Wide 3-Dimensional Macular Ganglion Cell Complex Imaging with Spectral-Domain Optical Coherence Tomography in Glaucoma

Investigative Ophthalmology and Visual Science

Satoshi Morooka, Masanori Hangai, Masayuki Nukada,Noriko Nakano, Kohei Takayama, Yugo Kimura, Tadamichi Akagi,Hanako Ohashi Ikeda, Atsushi Nonaka, Nagahisa Yoshimura

53(8): 4805-4812  July 2012

Purpose.To determine whether measurement of ganglion cell complex (GCC) thickness over a wide area (8-mm diameter) can improve the glaucoma-discriminating ability of spectral-domain optical coherence tomography (SD-OCT) compared to that in the standard macular area (6-mm diameter).

Methods. Ninety-three subjects were enrolled, including 46 healthy eyes of 46 volunteers and 47 eyes of 47 glaucoma patients (23 eyes with preperimetric glaucoma [PPG] and 24 eyes with early glaucoma [EG]). All patients underwent SD-OCT raster scanning over a 9 mm × 9 mm square area centered on the fovea. Areas under the receiver operating characteristic curves (AROCs) were compared between wide sector (1–8-mm ring) and standard-size sector (1–6-mm ring) charts.

Results. AROCs for average GCC thickness in the wide chart were significantly greater than those of the standard chart in eyes with PPG (0.928 vs. 0.891; P = 0.038), EG (0.912 vs. 0.861; P = 0.003), and both (0.920 vs. 0.876; P = 0.004). Overall, the AROCs of regional GCC thicknesses were nearly comparable between the middle ring (4–6 mm) and outer ring (6–8 mm). Coefficients of variation were 0.68% and 0.97% in the standard and wide sector charts, respectively, in eyes with PPG, and 0.45% and 0.72% in the standard and wide sector charts, respectively, in eyes with EG.

Conclusions. Addition of the GCC thickness outside the macula to the standard macular GCC thickness significantly increased the glaucoma-discriminating ability of SD-OCT.