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Structural changes of macular inner retinal layers in early normal-tension and high-tension glaucoma by spectral-domain optical coherence tomography

  • Glaucoma
  • Published:
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Abstract

Purpose

Assessment of the diagnostic ability of segmented macular inner retinal layer thickness and peripapillary retinal nerve fiber layer (pRNFL) measured by spectral-domain optical coherence tomography (SD-OCT) in patients with normal-tension (NT) and high-tension (HT) perimetric and preperimetric glaucoma.

Methods

The 212 participants included 45 healthy subjects, 55 patients with ocular hypertension, 56 patients with preperimetric glaucoma, and 56 patients with perimetric glaucoma. The preperimetric and perimetric groups were further subdivided into NT and HT groups. Sectoral and global thickness of macular retinal nerve fiber layer (mRNFL), ganglion cell layer (mGCL), inner plexiform layer (mIPL), ganglion cell complex (mGCC), and pRNFL were measured using SD-OCT (Spectralis, Heidelberg Engineering, Germany). Diagnostic performance was ascertained by sectoral and global comparison of the sensitivities at specificity ≥ 95%.

Results

For all layers, the largest thickness decrease was reported in the HT perimetric group. In all groups, the sensitivities of mGCL showed a comparable diagnostic value to pRNFL in order to distinguish between healthy subjects and glaucoma patients. In the perimetric group, mGCL (85.7%) exhibited higher sensitivities than mRNFL (78.6%) and mGCC (78.6%). Both mRNFL and pRNFL demonstrated equal diagnostic performance in the HT perimetric group (88.5 and 96.2%), in the NT groups, mRNFL was inferior to all other layers.

Conclusion

The sensitivities of mGCL and mRNFL were comparable to the sensitivities of pRNFL. In clinical application, mGCL and mRNFL, with a focus on the temporal and inferior sectors, may provide a convincing supplementation to pRNFL.

Clinical Trial Registration

Erlangen Glaucoma Registry www.clinicaltrials.gov ID: NCT00494923

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Authors and Affiliations

  1. Department of Ophthalmology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany

    Florian S. M. Edlinger, Laura M. Schrems-Hoesl, Christian Y. Mardin, Robert Laemmer, Friedrich E. Kruse & Wolfgang A. Schrems

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  1. Florian S. M. Edlinger
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  2. Laura M. Schrems-Hoesl
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  3. Christian Y. Mardin
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  4. Robert Laemmer
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  5. Friedrich E. Kruse
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  6. Wolfgang A. Schrems
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Corresponding author

Correspondence to Wolfgang A. Schrems.

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Financial support

The study was supported in part by the German Research Foundation (SFB539) from 1997 to 2009.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

The present work was performed in fulfillment of the requirements for obtaining the degree “Dr. med.” for Florian Edlinger.

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Edlinger, F.S.M., Schrems-Hoesl, L.M., Mardin, C.Y. et al. Structural changes of macular inner retinal layers in early normal-tension and high-tension glaucoma by spectral-domain optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 256, 1245–1256 (2018). https://doi.org/10.1007/s00417-018-3944-6

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  • DOI: https://doi.org/10.1007/s00417-018-3944-6

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