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Validity of temporal to nasal macular ganglion cell-inner plexiform layer thickness ratio as a diagnostic parameter in early glaucoma

Poster Details

First Author: S.Park SOUTH KOREA

Co Author(s):    H. Kim              

Abstract Details


To evaluate the diagnostic validity of temporal to nasal macular ganglion cell - inner plexiform layer thickness (TNM) ratio using Cirrus high-definition - optical coherence tomography (HD-OCT) in patients with early glaucomatous damage.


Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, South Korea.


Retrospective cross-sectinal study. Sixty-seven normal controls, 50 patients with preperimetric glaucoma and 106 patients with early glaucoma were enrolled. The patients with early glaucoma were classified into 2 subgroups according to the pattern of VF defect: paracentral scotoma group (PCS, n=54); peripheral scotoma group (PPS, n=52). Macular ganglion cell-inner plexiform layer (mGCIPL) thickness and circumpapillary retinal nerve fiber layer (cpRNFL) thickness were measured by Cirrus HD-OCT. TNM ratio were calculated. The area under the receiver operating characteristic curves (AROC) of each parameter were estimated and compared between each of the groups. The correlation between the perimetry global indices and various mGCIPL/cpRNFL parameters was evaluated.


The AROCs of TNM ratio, minimum and average mGCIPL of PCS group (0.980, 0.976 and 0.950) were significantly higher than those of PPS group (0.769, 0.936 and 0.866; p<0.001 , 0.008 and 0.003, respectively). However, the AROCs of average (0.972 in PCS group, 0.976 in PPS group; p=0.681) and inferior (0.969 in PCS group, 0.967 in PPS group; p=0.865) cpRNFL thickness between two subgroups did not show statistically significant differences. Parameter with the best AROC was the TNM ratio in PCS group and average cpRNFL in PPS group. There was a linear relationship between the TNM ratio and pattern standard deviation (PSD) in PCS group.


TNM ratio represented the best diagnostic and detecting ability for paracentral scotoma in early glaucoma. TNM ratio could be an important parameter in the diagnosis of early glaucoma with paracentral VF defect. FINANCIAL INTEREST: NONE

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