Can ganglion cell complex assessment on cirrus HD OCT aid in detection of early glaucoma?

Abstract

Context: Ganglion cell complex is damaged early in glaucoma. Does this loss of GCC help in early diagnosis of glaucoma. Aims: To compare the RNFL thickness and ganglion cell complex (GCC) in diagnosed patients of glaucoma, pre-perimetric glaucoma and normal controls. Settings and design: Case controlled, observational study. Methods and material: 33 glaucoma patients, 45 pre-perimetric glaucoma, and 30 controls were enrolled in the study. ONH parameters on cirrus HD OCT like CD ratio, para papillary RNFL thickness and GCC were calculated for each case. Statistical analysis used: ANOVA test to analyse differences between groups. ROC for ganglion cell layer. Results: RNFL thickness was 71.6 μ and GCC was 69.19 μ in glaucoma patients. RNFL thickness was 77.31 μ and GCC was 71 μ in pre-perimetric glaucoma and 99.6 μ and 85.16 μ in controls respectively. The difference of mean for RNFL and GCC by ANOVA was statistically significant for controls, glaucoma patients and pre-perimetric glaucoma patients. RNFL (p < 0.001) and GCC (p < 0.001). Receiver operating characteristic curve for GCC was 0.83 (p < 0.000). Conclusions: The RNFL analysis is increasingly being used as newer tool in diagnosis of glaucoma. In addition, GCC can be used as a supplementary tool in picking up cases of pre-perimetric glaucoma as loss is significant in pre-perimetric glaucoma also. Keywords: Ganglion cell complex, Optical coherence tomography, Retinal nerve fibre layer, Glaucoma