Skip to main content

  • Ganglion Cell Complex Thinning and Central VF Loss

    By Jean Shaw
    Selected and reviewed by Neil M. Bressler, MD, and Deputy Editors
    Glaucoma
    Add to My Bookmarks

    Journal Highlights

    JAMA Ophthalmology, January 2023

    Download PDF

    Mahmoudinezhad et al. set out to investigate the association between ganglion cell complex (GCC) thinning and the rate of central visual field (VF) loss. They found that rapid GCC thin­ning during a follow-up period of 4.7 years was associated with faster rates of central VF decline.

    This retrospective cohort study in­volved 139 patients (202 eyes) who had primary open-angle glaucoma (POAG; n = 154 eyes) or who were glaucoma suspects (n = 48 eyes). All had partici­pated in the Diagnostic Innovations in Glaucoma Study and the African De­scent and Glaucoma Evaluation Study and were followed from June 18, 2014, to Jan. 11, 2019.

    Data analysis for this study occurred in March 2022. Initial rates of GCC thinning were obtained from global GCC thickness values of the first three OCT scans during the original studies. To quantify rates of central VF loss, the researchers used univariable and multivariable linear mixed-effects models to assess the change in central (10-2) VF mean deviation (MD) during follow-up. Eyes were categorized as slow or fast progressors based on rates of GCC thinning.

    During the first 1.8 years of follow-up, the rate of GCC change was –.56 μm per year (95% CI, –.66 to –.46 μm/year). All told, 163 eyes (80.7%) were slow progressors, and 39 (19.3%) were fast progressors, with GCC rates of thinning of –.3 μm/year and –1.6 μm/year, respectively. Rapid initial GCC deterioration was associated with faster subsequent rates of central VF MD worsening: the rates of worsening among slow and fast progressors were –.10 dB/ and –.34 dB/year, respectively.

    As all of the patients were participat­ing in clinical trials, the results of this analysis may be conservative—that is, the fast progressors may have preferen­tially received intensified IOP-lowering treatment. Nonetheless, the authors said, these results support the use of macular imaging for monitoring patients at the time of diagnosis as well as for monitoring the rate of GCC thinning.

    The original article can be found here.