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Glaucoma appears to cause damage to retinal layers, macula
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Glaucoma can cause damage to the macular nerve fiber layer, ganglion cell layer, inner plexiform layer and inner nuclear layer, according to a recent study. Such damage can occur before any noticeable changes in visual field, the study authors noted.
"A combination of the three innermost layers seems to provide optimal glaucoma detection," they said.
Ou Tan, PhD, and colleagues in Los Angeles used the Stratus optical coherence tomography system (Carl Zeiss Meditec) to evaluate the retinal layers and macular regions of 149 glaucoma patients enrolled in the Advanced Imaging for Glaucoma Study. The patients were divided into three groups: 47 patients had normal ocular features; 73 patients had perimetric glaucoma; and 29 patients were either glaucoma suspect or had preperimetric glaucoma.
The investigators found that the macular nerve fiber layer, ganglion cell layer, inner plexiform layer and inner nuclear layer were thinner in eyes with either perimetric or preperimetric glaucoma, as well as glaucoma suspect eyes (P < .001).
The authors noted that thickness measurements could be most effectively reproduced if the macular nerve fiber layer, ganglion cell layer and inner plexiform layer were combined and considered the inner retinal layer.
"The [inner retinal layer] was the best macular parameter for glaucoma diagnosis and had discriminant power comparable with that of the [circumpapillary nerve fiber layer]," they said.
The study was published in the June issue of Ophthalmology.