Utilidad del estudio del complejo de células ganglionares de la mácula mediante tomografía de coherencia óptica en el diagnóstico de progresión del glaucoma

Abstract

Introduction

The aim of this work is to evaluate the usefulness of the study of the ganglion cell complex of the macula using optical coherence tomography (OCT) to estimate the progression of glaucoma according to its severity.

Material and methods

This is a retrospective cross-sectional study. It includes 205 eyes of 131 patients with glaucoma or ocular hypertension followed for a mean of 5.7 years. The parameters and rates of three tests have been analyzed using the progression software of each instrument: visual field, OCT in the ganglion cell complex of the macula and in the nerve fiber layer of the optic nerve. The results of each test, the concordance between them and how they differ according to severity stage have been evaluated.

Results

Visual field classifies more cases of progression in moderate-advanced glaucoma, while in mild glaucoma its capacity is limited. Optic nerve fiber layer OCT classifies more cases of progression in mild glaucoma than in moderate-advanced glaucoma, as it is artifacted by the floor effect. OCT of the macular ganglion cell complex is the test that classifies more cases of progression and has the highest agreement with visual field, regardless of severity.

Conclusion

The study of the macula ganglion cell complex using OCT could be a better biomarker of progression than the study of the optic nerve fiber layer, at any stage of glaucoma.