. Mitchell; Number of Ganglion Cells in Glaucoma Eyes Compared with Threshold Visual Field Tests in the Same Persons. Invest. Ophthalmol. Vis. Sci. 2000;41(3):741-748.
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© ARVO (1962-2015); The Authors (2016-present)
purpose. To compare the number of retinal ganglion cells (RGCs) topographically
mapped with specific visual field threshold test data in the same eyes
among glaucoma patients.
methods. Seventeen eyes of 13 persons with well-documented glaucoma histories
and Humphrey threshold visual field tests (San Leandro, CA) were
obtained from eye banks. RGC number was estimated by histologic counts
of retinal sections and by counts of remaining axons in the optic
nerves. The locations of the retinal samples corresponded to specific
test points in the visual field. The data for glaucoma patients were
compared with 17 eyes of 17 persons who were group matched for age, had
no ocular history, and had normal eyes by histologic examination.
results. The mean RGC loss for the entire retina averaged 10.2%, indicating
that many eyes had early glaucoma damage. RGC body loss averaged 35.7%
in eyes with corrected pattern SD probability less than 0.5%. When
upper to lower retina RGC counts were compared with their corresponding
visual field data within each eye, a 5-dB loss in sensitivity was
associated with 25% RGC loss. For individual points that were abnormal
at a probability less than 0.5%, the mean RGC loss was 29%. In
control eyes, the loss of RGCs with age was estimated as 7205 cells per
year in persons between 55 and 95 years of age. In optic nerves from
glaucoma subjects, smaller axons were significantly more likely to be
present than larger axons (R 2 = 0.78, P < 0.001).
conclusions. At least 25% to 35% RGC loss is associated with statistical
abnormalities in automated visual field testing. In addition, these
data corroborate previous findings that RGCs with larger diameter axons
preferentially die in glaucoma.
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