Although catching glaucoma early is the key to warding off its negative visual outcomes, it’s not always an easy task. Researchers from China recently provided more evidence to suggest using the advanced imaging features on your optical coherence tomographer (OCT) to track progressive macular ganglion cell inner plexiform layer (GCIPL) thinning and progressive parapapillary retinal nerve fiber layer (RNFL) thinning may be another important piece of the diagnostic puzzle.

The researchers captured OCT images of the macular GCIPL and parapapillary RNFL, as well as perimetry, for 136 primary open-angle glaucoma (POAG) patients for roughly five years, in four-month increments. The instruments’ guided progression analysis (GPA) software helped determine progressive thinning compared with 67 eyes of 36 healthy individuals followed for the same number of years.

All that data led the researchers to discover 24.7% of participants had progressive GCIPL thinning, 28.6% had progressive RNFL thinning and 15.2% had both. Thinning of either structure came with a higher risk of progressive thinning in the other structure.

In addition, the hazard ratios for likely and possible visual field (VF) progression were 3.48 and 2.74, respectively, on detection of progressive GCIPL thinning and 3.66 and 2.54, respectively, on detection of progressive RNFL thinning.

“Because progressive RNFL thinning and GCIPL thinning are both indicative of VF progression, integrating macular GCIPL and parapapillary RNFL measurements is relevant to facilitate early detection of disease deterioration in glaucoma patients,” the study concludes.

Hou HW, Lin C, Leung CK. Integrating macular ganglion cell inner plexiform layer and parapapillary retinal nerve fiber layer measurements to detect glaucoma progression. Ophthalmology. 2018 Jun;125(6):822-31.