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Determinants and factors affecting optical coherence tomography ganglion cell-inner plexiform layer measurement: The Singapore Epidemiology of Eye Disease Study

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Session Details

Session Title: Presented Poster Session: Glaucoma

Venue: Poster Village: Pod 2

First Author: : R.Siantar SINGAPORE

Co Author(s): :    M. Chee   Y. Tham   T. Wong   C. Cheng     

Abstract Details


The retinal ganglion cell layer has been reported to be the earliest site of glaucomatous damage. Ganglion cell-inner plexiform layer (GC-IPL), which forms part of the ganglion cell complex together with retinal nerve fibre layer (RNFL) at the macular region, is thought to be able to discriminate early glaucoma and aid early diagnosis. Our aim is to identify the influences of demographic, ocular and systemic factors on the measurement of GC-IPL thickness using optical coherence tomography (OCT) in a healthy Asian population, which will be helpful in the clinical interpretation and early diagnosis of glaucoma.


A total of 3874 subjects (1484 Chinese, 1054 Malays, and 1336 Indians) were consecutively recruited from the population-based Singapore Epidemiology of Eye Diseases Study. The study was conducted at the Singapore Eye Research Institute, the national research institute for ophthalmic and vision research in Singapore.


All subjects underwent a standardised interview, ophthalmic examination, and automated perimetry. OCT with macular cube protocol was used to measure the GC-IPL thickness. We included only subjects who had normal visual fields without signs of glaucoma or glaucoma suspect. Univariate and multiple linear regression analyses were performed to examine the relationship between GC-IPL thickness with ocular and systemic factors.


In multiple linear regression analysis, average GC-IPL thickness was significantly associated with age (β= -0.22, P<0.001), female sex (β= -1.66, P<0.001), Indian race (β= -3.76, P<0.001), axial length (β= -1.50, P<0.001), presence of cortical cataract (β= -0.55, P=0.007), disc area (β= 1.07, P<0.001), total cholesterol (β= 0.32, P=0.005) and creatinine level (β= -0.01, P=0.023). Thinner GC-IPL was associated with higher vertical cup-to-disc ratio and thinner RNFL (correlation coefficient: -0.1722 and 0.5131 respectively. Intra-ocular pressure, central corneal thickness, OCT signal strength, body mass index, serum glucose, diabetes mellitus and hypertension had no significant influence on GC-IPL thickness (all P>0.05).


Thinner GC-IPL was independently associated with older age, female sex, Indian race, longer axial length, presence of cortical cataract, smaller disc area, higher vertical cup-to-disc ratio, thinner average RNFL thickness, lower total cholesterol and higher creatinine level. These factors should be taken into account when interpreting GC-IPL thickness measurements with OCT when assessing for glaucoma.

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