Study of the ganglion cell complex of the macula by optical coherence tomography in the diagnosis of glaucoma progression

INTRODUCTION

The aim of this work is to evaluate the usefulness of the study of the ganglion cell complex of the macula using the OCT technique to estimate the progression of glaucoma according to its severity.

MATERIAL AND METHODS

This is a retrospective cross-sectional study. It includes 205 eyes of 131 patients with glaucoma or ocular hypertension followed for a mean of 5.7 years. The parameters and rates of three tests have been analyzed using the progression software of each instrument: visual field, optical coherence tomography (OCT) in the ganglion cell complex of the macula and in the nerve fiber layer of the optic nerve. The results of each test, the concordance between them and how they differ according to severity stage have been evaluated.

RESULTS

Visual field classifies more cases of progression in moderate-advanced glaucoma, while in mild glaucoma its capacity is limited. Optic nerve fiber layer OCT classifies more cases of progression in mild glaucoma than in moderate-advanced glaucoma, as it is artifacted by the floor effect. OCT of the macular ganglion cell complex is the test that classifies more cases of progression and has the highest agreement with visual field, regardless of severity.

CONCLUSION

In both mild and moderate-advanced glaucoma, OCT of the macula ganglion cell complex may be a better biomarker of progression than OCT of the macula ganglion cell complex.

Electroretinographic Changes during Childhood and Adolescence

Electroretinogram (ERG) changes with age have been studied widely, but there is no general agreement about the age at which ERG parameters reach adult values. We studied 296 eyes from 148 healthy subjects, divided into 14 age groups, ranging from 1 week to 21 years. Although most of the maturational changes or ERG take place during the first six months, the a wave completes development at three years of age and the b component shows a smooth increase in latency between 3 and 18–21 years. The latter component also shows an increase in amplitude from 7–8 to 12–14 years. During the first period of maturation the b wave parameters follow a multiplicative model. These data are discussed in relation to previously reported findings on ERG maturation and to morphological and functional eye changes with age.