Dysfunction and Morphological Involvement of Inner Macular Layers in Glaucoma.

Area of Science:

• Ophthalmology
• Neuroscience
• Glaucoma Research

Background:

• Open-angle glaucoma (OAG) is a progressive optic neuropathy.
• Retinal ganglion cells (RGCs) are crucial for vision and are affected in OAG.
• Understanding regional vulnerability within the macula is key to early detection and management.

Purpose of the Study:

• To investigate functional and morphological impairments in RGCs within specific macular regions in OAG patients.
• To determine if certain macular areas are more susceptible to damage in OAG.
• To correlate functional RGC deficits with structural changes in the ganglion cell layer (GCL).

Main Methods:

• Retrospective case-control study involving 21 OAG patients and 20 healthy controls.
• Measurement of multifocal photopic negative response (mfPhNR) response amplitude density (RAD) across macular rings and sectors.
• Assessment of ganglion cell layer thickness (GCL-T) using Spectral Domain-Optical Coherence Tomography (SD-OCT).

Main Results:

• OAG patients exhibited significantly reduced mfPhNR RAD and GCL-T compared to controls (p < 0.01).
• The most substantial reductions in both parameters were observed in the central macular area.
• A significant positive correlation was found between mfPhNR RAD and GCL-T in OAG eyes (p < 0.01).

Conclusions:

• RGC dysfunction in OAG is detectable through abnormal mfPhNR responses in localized macular areas, especially the central region.
• Localized macular RGC dysfunction is linearly associated with morphological changes in the GCL.
• These findings highlight the central macula's vulnerability in OAG and the utility of mfPhNR and SD-OCT for assessing RGC health.