Comparing gangion cell complex and retinal nerve fibre layer for the early diagnosis of glaucoma

Author : Dr. Ashok H. Madan, Dr. Minal Vyawahare, Dr. Smital M. Metange and Dr. Nilesh Gaddewar

Context: With the newertechnologies like Optical Coherence Tomography(OCT), it’s time to rethink whether Retinal Nerve Fibre Layer (RNFL) thickness is the earliest tool for glaucoma detection or Ganglion Cell Complex (GCC) needs a reconsideration as we know that the cell bodies die prior to their processes. Purpose: To evaluate and compare the early glaucoma detection abilities of circumpapillary RNFL (cpRNFL) and macular GCC (mGCC) retrospectively on the OCT. Patients and Methods: 60 preperimetric glaucoma patients and 80 controls in an age group of 18-60 years were enrolled in this cross- sectional study. The cpRNFL thickness and mGCC of each patient were measured. Results: The Area under receiver operating characteristic curve (AUROC) curve was significantly higher for mGCC than that for cpRNFL. It was noted that the mGCC loss occurs prior to the decrease in the cpRNFL thickness. Conclusion: Prior studies have labelled GCC as just being complementary to RNFL in early detection of glaucoma but our study detected GCC to be superior. Thus the mGCC analysis though commonly performed needs recognition as an early detection tool for glaucoma.

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