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M. Wang, D. C. Hood, J.-S. Cho, Q. Ghadiali, G. V. De Moraes, X. Zhang, V. C. Greenstein, R. Ritch, J. M. Liebmann; Local Retinal Ganglion Cell Thickness Can Be Measured in Patients With Glaucoma Using Frequency-Domain Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3321.
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To explore the feasibility of obtaining a local measure of the thickness of the retinal ganglion cell (RGC) layer in patients with glaucoma using frequency-domain optical coherence tomography (fdOCT) and a computer-aided manual segmentation procedure.
FdOCT scans were obtained from the horizontal midline for one eye of 26 patients with glaucoma and 20 control subjects. Raw images were exported and the thickness of the photoreceptor/RPE (REC+), inner nuclear (INL), RGC plus inner plexiform (RGC+), and retinal nerve fiber (RNFL) layers was measured with a manual segmentation procedure aided by a computer program. All patients had visual fields obtained with standard automated perimetry (SAP). The patients were divided into two groups based upon SAP foveal sensitivity: low (<34dB) and high (>34dB) sensitivity.
For the controls, the thickness profiles of the 4 layers along the horizontal meridian were consistent with known retinal anatomy. The thickness of the INL and REC+ layers were similar in all 3 groups. The thickness of the RGC+ layer and RNFL of the high sensitivity and control groups were similar. However, these layers were significantly thinner for the low sensitivity group (see figure), indicating there is a qualitative agreement between RGC+ thickness and field sensitivity. Further, a comparison of the local RGC+ layer thickness to local 10-2 visual field sensitivity in 3 glaucoma eyes provided additional evidence for this agreement.
Local measures of RGC layer thickness can be obtained from fdOCT scans using a computer-aided manual segmentation procedure and these measures show a qualitative agreement with visual field sensitivity.
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