Evaluation of a New Software Version of the RTVue Optical Coherence Tomograph for Image Segmentation and Detection of Glaucoma in High Myopia

Morphological and Functional Evaluation of Oral Citicoline Therapy in Chronic Open-Angle Glaucoma Patients: A Pilot Study With a 2-Year Follow-Up

Aims: To study the neuroprotective effect of oral citicoline (CT) therapy in primary open-angle glaucoma (POAG).

Methods: This study included one eye each of 60 POAG patients. Patients were randomly divided into two groups (A and B) of 30 participants each. Only patients of group A were administered with CT therapy. Age, sex, and disease duration were matched between groups. Despite a stable intraocular pressure (IOP), a slow disease progression—assessed by standard automated white-on-white perimetry (SAP) in the previous 3 years—occurred in all patients. All patients underwent a complete eye examination, including IOP measurement, SAP, retinal nerve fiber layer (RNFL) thickness, and ganglion cell complex (GCC) thickness measurements with optical coherence tomography (OCT), before starting CT treatment and at 6, 12, 18, and 24 months’ follow-up. Parameter differences between groups were evaluated at each eye check.

Results: After 18 months, mean values of SAP mean deviation (MD) of group A were significantly (p = 0.039) higher (−7.25 db) than those of group B (−8.64 db). Moreover, they appeared stable in the following visits, whereas in group B, mean MD values continued to significantly (p < 0.001) decrease (−9.28 db) over time. Mean RNFL and GCC thickness in group A were significantly (p < 0.01) higher (70.39 and 71.19 μm, respectively) than in group B (64.91 and 65.60 μm, respectively) after 12 months of CT therapy. Furthermore, they appeared to be stable over the later visits, whereas they thinned significantly (p < 0.001) over time in group B.

Conclusion: These findings suggest that CT therapy seems to be effective in slowing POAG progression. Further studies on a larger population and with a longer follow-up are needed to confirm this pilot investigation.

Diagnostic ability of ganglion cell complex thickness to detect glaucoma in high myopia eyes by Fourier domain optical coherence tomography

AIM

To evaluate the ability of macular ganglion cell complex (GCC) thickness using Fourier domain optical coherence tomography (FD-OCT) to detect glaucoma in highly myopic eyes.

METHODS

Cross-sectional study. A total of 114 participants, consecutively were enrolled. Macular GCC thickness and peripapillary retinal nerve fiber layer (RNFL) thickness were obtained with RTVue FD-OCT. Receiver operating characteristics curves were constructed for each measurement parameter, and areas under the curves (AUCs) were compared.

RESULTS

Both the average GCC and average RNFL thickness showed negative correlations with axial length (r_GCC=-0.404, P=0.001; r_RNFL=-0.561, P<0.001). The largest AUCs from GCC, and RNFL parameters were 0.968 [global loss volume (GLV)], and 0.855 (average RNFL), respectively. GLV was significantly better for detecting high myopic glaucoma than average RNFL (P<0.001).

CONCLUSION

Macular GCC thickness has higher diagnostic power than peripapillary RNFL thickness to discriminate glaucoma patients from non-glaucoma subjects in high myopia.

Quantification of Macular Vascular Density Using Optical Coherence Tomography Angiography and Its Relationship with Retinal Thickness in Myopic Eyes of Young Adults

Purpose

To quantify macular vascular density using optical coherence tomography angiography (OCTA) and to investigate its relationship with retinal thickness in myopic eyes of young adults.

Methods

In this cross-sectional study, 268 myopic eyes without pathological changes were recruited and divided into three groups: mild myopia (n = 81), moderate myopia (n = 117), and high myopia (n = 70). Macular vascular density was quantified by OCTA and compared among three groups. Average retinal thickness, central subfield thickness, and macular ganglion cell complex (mGCC) thickness were also evaluated and compared. Correlations among these variables were analyzed.

Results

There was no statistical difference in superficial (62.3 ± 5.7% versus 62.7 ± 5.9% versus 63.8 ± 5.5%) and deep macular vascular densities (58.3 ± 9.6% versus 59.2 ± 9.3% versus 60.9 ± 7.9%) among mild-myopia, moderate-myopia, and high-myopia groups (both P > 0.05). Superficial and deep macular vascular densities both had correlations with mean arterial pressure. Furthermore, superficial macular vascular density was significantly correlated with mGCC thickness.

Conclusions

Varying degrees of myopia did not affect macular vascular density in young healthy adults. In addition, superficial macular vascular density, as an independent factor, was positively correlated with mGCC thickness.

Clinical Utility of Optical Coherence Tomography in Glaucoma

Optical coherence tomography (OCT) has established itself as the dominant imaging modality in the management of glaucoma and retinal diseases, providing high-resolution visualization of ocular microstructures and objective quantification of tissue thickness and change. This article reviews the history of OCT imaging with a specific focus on glaucoma. We examine the clinical utility of OCT with respect to diagnosis and progression monitoring, with additional emphasis on advances in OCT technology that continue to facilitate glaucoma research and inform clinical management strategies.

Circumpapillary ganglion cell complex thickness to diagnose glaucoma: A pilot study

PURPOSE

The purpose of this study is to evaluate the applicability of a new optical coherence tomography parameter, the circumpapillary ganglion cell complex (cpGCC) thickness for glaucoma diagnostics.

SUBJECTS AND METHODS

The RS-3000 Advance SD-OCT (NIDEK, Aichi, Japan) was used to measure global and sector macular GCC (mGCC) thickness, circumpapillary retinal nerve fiber layer (cpRNFL) thickness, cpGCC, and circumpapillary total retina (cpTR) thickness in 1 eye of 48 preperimetric/early perimetric primary open-angle glaucoma patients and 28 healthy Japanese participants. Area under the receiver-operating characteristic (AUROC) curves were used for between-method comparisons.

RESULTS

All global and sector parameters except for the nasal sector differed significantly between the patient groups (P ≤ 0.009). The AUROC for global mGCC (0.917) was significantly higher (P < 0.01) than that for global cpRNFL (0.760), global cpGCC (0.828), and global cpTR (0.812). The AUROC values of global and temporal cpGCC were significantly higher than those of the corresponding cpRNFL parameters (P < 0.05). Correlation between the visual field means deviation and each of the global thickness parameters was similar (r: 0.418-0.473, P< 0.001). At >90% specificity, the cpGCC, cpTR, and cpRNFL were able to detect 4%, 10%, and 0% of glaucoma eyes that were not detected by the mGCC thickness.

CONCLUSIONS

In Japanese eyes, the diagnostic accuracy of cpGCC is lower than that of mGCC but higher than that of cpRNFL. Our results suggest that the use of cpGCC may not improve glaucoma diagnostics when there is no macular disease but may be of benefit when macular diseases prevent successful mGCC measurements.