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R. Andronaco, C. Bergonzi, M. Blini, M. Cigada, G. Staurenghi; Evaluation of Retinal Ganglion Cells Layer in Glaucomatous Patients Using Spectral Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3320.
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To evaluate whether the thickness of retinal ganglion cells (RCG) layer is correlated with the thickness of nerve fibre layer (RNFL) and with visual field (VF) defects in glaucomatous patients.
In this observational case series study, 60 eyes from 34 patients (12 females and 22 males) were subdivided in three groups on the basis of RNFL thickness using Heidelberg Retina Tomograph II and glaucoma level using Glaucoma Staging System 2 by P.Brusini (J.Glaucoma: Volume 15 February 2006 pp 40-46). The first group was composed by 20 control eyes with RNFL thickness > 18 micron and level 0, the second group was composed by 20 borderline eyes with RNFL thickness ≤ 18 micron and level 0-1, and the third group was composed by 20 pathological eyes with RNFL thickness ≤ 18 micron and level 2-3-4-5. Each eye was scanned with a spectral domain OCT. Two measures were done: the RGC layer thickness and RCG layer plus inner plexiform layer thickness. Measures were determined by manual counting method after a high zoom of a vertical high-resolution scan, 1000 micron up and down the foveal centre.
RGC layer thickness plus inner plexiform layer thickness resulted significantly correlated with three groups of eyes both 1000 micron up and down foveal centre (p=0.0000); RCG layer resulted significantly correlated with normal and borderline groups of eyes 1000 micron up the foveal centre (p=0.0025), but not so statistically significant down the foveal centre (p=0.0841).
The present results show that RGC layer thickness visualized through spectral domain OCT is reduced before thinning of RNFL identified by HRT II and before the loss of visual field test; according to this an earlier diagnosis of glaucoma seems to be possible. A further perspective study will confirm that RGC layer measurement could be a new diagnostic method.
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