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      Clinical Validity of Macular Ganglion Cell Complex by Spectral Domain-Optical Coherence Tomography in Advanced Glaucoma :

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          Abstract

          To evaluate the repeatability and diagnostic power of macular ganglion cell complex (mGCC) thickness and peripapillary retinal nerve fiber layer (pRNFL) thickness using a spectral domain-optical coherence tomography in advanced glaucoma.

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          Retinal ganglion cell atrophy correlated with automated perimetry in human eyes with glaucoma.

          We measured the number and size of retinal ganglion cells from six human eyes with glaucoma. In each, the histologic findings were correlated with visual field results. Five age-matched normal eyes were studied for comparison. In general, there were fewer remaining large ganglion cells in retinal areas with atrophy. In the perifoveal area, however, no consistent pattern of cell loss by size was found. Our estimates suggest that visual field sensitivity in automated testing begins to decline soon after the initial loss of ganglion cells. Throughout the central 30 degrees of the retina, 20% of the normal number of cells were gone in locations with a 5-dB sensitivity loss, and 40% cell loss corresponded to a 10-dB decrease. There were some remaining ganglion cells in areas that had 0-dB sensitivity in the field test.
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            Reproducibility of retinal nerve fiber layer and macular thickness measurement with the RTVue-100 optical coherence tomograph.

            To evaluate the reproducibility of peripapillary retinal nerve fiber layer thickness (RNFLT) and ganglion cell complex (GCC) measurements made with the RTVue-100 Fourier-domain optical coherence tomography (OCT) device (Optovue, Inc., Fremont, CA) and to determine the influence of 4 factors: pupil dilation, subject age, experience in imaging examinations, and glaucoma severity. Prospective study for evaluation of a diagnostic test. Thirty-seven hospital-based participants (14 normal and ocular hypertensive subjects, 11 patients with moderate and 12 with severe glaucoma), all experienced in imaging examinations, and 40 consecutive screening trial participants lacking such experience. One eye of all participants was imaged 5 times. For the hospital-based participants, on the same day the measurement series was repeated after pupil dilation. For determination of intersession reproducibility, measurements were performed again 3 months later. Intrasession and intersession coefficient of variation (CV), intraclass correlation coefficient (ICC), intratest variability, and test-retest variability. For the average and quadrant RNFLT parameters and the GCC parameters, intrasession ICC varied between 93.9% and 99.0%, intrasession CV between 1.95% and 5.69%, and intratest variability varied between 3.11 and 9.13 microm. Most thickness values, all intrasession CV and intratest variability values, and the signal strength index were not changed significantly after pupil dilation. Intrasession CV of the 16 peripapillary RNFLT sectors varied between 4.90% and 11.66%. Most intrasession CV values increased significantly with increased disease severity, but intratest variability for average RNFLT and the quadrant RNFLT parameters, which are used for statistical comparison with the normative database, were unaffected by the severity of glaucoma. Patient age and experience in imaging examinations had no influence on intrasession CV. Intratest variability and intrasession CV represented 79.1% to 98.6% and 77.1% to 95.0% of test-retest variability and intervisit CV, respectively, for the average and quadrant RNFLT and the GCC parameters. Intrasession and intersession reproducibility of RNFLT and GCC measurements with the RTVue-100 OCT are satisfactory for diagnostic purposes, both in normals and in patients with different glaucoma severity. Pupil dilation, age, and experience in imaging examinations did not influence reproducibility in a clinically significant manner. Proprietary or commercial disclosure may be found after the references. Copyright 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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              Clinical evaluation of nerve fiber layer atrophy as an indicator of glaucomatous optic nerve damage.

              To evaluate the usefulness of the retinal nerve fiber layer (NFL) appearance in the estimation of glaucomatous optic nerve damage, we examined 335 eyes of normal, glaucoma suspect, of glaucomatous patients. In eyes with field loss, 84% had NFL atrophy. In normal eyes, NFL atrophy was suspected in 3%. In glaucoma suspects, 13% of eyes had NFL defects. Defects in glaucoma suspect eyes were more often localized, compared with the diffuse atrophy found in eyes with visual field loss. The NFL abnormalities were seen in areas of the retina corresponding to the location of visual field defects with a high accuracy. The NFL examination is as sensitive in detecting eyes with field loss as the optic disc configuration and may help to identify which eyes are suffering optic nerve damage prior to field loss.
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                Author and article information

                Journal
                Journal of Glaucoma
                Journal of Glaucoma
                Ovid Technologies (Wolters Kluwer Health)
                1057-0829
                2014
                August 2014
                : 23
                : 6
                : 341-346
                Article
                10.1097/IJG.0b013e318279c932
                23221905
                42b42a82-8c82-40ce-9c04-f0aa2b1e5d33
                © 2014
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