Abstract
Purpose :
OCT has been arguably the greatest advance in ophthalmology since the slit lamp 100 years ago. It allows quantitation of the various aspects of the eye including the retina, nerve fiber layer, and optic pathways. The standard use of OCT in neuro-ophthalmology and glaucoma has been to look at nerve fiber layer. There are several instances where ganglion cell analysis may be far more useful, stable, and reproducible.
Methods :
A retrospective review of 140 cases of comparison of ganglion cell analysis with nerve fiber layer and psychophysical evaluation.
Results :
In many cases the ganglion cell analysis shows pathology earlier than nerve fiber layer abnormalities. Ganglion cell analysis is far less prone to several forms of artifact including masking of the optic nerve damage by compression induced edema. There are, however, some major residual disadvantages as the current algorithms available are prone to artifact of registration.
Conclusions :
Ganglion cell analysis is an extremely useful means of looking at optic nerve function, and in some cases, such as Leber’s optic neuropathy, may proceed nerve fiber layer changes and be more sensitive. Improvement in the algorithms, such as manual segmentation as done in Iowa, or with the new algorithms available on the Spectralis unit, may improve or ability to continue using ganglion cell analysis. It is likely that eventually ganglion cell analysis will be the primary way of looking at optic nerve function in the future.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.