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Kathleen Ellen Guinn, Nithya Rajagopalan, Peter Bracha, Mohammad Ali Sadiq, Jose Maya, Mohamed Ibraheem, Sushma Rai, Vikas Gulati, Quan Dong Nguyen, Yasir Sepah; Evaluation of retinal architecture in glaucoma patients using spectral-domain optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2014;55(13):333.
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To examine the thickness of retinal layers in patients with established diagnosis of glaucoma compared to a normative database.
Spectral-domain optical coherence tomography (SD-OCT) images were acquired for 36 eyes (24 consecutive patients) with known diagnosis of glaucoma and no known macular disease. Horizontal B-scans passing through the fovea were then segmented using Heyex v.5.2 software; retinal thickness was recorded for each layer. Layers were measured every 0.5 mm; an average of temporal, central, and nasal regions was taken. Various layers included: full retinal thickness (FRT), photoreceptor layer (PRL), bipolar layer (BPL), retinal pigment epithelium (RPE), nerve fiber layer (NFL), ganglion cell layer and inner plexiform layer (GCL+). These measured values were then compared to a database of 51 eyes with no known disease. Humphrey visual field (obtained on same day as OCT) results were also correlated to the retinal thicknesses of each layer.
Mean age of glaucoma subjects was 61 while mean age of normals was 52. Twelve (50%) patients were male while 26 (51%) normals were male. FRT, BP, GCL+ and NFL/GCL+ complex showed significant thinning in all regions of the fovea. The PRL showed significant thinning in the central and temporal zones only. Conversely, the NFL showed significant thinning only in the central and nasal regions. The RPE showed no significant thinning in any region. VFI showed a decreasing trend with the loss of both FRT and individual retinal layers.
Overall, eyes with glaucoma demonstrate thinning in various retinal layers. In particular, this study has shown for the first time that thinning of the BPL in all foveal regions and PRL in the central and temporal regions occurs in glaucomatous eyes. In addition, VFI appears to correlate with retinal thickness.
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