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

The effect of trifocal and extended-depth-of-focus intraocular lenses on optical coherence tomography parameters

PURPOSE

Optical properties of commonly used multifocal and extended-depth-of-focus (EDOF) intraocular lenses (IOLs) can induce artifacts or changes in optical coherence tomography (OCT) measurements. Our purpose was to investigate the possible effects of different IOLs on peripapillary and macular OCT parameters.

METHODS

The preoperative and postoperative third-month peripapillary OCT and ganglion cell analysis (GCA) parameters of patients having monofocal (Alcon IQ), multifocal (PanOptix), or EDOF (Vivity) IOL implanted during cataract surgery were compared.

RESULTS

Sixty-four eyes of 64 patients were included (21 monofocal, 24 multifocal, and 19 EDOF). Although all OCT image qualities increased postoperatively, only GCA image quality changes in the monofocal and multifocal groups reached statistical significance. Most peripapillary retinal nerve fiber layer (RNFL) and GCA parameters were similar preoperatively and postoperatively. The superior RNFL thickness in the monofocal group and the temporal RNFL thickness in the EDOF group were higher postoperatively ( P = 0.04 and P = 0.02, respectively). Most GCA and RNFL value changes between preoperative and postoperative measurements were similar between groups. In the parameters that changed, postoperative values were higher in the monofocal group ( P = 0.02 for minimum ganglion cell layer and inner plexiform layer, P = 0.04 for average RNFL).

CONCLUSION

Trifocal and EDOF IOLs do not seem to have a negative effect on OCT parameters.

Optical coherence tomography evaluation of retinal nerve fiber layer thickness in non-arteritic anterior ischemic optic neuropathy and primary open angle glaucoma: a systematic review and Meta-analysis

AIM

To assess the differences in average and sectoral peripapillary retinal nerve fiber layer (pRNFL) thickness using spectral domain optical coherence tomography (SD-OCT) in patients with non-arteritic anterior ischemic neuropathy (NAION) compared with those with primary open angle glaucoma (POAG).

METHODS

A comprehensive literature search of the PubMed, Cochrane Library, and Embase databases were performed prior to October, 2021. Studies that compared the pRNFL thickness in NAION eyes with that in POAG eyes with matched mean deviation of the visual fields were included. The weighted mean difference (WMD) with 95% confidence interval (CI) was used to pool continuous outcomes.

RESULTS

Ten cross-sectional studies (11 datasets) comprising a total of 625 eyes (278 NAION eyes, 347 POAG eyes) were included in the qualitative and quantitative analyses. The pooled results demonstrated that the superior pRNFL was significantly thinner in NAION eyes than in POAG eyes (WMD=-6.40, 95%CI: -12.22 to -0.58, P=0.031), whereas the inferior pRNFL was significant thinner in POAG eyes than in NAION eyes (WMD=11.10, 95%CI: 7.06 to 15.14, P≤0.001). No difference was noted concerning the average, nasal, and temporal pRNFL thickness (average: WMD=1.45, 95%CI: -0.75 to 3.66, P=0.196; nasal: WMD=-2.12, 95%CI: -4.43 to 0.19, P=0.072; temporal: WMD=-1.24, 95%CI: -3.96 to 1.47, P=0.370).

CONCLUSION

SD-OCT based evaluation of inferior and superior pRNFL thickness can be potentially utilized to differentiate NAION from POAG, and help to understand the different pathophysiological mechanisms between these two diseases. Further longitudinal studies and studies using eight-quadrant or clock-hour classification method are required to validate the obtained findings.

Global Glaucoma Staging System (GGSS): A New Method to Simultaneously Assess the Severity of Both Functional and Structural Damage in Glaucoma

Background: The classification of damage in glaucoma is usually based either on visual field or optical coherent tomography (OCT) assessment. No currently available method is able to simultaneously categorize functional and structural damage. Material and Methods: In this study, 283 patients with chronic open-angle glaucoma (OAG) at different stages and 67 healthy subjects were tested with both standard automated perimetry and spectral domain OCT for retinal nerve fiber layer (RNFL) assessment. The visual field data were classified using the Glaucoma Staging System 2, whereas OCT results were processed with the OCT Glaucoma Staging System. These data were used to create a new staging system (global glaucoma staging system, GGSS), in which the severity of visual field and RNFL damage is reported on the Y and X axis, respectively. The GGSS was tested in a different sample of 147 patients with manifest OAG, 56 with preperimetric glaucoma and 43 normal subjects. A six-stage clinical classification, based on the analysis of visual fields and optic disc appearance, was used as gold standard. Results: The GGSS was able to correctly classify in the same stage or within the immediately adjacent stages 145 cases on 147 (98.6%). Fifty-four preperimetric cases (96.4%) were classified as borderline or abnormal (Stage 1 or 2). Here, 41 normal eyes out of 43 were correctly classified as Stage 0, with a specificity of 95.3%. Conclusions: Preliminary results from this study are encouraging and suggest that the new GGSS is able to provide information concerning the severity of structural and functional damage in an integrated manner.