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. 2020 Oct 14;9(10):3294.
doi: 10.3390/jcm9103294.

Using the Thickness Map from Macular Ganglion Cell Analysis to Differentiate Retinal Vein Occlusion from Glaucoma

Nam Ho Lee  1 , Kee Sup Park  2 , Han Min Lee  2 , Jung Yeul Kim  2 , Chang-Sik Kim  2 , Kyoung Nam Kim  2
Affiliations

Using the Thickness Map from Macular Ganglion Cell Analysis to Differentiate Retinal Vein Occlusion from Glaucoma

Nam Ho Lee et al. J Clin Med. .

Abstract

Purpose: We hypothesized that the thickness map from macular ganglion cell analysis (GCA) acquired from spectral-domain optical coherence tomography can be used to differentiate retinal vein occlusion (RVO) from glaucoma.

Methods: In this retrospective case control study, 37 patients with resolved RVO and 74 patients with primary open-angle glaucoma (POAG) were enrolled. Two independent examiners diagnosed patients with RVO or POAG based on the topographic pattern in the GCA thickness map. Inter-observer agreement for a decision between RVO and POAG was assessed using kappa statistics. Diagnostic specificity and accuracy were calculated.

Results: Inter-observer agreement was good, with a kappa value of 0.765 (95% confidence interval, 0.634-0.896, p < 0.001). The diagnostic specificity of RVO from POAG using the GCA thickness map was 93.2% and diagnosis accuracy was 80.4%.

Conclusions: An irregular GCA thickness map represents a simple and convenient differential diagnostic clue to distinguish RVO from POAG.

Keywords: ganglion cell-inner plexiform layer; optical coherence tomography; primary open-angle glaucoma; retinal vein occlusion.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Representative cases from each patient group: patients (A) and (B) have retinal vein occlusion (RVO) and patient (C) has primary open-angle glaucoma (POAG). In patient (A), a fundus photograph (a) shows a superotemporal retinal nerve fiber layer (RNFL) defect. Fluorescein angiography (b) shows superiorly localized abnormal retinal vessels and small fovea non-perfusion. The thickness map of the ganglion cell analysis (GCA) (c) shows non-arcuate and interrupted ganglion cell-inner plexiform layer (GCIPL) thinning with blue/black color in the superior hemisphere. In patient (B), a superotemporal RNFL defect (a) and corresponding regularly arcuate GCIPL thinning on the thickness map (c) are shown. Mild leakage of the fluorescein from an abnormal retinal vessel localized in the superotemporal peripapillary area is shown (b). In patient (C), an inferotemporal RNFL defect (a) and corresponding regularly arcuate GCIPL thinning (b) are shown.
Figure 2
Figure 2
Thickness maps of the ganglion cell analysis (GCA) of (A) 12 retinal vein occlusion (RVO) patients diagnosed as primary open-angle glaucoma (POAG) by one or two examiners and (B) 5 POAG patients diagnosed as RVO by one or two examiners.
See this image and copyright information in PMC

References

    1. Jaulim A., Ahmed B., Khanam T., Chatziralli I.P. Branch retinal vein occlusion: Epidemiology, pathogenesis, risk factors, clinical features, diagnosis, and complications. An update of the literature. Retina. 2013;33:901–910. doi: 10.1097/IAE.0b013e3182870c15. - DOI - PubMed
    1. Aghi M.K., Chen C.C., Fleseriu M., Newman S.A., Lucas J.W., Kuo J.S., Barkhoudarian G., Farrell C.J., Sheehan J., Ziu M. Congress of neurological surgeons systematic review and evidence-based guidelines on the management of patients with nonfunctioning pituitary adenomas: Executive summary. Neurosurgery. 2016;79:521–523. doi: 10.1227/NEU.0000000000001386. - DOI - PubMed
    1. Micieli J.A., Newman N.J., Biousse V. The role of optical coherence tomography in the evaluation of compressive optic neuropathies. Curr. Opin. Neurol. 2019;32:115–123. doi: 10.1097/WCO.0000000000000636. - DOI - PubMed
    1. Iorga R.E., Moraru A., Ozturk M.R., Costin D. The role of optical coherence tomography in optic neuropathies. Rom. J. Ophthalmol. 2018;62:3. doi: 10.22336/rjo.2018.2. - DOI - PMC - PubMed
    1. Lee E.J., Han J.C., Kee C. Difference in Topographic Pattern of Prelaminar and Neuroretinal Rim Thinning Between Nonarteritic Anterior Ischemic Optic Neuropathy and Glaucoma. Investig. Ophthalmol. Vis. Sci. 2019;60:2461–2467. doi: 10.1167/iovs.19-26891. - DOI - PubMed

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