April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Relationship between retinal ganglion cell layer thickness and estimated retinal ganglion cell counts in the glaucomatous macula
Author Affiliations & Notes
  • Chunwei Zhang
    Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, San Diego, CA
    Department of Ophthalmology, the First Affiliated Hospital, Harbin Medical University, Harbin, China
  • Andrew J Tatham
    Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, San Diego, CA
  • Robert N Weinreb
    Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, San Diego, CA
  • James Zexi Zhang
    Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, San Diego, CA
  • Linda M Zangwill
    Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, San Diego, CA
  • Felipe A Medeiros
    Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, San Diego, CA
  • Footnotes
    Commercial Relationships Chunwei Zhang, None; Andrew Tatham, Heidelberg Engineering (F); Robert Weinreb, Aerie, Carl Zeiss Meditec, Genentech, Heidelberg Engineering GmbH, National Eye Institute, Nidek, Novartis, Optovue, Topcon (F), Alcon, Allergan, Bausch&Lomb, Carl Zeiss Meditec, Sensimed, Topcon (C); James Zhang, None; Linda Zangwill, Carl-Zeiss Meditec, Heidelberg Engineering, Topcon and Nidek (F); Felipe Medeiros, Alcon Laboratories, Bausch & Lomb, Carl Zeiss Meditec, Heidelberg Engineering, Merck, Allergan, Sensimed, Topcon, Reichert, National Eye Institute. R; Alcon Laboratories, Allergan, Carl Zeiss Meditec, Reichert (F), Allergan, Carl-Zeiss Meditec; Novartis (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4758. doi:
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    • Get Citation

      Chunwei Zhang, Andrew J Tatham, Robert N Weinreb, James Zexi Zhang, Linda M Zangwill, Felipe A Medeiros; Relationship between retinal ganglion cell layer thickness and estimated retinal ganglion cell counts in the glaucomatous macula. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4758.

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

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Abstract
 
Purpose
 

To investigate the relationship between macular ganglion cell and inner plexiform layer (mGCIPL) thickness and estimated macular retinal ganglion cell (RGC) counts in glaucoma.

 
Methods
 

A cross-sectional study of 77 healthy, 154 suspect and 159 glaucomatous eyes from the Diagnostic Innovations in Glaucoma Study (DIGS). All eyes had 24-2 Standard Automated Perimetry (SAP) and optic nerve and macular imaging using Cirrus high definition optical coherence tomography (HDOCT). The total number of RGCs was estimated using a previously described model that utilizes SAP and OCT circumpapillary retinal nerve fiber layer (cpRNFL) measurements. The number of macular RGCs was estimated from the temporal cpRNFL and SAP test points within the central 10 degrees.

 
Results
 

The average estimated macular RGC count in glaucomatous eyes was 306,010 ± 109,449 cells, which was significantly lower than the estimate of 520,678 ± 106,843 cells in healthy eyes (P<0.001). Glaucomatous eyes had 41% fewer estimated macular RGCs than healthy eyes and suspects 21% fewer. There was strong correlation between estimated macular RGC counts and mGCIPL thickness (R2 = 0.66; P < 0.001). Macular RGC counts performed better than average mGCIPL thickness in discriminating healthy and glaucomatous eyes with receiver operating characteristic (ROC) curve areas of 0.873 and 0.775, respectively (P = 0.015).

 
Conclusions
 

The strong association between estimated macular RGC counts and mGCIPL thickness and the better diagnostic performance of the macular RGC counts compared to mGCIPL thickness provides further evidence that estimates of RGC number from cpRNFL thickness and SAP sensitivity can be used to assess neural losses in glaucoma.

 
 
Scatterplots and ordinary least squares (OLS) regression lines showing the relationship between estimated number of macular RGCs and the macular ganglion cell-inner plexiform layer (mGCIPL) thickness
 
Scatterplots and ordinary least squares (OLS) regression lines showing the relationship between estimated number of macular RGCs and the macular ganglion cell-inner plexiform layer (mGCIPL) thickness
 
 
Receiver operating characteristic curves showing the ability of estimated number of macular retinal ganglion cells and ganglion cell-inner plexiform layer (mGCIPL) thickness to differentiate glaucomatous and healthy eyes.
 
Receiver operating characteristic curves showing the ability of estimated number of macular retinal ganglion cells and ganglion cell-inner plexiform layer (mGCIPL) thickness to differentiate glaucomatous and healthy eyes.
 
Keywords: 531 ganglion cells • 550 imaging/image analysis: clinical • 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)  
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