With modern OCT devices it is possible to measure the GCL alone and not as a complex with the IPL. The measurement of the RNFL has been thoroughly investigated in different diseases such as glaucoma, idiopathic intracranial hypertension (IIH) and optic neuritis on the other hand, the GCL has also been measured and investigated as the retinal ganglion cell complex (GCC), which includes both the ganglion cell layer and the inner plexiform layer (IPL). This anatomical separation makes it possible to study the GCL by direct imaging using OCT and consider it as a window into different physiological and pathological processes in the brain. The ganglion cell is the first order neuron in the visual pathway, with the cell body located in the retinal GCL while the retinal nerve fiber layer (RNFL) represents the axon of these neurons that leaves the eye and enters the brain through the optic nerve, where it synapses at the lateral geniculate body. Automated OCT segmentation should be reviewed for manual adjustments. ConclusionĪge, sex and axial length should be taken into consideration when measuring the GCL thickness and volume with OCT. GCL volume declined with longer axial length after adjustment for age and sex ( P = 0.048). GCL volume declined with age ( P = 0.031) but not after adjustment for sex and axial length ( P = 0.138). GCL thickness differed between males and females in the inner retinal ring ( P = 0.025) but not in the outer ring ( P = 0.66). GCL volume was greater in males relative to females after adjustment for age and axial length (1.13 ± 0.07 mm 3 for males vs 1.09 ± 0.09 mm 3 for females P = 0.031). GCL thickness did not differ in similar anatomic regions in right and left eyes ( P > 0.05). About 25% of the OCT-automated GCL measurements required manual correction. One hundred and sixteen eyes of 60 subjects (12–76 years of age, 55% female) were examined of which 77% had 0 ± 2 D of spherical equivalent, and mean axial length was 23.86 mm. A mixed linear model was used to determine the association of the effect of the various parameters on the GCL thickness and volume. Visual acuity, AL, and autorefraction were also measured. MethodsĪ prospective cross-sectional study was designed to measure GCL thickness and total volume with OCT with automated segmentation and manual correction where needed. The purpose of this study is to examine the effect of age, sex, and AL on normal retinal GCL thickness and volume in a healthy population without any neurological diseases. Studies conducted to measure the GCL have overlooked many of these factors. Different factors can affect these measurements, such as brain pathologies, ocular axial length (AL) as well as age and sex. The ganglion cell layer (GCL) measurements with Optical Coherence Tomography (OCT) are important for both ophthalmologists and neurologists because of their association with many ophthalmic and neurological diseases.
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