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Gallo Afflitto G, Swaminathan SS. Racial-ethnic disparities in concurrent rates of peripapillary & macular OCT parameters among a large glaucomatous clinical population. Eye (Lond) 2024:10.1038/s41433-024-03103-3. [PMID: 38704424 DOI: 10.1038/s41433-024-03103-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 03/20/2024] [Accepted: 04/19/2024] [Indexed: 05/06/2024] Open
Abstract
OBJECTIVES To compare rates of change in peripapillary retinal nerve fibre layer (pRNFL) and macular ganglion cell-inner plexiform layer (mGCIPL) parameters among different race-ethnicities from a large electronic health record database of subjects with or suspected of glaucoma. METHODS In this retrospective cohort study, rates of change were obtained using joint longitudinal linear mixed models for eyes with ≥3 visits and ≥1 year of follow-up, adjusting for age, sex, intraocular pressure, central corneal thickness, and baseline pRNFL and mGCIPL thickness. Best linear unbiased predictor estimates of various parameters were stratified by baseline glaucoma severity and analysed by racial-ethnic group. RESULTS A total of 21,472 spectral domain optical coherence tomography (OCT) pRNFL scans and 14,431 mGCIPL scans from 2002 eyes were evaluated. A total of 200 (15.6%) and 601 (46.8%) subjects identified as non-Hispanic Black (NHB) and Hispanic, respectively. NHB eyes exhibited faster rates of change in pRNFL among glaucoma suspect (global pRNFL -0.57 ± 0.55 µm/year vs. -0.37 ± 0.62 µm/year among Hispanics, p < 0.001), mild glaucoma (superior pRNFL quadrant -1.20 ± 1.06 µm/year vs. -0.75 ± 1.51 µm/year among non-Hispanic Whites (NHW), p = 0.043), and moderate glaucoma eyes (superior pRNFL quadrant -1.31 ± 1.49 µm/year vs. -0.52 ± 1.26 µm/year among Hispanics, p = 0.003). NHB eyes exhibited faster rates of mGCIPL loss corresponding to pRNFL rates. Global pRNFL and mGCIPL rates were strongly correlated (R2 = 0.70). CONCLUSIONS Adjusted rates of pRNFL and mGCIPL loss significantly differed between racial-ethnic groups when stratified by glaucoma severity, with faster rates among NHB patients. These differences highlight key racial-ethnic disparities in adjusted rates of glaucoma OCT parameters.
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Affiliation(s)
- Gabriele Gallo Afflitto
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
- Ophthalmology Unit, Department of Experimental Medicine, Università di Roma "Tor Vergata", Rome, Italy
| | - Swarup S Swaminathan
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
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Zawadzka I, Konopińska J. From the past to the present, optical coherence tomography in glaucoma: a practical guide to a common disease. F1000Res 2024; 12:1186. [PMID: 38511134 PMCID: PMC10951567 DOI: 10.12688/f1000research.139975.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 03/22/2024] Open
Abstract
Glaucoma comprises a group of disorders of the optic nerve that cause degenerative optic neuropathy, characterised by failure of neuroretinal rim tissue in the optic nerve head, retinal nerve fibre layer, and retinal ganglion cells. Glaucoma imposes a serious epidemiological threat, with an steady increase in the global number of cases. In the current ophthalmological practice, glaucoma is diagnosed via a series of examinations, including routine funduscopic examination, ocular tonometry, gonioscopy, measurement of the visual field, and assessment using the optical coherence tomography (OCT) technique. Nowadays, the OCT technique helps in systematising the diagnostic pathway and is a basic diagnostic tool for detection of early glaucomatous eye changes. It is also vital in assessing progression and monitoring treatment results of patients. The aim of this review was to present the OCT technique as a main tool in diagnosing and monitoring glaucoma.
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Affiliation(s)
- Izabela Zawadzka
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, podlaskie, 15-081, Poland
| | - Joanna Konopińska
- Department of Ophthalmology, Medical University of Bialystok, Bialystok, podlaskie, 15-081, Poland
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Prada AM, Tello A, Rangel CM, Galvis V, Espinoza G. Agreement between Two Swept-source Optical Coherence Tomography: Optic Nerve Head, Retinal Nerve Fiber Layer and Ganglion Cell Layers in Healthy Eyes. J Curr Glaucoma Pract 2023; 17:85-90. [PMID: 37485462 PMCID: PMC10357020 DOI: 10.5005/jp-journals-10078-1409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/01/2023] [Indexed: 07/25/2023] Open
Abstract
Aim and background Precision of optical coherence tomography (OCT) measurements of the optic nerve head (ONH), retinal nerve fiber layer (RNFL), and macular ganglion cell layer (GCL) is essential for the diagnosis and monitoring of glaucoma. The purpose of this research was to evaluate the repeatability and reproducibility of retinal and ONH parameters measured with two identical swept-source optical coherence devices. Methods A cross-sectional study was conducted. A total of 30 eyes of 15 healthy subjects were included. Two technicians performed four OCT-wide protocol scans in the same visit using two identical Triton swept-source OCT (DRI-OCT) instruments. The interdevice and interobserver reproducibility and the repeatability of both instruments for all ONH, RNFL, and macular GCL parameters were evaluated by the intraclass correlation coefficient (ICC). Additionally, Bland-Altman test analysis was used for repeatability and reproducibility measurements. Results Intraclass correlation coefficient (ICCs) of the ONH, RNFL, and GCL measurements were excellent for repeatability and interdevice reproducibility (>0.9). Interobserver reproducibility was good for all parameters except for RNFL clock hour 11 (ICC = 0.72). The variability of the average RNFL was from -4.103 to 4.97 µm, with a mean percentage of the difference (PD) of 0.37 ± 2.03%. Among GCL parameters, the greatest variability was found in the inferior sector (PD = -0.88 ± 5.39%, limits of agreement (LoA) = -8.345-7.078 μm). Conclusion Using two identical swept-source OCT instruments for the evaluation of the structural parameters of the ONH, RNFL, and macular GCL showed high repeatability and reproducibility. This allows the clinician to make a therapeutic decision based on OCT findings coupled with the clinical evaluation of the patient. When evaluating RNFL clock hours measurements, interobserver reproducibility might decrease. Clinical significance The understanding of measurement variability while using different devices and the impact of the observer capturing the images, is clinically relevant. How to cite this article Prada AM, Tello A, Rangel CM, et al. Agreement between Two Swept-source Optical Coherence Tomography: Optic Nerve Head, Retinal Nerve Fiber Layer and Ganglion Cell Layers in Healthy Eyes. J Curr Glaucoma Pract 2023;17(2):85-90.
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Affiliation(s)
- Angelica M Prada
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia; Department of Ophthalmology, Fundacion Oftalmologica de Santander (FOSCAL), Floridablanca, Colombia; Department of Ophthalmology, Universidad Autonoma de Bucaramanaga (UNAB), Bucaramanga, Colombia
| | - Alejandro Tello
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia; Department of Ophthalmology, Fundacion Oftalmologica de Santander (FOSCAL), Floridablanca, Colombia; Department of Ophthalmology, Universidad Autonoma de Bucaramanaga UNAB, Bucaramanga, Colombia; Department of Ophthalmology, Universidad Industrial de Santander (UIS), Bucaramanga, Colombia
| | - Carlos M Rangel
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia; Department of Ophthalmology, Fundacion Oftalmologica de Santander (FOSCAL), Floridablanca, Colombia; Department of Ophthalmology, Universidad Autonoma de Bucaramanaga UNAB, Bucaramanga, Colombia; Department of Ophthalmology, Universidad Industrial de Santander (UIS), Bucaramanga, Colombia
| | - Virgilio Galvis
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia; Department of Ophthalmology, Fundacion Oftalmologica de Santander (FOSCAL), Floridablanca, Colombia; Department of Ophthalmology, Universidad Autonoma de Bucaramanaga (UNAB), Bucaramanga, Colombia
| | - Gustavo Espinoza
- Centro Oftalmologico Virgilio Galvis, Floridablanca, Colombia; Department of Ophthalmology, Fundacion Oftalmologica de Santander (FOSCAL), Floridablanca, Colombia; Department of Ophthalmology, Universidad Autonoma de Bucaramanaga (UNAB), Bucaramanga, Colombia
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Ablordeppey RK, Lin C, Benavente-Perez A. The age-related pattern of inner retinal thickening is affected by myopia development and progression. Sci Rep 2022; 12:22190. [PMID: 36564498 PMCID: PMC9789149 DOI: 10.1038/s41598-022-26598-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
The longitudinal effect of myopic eye growth on each individual retinal layer has not been described to date on an established non-human primate (NHP) model of myopia. We evaluated the changes experienced by the overall and individual central and mid-peripheral retinal thickness profiles in marmosets (Callithrix jacchus) induced with myopia continuously for 5.5 months compared to controls using spectral-domain optical coherence tomography. Cycloplegic refractive state (Rx), vitreous chamber depth (VCD) and retinal thickness were measured at baseline and after 3 and 5.5 months on thirteen marmosets: eight animals with lens-induced myopia and five untreated controls. The overall and individual retinal layer thickness in the central and mid-peripheral retina were obtained and compared between groups. Regression models were used to explore the extent to which VCD or Rx changes could predict the thickness changes observed. While the retinas of control marmosets thickened significantly over 5.5 months, marmosets with lens-induced myopia experienced less retinal thickening and thinning at times, mostly in the inner neuroretinal layers and the ganglion cell-inner plexiform layer. The regression models suggest that 90% of the growth and refractive changes observed could be predicted by the thickness changes in the near to mid peripheral retina. This study confirms the longitudinal effect that myopia has on the inner retina of a NHP model during the early stages of myopia development. The observed myopia-driven differences in inner retina thickness templates might represent early biomarkers of myopia progression and associated complications.
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Affiliation(s)
- Reynolds Kwame Ablordeppey
- grid.410412.20000 0004 0384 8998Department of Biological and Vision Sciences, College of Optometry, State University of New York, 33 West 42nd Street, New York, NY 10036 USA
| | - Carol Lin
- grid.410412.20000 0004 0384 8998Department of Biological and Vision Sciences, College of Optometry, State University of New York, 33 West 42nd Street, New York, NY 10036 USA
| | - Alexandra Benavente-Perez
- grid.410412.20000 0004 0384 8998Department of Biological and Vision Sciences, College of Optometry, State University of New York, 33 West 42nd Street, New York, NY 10036 USA
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Yusof AMZ, Othman O, Tang SF, Hassan MR, Din NM. Diagnostic evaluation of optical coherence tomography parameters in normal, preperimetric and perimetric glaucoma patients. Int J Ophthalmol 2022; 15:1782-1790. [PMID: 36404967 PMCID: PMC9631180 DOI: 10.18240/ijo.2022.11.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/14/2022] [Indexed: 12/14/2022] Open
Abstract
AIM To compare the diagnostic ability of glaucoma parameters measured by the optical coherence tomography (OCT) in normal, preperimetric glaucoma (PPG) and perimetric glaucoma (PG) patients. METHODS This cross-sectional observational study includes 127 eyes of 127 subjects. Patients were divided into PPG (51 eyes), PG (46 eyes), and normal controls (30 eyes) based on clinical optic disc assessment and Humphrey visual field changes. The Heidelberg Spectralis OCT machine using Glaucoma Module Premium Edition software was used to measure the retinal nerve fiber layer (RNFL) and Bruch's membrane opening-minimum rim width (BMO-MRW) to assess the optic nerve head and ganglion cell layer (GCL) thickness in the macula. RESULTS RNFL, MRW, and GCL thickness were all significantly thinner in PG compared to PPG and the normal group. The BMO-MRW parameters showed better specificity (>70%) at 90% specificity compared to both RNFL and GCL parameters to discriminate normal, PPG, and PG patients. All BMO-MRW parameters showed higher area under curves (AUC) compared to RNFL and GCL parameters with the highest AUC observed in the superotemporal sector of the BMO-MRW (AUC=0.819 and and 0.897 between normal and PPG and PG groups respectively). CONCLUSION While the BMO-MRW best discriminates PPG and PG against normal eyes, GCL parameters poorly differentiate the three groups.
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Affiliation(s)
| | - Othmaliza Othman
- Department of Ophthalmology, UKM Medical Center, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia
| | - Seng Fai Tang
- Department of Ophthalmology, UKM Medical Center, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, UKM Medical Center, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia
| | - Norshamsiah Md Din
- Department of Ophthalmology, UKM Medical Center, Jalan Yaacob Latif, Cheras 56000, Kuala Lumpur, Malaysia
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Chou R, Selph S, Blazina I, Bougatsos C, Jungbauer R, Fu R, Grusing S, Jonas DE, Tehrani S. Screening for Glaucoma in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2022; 327:1998-2012. [PMID: 35608575 DOI: 10.1001/jama.2022.6290] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
IMPORTANCE Two 2013 systematic reviews to inform the US Preventive Services Task Force (USPSTF) found insufficient evidence to assess benefits and harms of screening for primary open-angle glaucoma (OAG) in adults. OBJECTIVE To update the 2013 reviews on screening for glaucoma, to inform the USPSTF. DATA SOURCES Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews (to February 2021); surveillance through January 21, 2022. STUDY SELECTION Randomized clinical trials (RCTs) of screening, referral, and treatment; and studies of screening test diagnostic accuracy. DATA EXTRACTION AND SYNTHESIS One investigator abstracted data and a second checked accuracy. Two investigators independently assessed study quality. RESULTS Eighty-three studies (N = 75 887) were included (30 trials and 53 diagnostic accuracy studies). One RCT (n = 616) found screening of frail elderly persons associated with no difference in vision outcomes vs no screening but with significantly greater falls risk (relative risk [RR], 1.31 [95% CI, 1.13-1.50]). No study evaluated referral to an eye health professional. For glaucoma diagnosis, spectral domain optical coherence tomography (providing high-resolution cross-sectional imaging; 15 studies, n = 4242) was associated with sensitivity of 0.79 (95% CI, 0.75-0.83) and specificity of 0.92 (95% CI, 0.87-0.96) and the Humphrey Visual Field Analyzer (for perimetry, or measurement of visual fields; 6 studies, n = 11 244) with sensitivity of 0.87 (95% CI, 0.69-0.95) and specificity 0.82 (95% CI, 0.66-0.92); tonometry (for measurement of intraocular pressure; 13 studies, n = 32 892) had low sensitivity (0.48 [95% CI, 0.31-0.66]). Medical therapy for ocular hypertension and untreated glaucoma was significantly associated with decreased intraocular pressure and decreased likelihood of glaucoma progression (7 trials, n = 3771; RR, 0.68 [95% CI, 0.49-0.96]; absolute risk difference -4.2%) vs placebo, but 1 trial (n = 461) found no differences in visual acuity, quality of life, or function. Selective laser trabeculoplasty and medical therapy had similar outcomes (4 trials, n = 957). CONCLUSIONS AND RELEVANCE This review found limited direct evidence on glaucoma screening, showing no association with benefits. Screening tests can identify persons with glaucoma and treatment was associated with a lower risk of glaucoma progression, but evidence of improvement in visual outcomes, quality of life, and function remains lacking.
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Affiliation(s)
- Roger Chou
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Shelley Selph
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
- Department of Family Medicine, Oregon Health & Science University, Portland
| | - Ian Blazina
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Christina Bougatsos
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Rebecca Jungbauer
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Rongwei Fu
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
- School of Public Health, Oregon Health & Science University, Portland
| | - Sara Grusing
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Daniel E Jonas
- Department of Internal Medicine, The Ohio State University; Columbus
- RTI International, University of North Carolina at Chapel Hill Evidence-based Practice Center
| | - Shandiz Tehrani
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland
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Kalyani VK, Bharucha KM, Goyal N, Deshpande MM. Comparison of diagnostic ability of standard automated perimetry, short wavelength automated perimetry, retinal nerve fiber layer thickness analysis and ganglion cell layer thickness analysis in early detection of glaucoma. Indian J Ophthalmol 2021; 69:1108-1112. [PMID: 33913843 PMCID: PMC8186634 DOI: 10.4103/ijo.ijo_2409_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose: The aim of this study was to compare the diagnostic ability of macular ganglion cell layer (GCL) analysis using spectral domain optical coherence tomography against retinal nerve fiber layer analysis (RNFL), short-wavelength automated perimetry (SWAP), and standard automated perimetry (SAP) in early detection of glaucoma. Methods: Participants fulfilling the inclusion criteria were consecutively enrolled from the glaucoma clinic of tertiary care eye hospital in Western India from November 2015 to October 2016. The subjects underwent a detailed evaluation by trained glaucoma specialists. On suspicion of glaucoma, the patients underwent SAP, SWAP, and SD-OCT for GCL and RNFL analysis. Results: There were 91 patients in total of which experts classified 54 eyes into GON and 37 eyes into nonglaucomatous group. Sensitivity of SAP (42.59%) was significantly lower (P < 0.05) than that of average GCL thickness (79.63%) and average RNFL thickness (72.22%). Specificity and positive LR of SWAP (97.3% and 19.19, respectively) and SAP (94.6% and 7.88, respectively) were greater than those of GCL (81.08% and 4.21) and RNFL (67.57% and 2.23) parameters. Negative LR of average GCL thickness (0.25) was superior to that of average RNFL thickness (0.411), SWAP (0.495), and SAP (0.607). Conclusion: Macular GCL parameters perform better than RNFL parameters in patients with early glaucomatous damage. There is superior ability of SWAP over SAP in detecting glaucomatous changes in glaucoma suspect group. GCL thickness analysis has higher sensitivity and negative likelihood ratio, whereas SWAP had higher specificity and positive likelihood ratio. Thus, combining both tests can lead to better diagnostic ability for early glaucomatous damage.
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Affiliation(s)
- V Ks Kalyani
- PBMA's H.V. Desai Eye Hospital, Pune, Maharashtra, India
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Dikmetas O, Deliktas O, Toprak H, Karahan S, Kocabeyoglu S, Cankaya AB. Correlation of Ocular Biometric Parameters and Macular Ganglion Cell Layer in Normal Eyes. Semin Ophthalmol 2021; 36:812-817. [PMID: 33952048 DOI: 10.1080/08820538.2021.1922711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To determine the association between ocular biometric parameters and macular ganglion cell layer (MGCL) thickness in normal eyes. METHODS This observational cohort study was conducted with 76 eyes of 76 healthy subjects. Keratometry, pachymetry, corneal volume, iridocorneal angle were measured with Sirius (CSO, Florence, Italy); axial length, anterior chamber depth, anterior chamber volume, corneal diameter were measured with IOL Master (Carl Zeiss Meditec, Dublin, California). For all participants, serial horizontal Spectralis Domain Optical Coherence Tomography (SD-OCT, Heidelberg Engineering, GmbH, Dossenheim, Germany) scans of the macula and peripapillary retinal nerve fiber layer (RNFL) analysis were obtained using SD-OCT. The relationship between numerical variables was given by Pearson correlation coefficient. RESULTS The mean age of the subjects was 36.3 ± 11.9 years (between 19 and 70 y). Fifty-one patients were female (67.1%) and twenty-five patients were male (32.9%). MGCL was found to be correlated with anterior chamber depth, anterior chamber volume, iridocorneal angle, axial length and white to white (p = .015 r = 0.594, p = .002 r = 0.365, p = .013 r = 0.299, p = .004 r = 0.335, p = .013 r = 0.289, respectively). In addition, MGCL was correlated positively with the mean global and superotemporal RNFL (p ≤ 0.005). However, neither central corneal thickness nor keratometry values were found to be correlated with MGCL. CONCLUSION The results of this study showed that MGCL thickness is affected by ocular biometric parameters. Therefore, these parameters should be taken into consideration when interpreting MGCL thickness measurements in the diagnosis of glaucoma.
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Affiliation(s)
- Ozlem Dikmetas
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ozge Deliktas
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Hilal Toprak
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Sevilay Karahan
- Department of Biostatistics, Hacettepe University School of Medicine, Ankara, Turkey
| | - Sibel Kocabeyoglu
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ali Bülent Cankaya
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
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Gür Güngör S, Sarigül Sezenöz A, Öztürk C, Gökgöz G, Akman A. Peripapillary and Macular Vessel Density Measurement With Optical Coherence Tomography Angiography in Exfoliation Syndrome. J Glaucoma 2021; 30:71-77. [PMID: 32976289 DOI: 10.1097/ijg.0000000000001685] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/12/2020] [Indexed: 11/25/2022]
Abstract
PRECIS Although peripapillary retinal nerve fiber layer thickness (RNFLTs) and vessel density (VD) values were similar to healthy group, eyes with exfoliation syndrome had significantly lower superficial macular VDs and minimum ganglion cell analysis values. PURPOSE To compare peripapillary and macular perfused capillary densities with optical coherence tomography angiography (OCT-A) between patients with eyes having exfoliation syndrome (XFS) and normal age-matched healthy controls. PATIENTS AND METHODS This cross-sectional study included patients diagnosed with XFS from December 2017 to January 2020 at the Glaucoma Department. Peripapillary and parafoveal superficial VDs were obtained using OCT-A. The RNFLTs and ganglion cell analysis values were compared. RESULTS Thirty-nine eyes of 39 XFS patients (26 women; mean age, 69.0±8.1 y) and 39 eyes of 39 healthy patients (25 women; mean age, 68.0±8.6 y) were enrolled. There were no statistically significant differences in sex or age distribution, central corneal thickness measurements, refractive errors, or intraocular pressures between both groups (all P>0.05). There were no statistically significant differences in the peripapillary VD or peripapillary RNFLT between XFS eyes and healthy eyes (P>0.05 for all). In the macular region, most superficial VD parameters were significantly reduced in the XFS group (P=0.02 for parafoveal VD, P=0.04 for both hemifields). While the average ganglion cell and internal plexiform layer (GCL+IPL) values were similar between groups (P=0.19), the minimum GCL+IPL value was lower in the XFS group than in the healthy group (P=0.03). CONCLUSION Although structural test results, especially peripapillary RNFLT and mean GCL+IPL, were similar between the healthy and XFS groups, macular VD values were lower in XFS eyes. Our findings implicate microvascular damage can be the mechanism underlying XFS-related changes and indicate that it precedes significant structural damage.
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Affiliation(s)
- Sirel Gür Güngör
- Department of Ophthalmology, Faculty of Medicine, Başkent University, Ankara, Turkey
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Abrol S, Gupta S, Naik M, Agarwal S. Can We Corroborate Peripapillary RNFL Analysis with Macular GCIPL Analysis? Our 2-Year Experience at a Single-Centre Tertiary Healthcare Hospital Using Two OCT Machines and a Review of Literature. Clin Ophthalmol 2020; 14:3763-3774. [PMID: 33177803 PMCID: PMC7650039 DOI: 10.2147/opth.s266112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/10/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine whether macular volume and macular GCA measurements in patients are comparable to their RNFL thickness parameters. Materials and Methods The cross-sectional, observational study was conducted on 1380 eyes with 460 each, into three groups. Group I: patients with healthy eyes. Group II: patients diagnosed as pre-perimetric glaucoma. Group III: patients with diagnosed perimetric glaucoma. After patients were selected on the basis of inclusion and exclusion criteria, baseline standard ophthalmic examination was done by the same operator under the same settings, including SD-OCT using both the Spectralis SD-OCT and the Cirrus SD-OCT as elaborated below. Statistical Analysis Data were checked for normality before statistical analysis using Shapiro-Wilk test. Normally distributed continuous variables were compared using ANOVA. For all statistical tests, a p < 0.05 was taken to indicate a significant difference. Receiver operating characteristic (ROC) curves were used to define the ability RNFL and GCC parameters to distinguish perimetric and preperimetric glaucomatous eyes from control eyes. Results There was a statistically significant difference in the average, superior, inferior RNFL thickness and average, superior, inferior GCIPL thickness between Group I and Group II (p<0.001), between Group I and Group III (p<0.001) and also between Group II and Group III (p<0.001). The statistical significance was also reflected in their AUROCs. Conclusion Mean, superior, inferior GCIPL thickness along with macular volume analysis can substantiate RNFL analysis for diagnosis, serial monitoring and follow-up of glaucoma patients and suspects.
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Affiliation(s)
- Sangeeta Abrol
- Department of Ophthalmology, V.M.M.C & Safdarjung Hospital, New Delhi 110029, India
| | - Sukriti Gupta
- Department of Ophthalmology, V.M.M.C & Safdarjung Hospital, New Delhi 110029, India
| | - Mayuresh Naik
- Department of Ophthalmology, H.I.M.S.R & H.A.H. Centenary Hospital, New Delhi 110062, India
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Saks D, Schulz A, Craig J, Graham S. Determination of retinal nerve fibre layer and ganglion cell/inner plexiform layers progression rates using two optical coherence tomography systems: The
PROGRESSA
study. Clin Exp Ophthalmol 2020; 48:915-926. [DOI: 10.1111/ceo.13826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/19/2020] [Accepted: 06/27/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Danit Saks
- Department of Clinical Medicine Macquarie University Sydney New South Wales Australia
| | - Angela Schulz
- Department of Clinical Medicine Macquarie University Sydney New South Wales Australia
| | - Jamie Craig
- Department of Ophthalmology Flinders University Adelaide South Australia Australia
| | - Stuart Graham
- Department of Clinical Medicine Macquarie University Sydney New South Wales Australia
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Tham YC, Chee ML, Dai W, Lim ZW, Majithia S, Siantar R, Thakur S, Rim T, Cheung CY, Sabanayagam C, Aung T, Wong TY, Cheng CY. Profiles of Ganglion Cell-Inner Plexiform Layer Thickness in a Multi-Ethnic Asian Population: The Singapore Epidemiology of Eye Diseases Study. Ophthalmology 2020; 127:1064-1076. [PMID: 32197910 DOI: 10.1016/j.ophtha.2020.01.055] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/31/2019] [Accepted: 01/30/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To examine the normative profile and determinants of macular ganglion cell-inner plexiform layer (GCIPL) thickness based on spectral-domain OCT (SD-OCT) in a nonglaucoma, multi-ethnic Asian population. DESIGN Population-based, cross-sectional study. PARTICIPANTS Ethnic Chinese, Malay, and Indian adults aged ≥40 years recruited from the Singapore Epidemiology of Eye Diseases Study. METHODS All participants underwent standardized examinations. The GCIPL thickness was measured using Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA). Participants with glaucoma or poor-quality scans were excluded. Eye-specific data were used. Associations of ocular and systemic factors with GCIPL thickness parameters were investigated using multivariable linear regression with generalized estimating equation models to account for correlation between both eyes. MAIN OUTCOME MEASURES GCIPL thickness. RESULTS A total of 4464 participants (7520 eyes) consisting of 1625 Chinese, 1212 Malay, and 1627 Indian adults contributed to this analysis. Average GCIPL thickness was 82.6±6.1 μm in Chinese, 81.5±6.8 μm in Malays, and 78.0±6.9 μm in Indians (P < 0.001 by analysis of variance). The 5th percentile limit of average GCIPL thickness was 72 μm in Chinese, 70 μm in Malays, and 67 μm in Indians. In multivariable analysis adjusting for age, gender, axial length, presence of cataract, OCT signal strength, disc area, hypertension, diabetes, and hyperlipidemia, eyes of Indians were observed to have 3.43 μm thinner GCIPL on average compared with Chinese (P < 0.001) and 3.36 μm thinner GCIPL compared with Malays (P < 0.001). In addition, older age (per decade; β = -2.51), female (β = -1.57), longer axial length (per mm; β = -1.54), and presence of chronic kidney disease (β = -1.49) were significantly associated with thinner average GCIPL (all P ≤ 0.008). Larger optic disc area (per mm2; β = 0.78; P < 0.001) was associated with thicker GCIPL. These factors were consistently observed to be significant for superior and inferior hemisphere GCIPL thickness. CONCLUSIONS GCIPL thickness profiles were significantly thinner in Indians compared with Chinese and Malays. Our findings further highlight the need of a more refined, ethnic-specific normative database for GCIPL thickness, which in turn may improve the detection and diagnosis of glaucoma in Asians.
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Affiliation(s)
- Yih-Chung Tham
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Miao Li Chee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Wei Dai
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Zhi Wei Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Shivani Majithia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | | | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Tyler Rim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Xu XY, Lai KB, Xiao H, Lin YQ, Guo XX, Liu X. Comparisons of ganglion cell-inner plexiform layer loss patterns and its diagnostic performance between normal tension glaucoma and primary open angle glaucoma: a detailed, severity-based study. Int J Ophthalmol 2020; 13:71-78. [PMID: 31956573 DOI: 10.18240/ijo.2020.01.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/24/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the patterns of macular ganglion cell-inner plexiform layer (GCIPL) loss in normal tension glaucoma (NTG) and primary open angle glaucoma (POAG) in a detailed, disease severity-matched way; and to assess the diagnostic capabilities of GCIPL thickness parameters in discriminating NTG or POAG from normal subjects. METHODS A total of 157 eyes of 157 subjects, including 57 normal eyes, 51 eyes with POAG and 49 eyes with NTG were enrolled and strictly matched in age, refraction, and disease severity between POAG and NTG groups. The average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal GCIPL thickness, and the average, superior, temporal, inferior, and nasal retinal nerve fiber layer (RNFL) thickness were obtained by Cirrus optical coherence tomography (OCT). The diagnostic capabilities of OCT parameters were assessed by area under receiver operating characteristic (AUROC) curves. RESULTS Among all the OCT thickness parameters, no statistical significant difference between NTG group and POAG group was found (all P>0.05). In discriminating NTG or POAG from normal subjects, the average and inferior RNFL thickness, and the minimum GCIPL thickness had better diagnostic capabilities. There was no significant difference in AUROC curve between the best GCIPL thickness parameter (minimum GCIPL) and the best RNFL thickness parameter in discriminating NTG (inferior RNFL; P=0.076) and indiscriminating POAG (average RNFL; P=0.913) from normal eyes. CONCLUSION Localized GCIPL loss, especially in the inferior and inferotemporal sectors, is more common in NTG than in POAG. Among all the GCIPL thickness parameters, the minimum GCIPL thickness has the best diagnostic performance in differentiating NTG or POAG from normal subjects, which is comparable to that of the average and inferior RNFL thickness.
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Affiliation(s)
- Xiao-Yu Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Kun-Bei Lai
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Hui Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Yi-Quan Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Xin-Xing Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Xing Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong Province, China
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Kim BG, Park JY, Oh WH, Choi J. Retinal Ganglion Cell Layer Thicknesses and Visual Functions in Patients with Bilateral Temporal Optic Atrophy. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.1.92] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Bum Gi Kim
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jae Yong Park
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Won Hyuk Oh
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jin Choi
- Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Ustaoglu M, Solmaz N, Onder F. Discriminating performance of macular ganglion cell-inner plexiform layer thicknesses at different stages of glaucoma. Int J Ophthalmol 2019; 12:464-471. [PMID: 30918817 DOI: 10.18240/ijo.2019.03.18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 12/24/2018] [Indexed: 10/27/2022] Open
Abstract
AIM To determine the discriminating performance of the macular ganglion cell-inner plexiform layer (GC-IPL) parameters between all the consecutive stages of glaucoma (from healthy to moderate-to-severe glaucoma), and to compare it with the discriminating performances of the peripapillary retinal nerve fiber layer (RNFL) parameters and optic nerve head (ONH) parameters. METHODS Totally 147 eyes (40 healthy, 40 glaucoma suspects, 40 early glaucoma, and 27 moderate-to-severe glaucoma) of 133 subjects were included. Optical coherence tomography (OCT) was obtained using Cirrus HD-OCT 5000. The diagnostic performances of GC-IPL, RNFL, and ONH parameters were evaluated by determining the area under the curve (AUC) of the receiver operating characteristics. RESULTS All GC-IPL parameters discriminated glaucoma suspect patients from subjects with healthy eyes and moderate-to-severe glaucoma from early glaucoma patients (P<0.017, for all). Also, minimum, inferotemporal and inferonasal GC-IPL parameters discriminated early glaucoma patients from glaucoma suspects, whereas no RNFL or ONH parameter could discriminate between the two. The best parameters to discriminate glaucoma suspects from subjects with healthy eyes were superonasal GC-IPL, superior RNFL and average c/d ratio (AUC=0.746, 0.810 and 0.746, respectively). Discriminating performances of all the parameters for early glaucoma vs glaucoma suspect comparison were lower than that of the other consecutive group comparisons, with the best GC-IPL parameters being minimum and inferotemporal (AUC=0.669 and 0.662, respectively). Moreover, minimum GC-IPL, average RNFL, and rim area (AUC=0.900, 0.858, 0.768, respectively) were the best parameters for discriminating moderate-to-severe glaucoma patients from early glaucoma patients. CONCLUSION GC-IPL parameters can discriminate glaucoma suspect patients from subjects with healthy eyes, and also all the consecutive stages of glaucoma from each other (from glaucoma suspect to moderate-to-severe glaucoma). Further, the discriminating performance of GC-IPL thicknesses is comparable to that.
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Affiliation(s)
- Melih Ustaoglu
- Glaucoma Research Center, Wills Eye Hospital, Philadelphia, PA 19107, USA.,Ophthalmology Clinic, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul 34371, Turkey
| | - Nilgun Solmaz
- Ophthalmology Clinic, Haseki Training and Research Hospital, Istanbul 34096, Turkey
| | - Feyza Onder
- Ophthalmology Clinic, Haseki Training and Research Hospital, Istanbul 34096, Turkey
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Xu XY, Xiao H, Luo JY, Liu X. Evaluation of spectral domain optical coherence tomography parameters in discriminating preperimetric glaucoma from high myopia. Int J Ophthalmol 2019; 12:58-65. [PMID: 30662841 DOI: 10.18240/ijo.2019.01.09] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 09/11/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the diagnostic ability of macular ganglion cell-inner plexiform layer (GCIPL) thickness obtained by spectral-domain optical coherence tomography (SD-OCT) in discriminating non-highly myopic eyes with preperimetric glaucoma (PPG) from highly myopic healthy eyes. METHODS A total of 254 eyes, including 76 normal controls (NC), 116 eyes with high myopia (HM) and 62 non-highly myopic eyes with PPG were enrolled. The diagnostic ability of OCT parameters was accessed by the areas under the receiver operating characteristic (AUROC) curve in two distinguishing groups: PPG eyes with non-glaucomatous eyes including NC and HM (Group 1), and PPG eyes with HM eyes (Group 2). Differences in diagnostic performance between GCIPL and RNFL parameters were evaluated. RESULTS The minimum (AUROC curve of 0.782), inferotemporal (0.758) and inferior (0.705) GCIPL thickness were the top three GCIPL parameters in discriminating PPG from non-glaucomatous eyes, all of which had statistically significant lower diagnostic ability than average RNFL thickness (0.847). In discriminating PPG from HM, the best GCIPL parameter was minimum (0.689), statistically significant lower in diagnostic ability than average RNFL thickness (0.789) and three other RNFL thickness parameters of temporal and inferotemporal clock-hour sectors. CONCLUSION The minimum GCIPL thickness is the best GCIPL parameter to detect non-highly myopic PPG from highly myopic eyes, whose diagnostic ability is inferior to that of average RNFL thickness and RNFL thickness of several temporal and inferotemporal clock-hour sectors. The average RNFL thickness is recommended for discriminating PPG from highly myopic healthy eyes in current clinical practice in a Chinese population.
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Affiliation(s)
- Xiao-Yu Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Hui Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jing-Yi Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Xing Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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