Role of Ganglionic Cell Complex, Retinal Nerve Fibre Layer in Glaucoma EvaluationCorrespondence Address :
Dr. Hari Kumar Sreerangam,
Department of Ophthalmology, 7 Air Force Hospital, Nathusingh Road, Kanpur Cantt,
Kanpur-208004, Uttar Pradesh, India.
Introduction: Glaucoma is a multifactorial disease characterised by damage to Retinal Ganglion Cells (RGCs) that inturn results in damage of nerve fibers resulting in functional visual impairment.
Aim: To evaluate the sensitivity and specificity of Ganglion Cell Complex (GCC) parameters and Retinal Nerve Fibre Layer (RNFL) thickness obtained with Spectral Domain-Optical Coherence Tomography (SD-OCT) and to determine their role in the diagnosis of primary open-angle glaucoma patients.
Materials and Methods: A case control observational study was conducted on 55 patients of Primary Open Angle Glaucoma (POAG) cases and 50 normal (control) patients presenting to the Eye OPD at tertiary eye hospital over a period from August 2015 to November 2017. Institutional ethical clearance was taken and tenants of a declaration of Helsinki were adhered to. Apart from complete ophthalmic examination, all patients underwent reliable standard automated perimetry (30-2) testing and SD-OCT imaging for RNFL thickness, Optic Nerve Head (ONH) analysis and GCC. Receiver Operating Characteristic Curves (ROC) were studied for all parameters.
Results: The diagnostic ability for distinguishing between normal and glaucoma patients were same when we consider average RNFL thickness and avgerage GCC thickness. Diagnostic accuracy increases when we consider both RNFL and GCC thickness. There was a significant difference in both RNFL and GCC thickness between normal and glaucoma patients (p<0.001). The Mean Deviation (MD) showed a significant correlation with all the parameters in eyes with glaucoma (<0.001).
Conclusion: GCC thickness seems to have higher sensitivity and specificity for the detection of early glaucoma. Diagnostic accuracy increases when we include other parameters like RNFL and visual fields.
Optical coherence tomography, Optic nerve head, Primary open angle glaucoma, Visual fields
Atul Kumar Singh, Hari Kumar Sreerangam, Dattakiran Joshi, Ashish Pandey. Role of Ganglionic Cell Complex, Retinal Nerve Fibre Layer in Glaucoma Evaluation. Journal of Clinical and Diagnostic Research [serial online] 2020 January [cited: 2020 May 26 ]; 14:NC01-NC04. Available from
Date of Submission: Oct 22, 2019
Date of Peer Review: Nov 22, 2019
Date of Acceptance: Dec 17, 2019
Date of Publishing: Jan 01, 2020
â€¢ Financial or Other Competing Interests: No
â€¢ Was Ethics Committee Approval obtained for this study? Yes
â€¢ Was informed consent obtained from the subjects involved in the study? Yes
â€¢ For any images presented appropriate consent has been obtained from the subjects. Yes
PLAGIARISM CHECKING METHODS:
â€¢ Plagiarism X-checker: Oct 23, 2019
â€¢ Manual Googling: Dec 06, 2019
â€¢ iThenticate Software: Dec 23, 2019 (20%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)