Blanca Ferrandez

Retinal Sensitivity Is Reduced in Patients With Obstructive Sleep Apnea

PURPOSE To evaluate the outcomes of standard automated perimetry (SAP) in patients with obstructive sleep apnea (OSA). METHODS Eighty OSA patients and 111 age-matched controls were consecutively and prospectively enrolled. One eye per subject was randomly selected. All participants underwent at least one reliable SAP (24-2 SITA Standard algorithm). The peripapillary retinal nerve fiber layer thickness (RNFL) was measured with spectral-domain optical coherence tomography (OCT). Patients with OSA were classified into three groups according to the apnea/hypopnea index: mild, moderate, or severe OSA. Parameters of SAP and OCT were compared between healthy controls and OSA patients. Correlation of apnea/hypopnea index with OCT and SAP measurements were calculated. RESULTS Mean age, best-corrected visual acuity, and central corneal thickness were similar between groups. Intraocular pressure, however, was lower in the OSA group. Mean deviation of SAP was -0.23 ± 0.8 dB in the control group and -1.74 ± 2.8 dB in the OSA group (P < 0.001). Thickness of RNFL measured with OCT did not differ significantly between groups. Patients with OSA showed reduced sensitivity at most points tested by white-on-white perimetry compared with healthy individuals. The threshold values were more depressed in the peripheral visual field. The apnea/hypopnea index was related to the SAP indices: Pearson correlations were -0.432 with mean deviation, 0.467 with pattern standard deviation, and -0.416 with the visual field index (P < 0.001). CONCLUSIONS Patients with OSA exhibited reduced retinal sensitivity measured with SAP compared with healthy controls.

Relationship between Spectral-Domain Optical Coherence Tomography and Standard Automated Perimetry in Healthy and Glaucoma Patients

Objective. To evaluate the relationship between spectral-domain optical coherence tomography (OCT) and standard automated perimetry (SAP) in healthy and glaucoma individuals. Methods. The sample comprised 338 individuals divided into 2 groups according to intraocular pressure and visual field outcomes. All participants underwent a reliable SAP and imaging of the optic nerve head with the Cirrus OCT. Pearson correlations were calculated between threshold sensitivity values of SAP (converted to linear scale) and OCT parameters. Results. Mean age did not differ between the control and glaucoma groups (59.55 ± 9.7 years and 61.05 ± 9.4 years, resp.; P = 0.15). Significant differences were found for the threshold sensitivities at each of the 52 points evaluated with SAP (P < 0.001) and the peripapillary retinal nerve fiber layer (RNFL) thicknesses, except at 3 and 9 clock-hour positions between both groups. Mild to moderate correlations (ranging between 0.286 and 0.593; P < 0.001) were observed between SAP and most OCT parameters in the glaucoma group. The strongest correlations were found between the inferior RNFL thickness and the superior hemifield points. The healthy group showed lower and weaker correlations than the glaucoma group. Conclusions. Peripapillary RNFL thickness measured with Cirrus OCT showed mild to moderate correlations with SAP in glaucoma patients.

Evaluation of the Macular Ganglion Cell-Inner Plexiform Layer and the Circumpapillary Retinal Nerve Fiber Layer in Early to Severe Stages of Glaucoma: Correlation with Central Visual Function and Visual Field Indexes

Objectives: To compare the circumpapillary retinal nerve fiber layer (cpRNFL) and the macular ganglion cell-inner plexiform layer (GCIPL) in glaucoma patients at different disease stages and to evaluate correlations between optical coherence tomography (OCT) parameters with central visual function and visual field (VF) indexes. Patients and Methods: One hundred forty patients were included in this prospective cross-sectional study. Subjects diagnosed with chronic open-angle glaucoma and 20/40 or better vision were recruited and classified as having early, moderate, or severe VF defects based on Hodapp-Parrish-Anderson criteria. cpRNFL and macular GCIPL were measured using Cirrus high-definition OCT. Central retinal sensitivity and visual acuity were recorded. Results: All OCT measurements differed significantly between patients with early and severe VF defects (p < 0.001). Correlations between central vision and VF indexes with OCT measurements were moderate but significant; better-correlated OCT parameters were the inferior cpRNFL quadrant, average cpRNFL thickness, inferior and inferior temporal GCIPL sectors, and minimum GCIPL thickness (r = 0.63-0.71, p < 0.001). Visual acuity was not correlated with either circumpapillary or macular OCT measurements. Conclusions: Inner macular parameters performed as well as cpRNFL in patients with different stages of glaucoma. Inferior macular GCIPL sectors, minimum GCIPL thickness, and the inferior cpRNFL quadrant best differentiate disease severity and correlate with central visual function and VF indexes.

Macular Retinal Ganglion Cell Layer Thickness Is Not Reduced in Patients with Obstructive Sleep Apnea

Purpose: To evaluate macular ganglion cell layer (GCL) and ganglion cell-inner plexiform layer (GCIPL) thicknesses in patients with obstructive sleep apnea (OSA) syndrome. Methods: 73 OSA patients and 67 age-matched controls were consecutively and prospectively enrolled. All participants underwent at least one reliable standard automated perimetry (SAP) and were imaged with spectral-domain optical coherence tomography (OCT) using two different devices. The OCT parameters were compared between groups, and Pearson correlations between main indices of SAP and OCT parameters were calculated. Results: The pattern standard deviation of SAP was higher in the OSA group (p = 0.001). Mean GCIPL thickness was 82.99 ± 10.30 and 80.78 ± 12.15 µm in the control and OSA groups, respectively (p = 0.25), and GCL thickness was 44.93 ± 11.42 µm in the control group and 48.81 ± 10.85 µm in OSA individuals (p = 0.47). Pearson correlations between the GCIPL-GCL measurements and the main indices of SAP were not significant. Conclusions: Neither GCIPL nor GCL thickness were reduced in OSA subjects compared with healthy individuals. Retinal sensitivity evaluated with SAP was however decreased in OSA patients.

Diagnostic ability of inner macular layers to discriminate early glaucomatous eyes using vertical and horizontal B-scan posterior pole protocols

Purpose To evaluate the diagnostic ability of macular ganglion cell (mGCL) and macular retinal nerve fiber (mRNFL) layers, to detect early glaucomatous eyes, using the new segmentation software of Spectralis optical coherence tomography (OCT) device (Heidelberg Engineering). Methods A total of 83 eyes from 83 subjects were included in this observational, prospective cross-sectional study: 43 healthy controls and 40 early primary open-angle glaucoma (POAG) patients. All participants were examined using the Horizontal and Vertical Posterior Pole protocols, and the peripapillary RNFL (pRNFL) protocol of Spectralis OCT device. The new automated retinal segmentation software was applied to horizontal and vertical macular B-scans to determine mGCL and mRNFL thicknesses in each one of the 9 sectors of the Early Treatment Diagnostic Retinopathy Study circle. Thickness of each layer was compared between groups, and the sectors with better area under the receiver operating characteristic curve (AUC) were identified. Results mGCL was significantly thinner in the POAG group, especially in outer and inner temporal sectors (p<0.001); and mRNFL was significantly thinner in the POAG group in the outer inferior and the outer superior sector (p<0.001). Diagnostic accuracy of inner macular layers was good, and in general mGCL was superior to mRNFL. pRNFL obtained the best diagnostic capability (AUC, 0.886). Horizontal and vertical Posterior Pole protocols performed similarly. Conclusions Inner macular layers using either horizontal or vertical B-scans, especially temporal sectors of mGCL, have good diagnostic capability to differentiate early glaucomatous eyes from control eyes; however, pRNFL has the highest diagnostic sensitivity for glaucoma detection.

Peripapillary Choroidal Thickness Analysis Using Swept-Source Optical Coherence Tomography in Glaucoma Patients: A Broader Approach

Aims: To evaluate and compare peripapillary choroidal thickness (PPCT) in a wide area around the optic disk and various choroidal established zones in healthy controls and primary open-angle glaucoma (POAG) patients using a new swept-source (SS) optical coherence tomography (OCT) device. Methods: A total of 246 eyes were finally included in this observational, prospective, cross-sectional study: 111 healthy controls and 135 POAG patients. The healthy subjects were divided into 2 populations: the teaching population (25 used to establish choroidal zones) and the validating population (86 used for comparing choroidal thickness with POAG patients). A 26 × 26 cube grid centered on the optic disk was generated using an SS-OCT to automatically measure choroidal thickness. Four choroidal zones were established and used to compare PPCT between healthy controls and POAG patients. Results: PPCT was significantly thinner in zones 3 and 4 of the POAG group. The choroid exhibited a similar pattern in controls and patients with POAG; it was thickest in the superior region, followed in order by the temporal, nasal, and inferior regions. Conclusions: Peripapillary choroidal tissue shows a concentric pattern in both groups, and glaucoma patients present with peripapillary choroidal thinning compared with healthy subjects, especially in areas further away from the optic disk.

Contents Vol. 57, 2017

13 SIRCOVA-OFTARED Joined Congress Abstracts Valencia (Spain), June 30 – July 2, 2016 (online only) E-Mail karger@karger.com www.karger.com