Korean J Ophthalmol.  2018 Dec;32(6):506-516. 10.3341/kjo.2018.0030.

Thickness of the Macula, Retinal Nerve Fiber Layer, and Ganglion Cell-inner Plexiform Layer in the Macular Hole: The Repeatability Study of Spectral-domain Optical Coherence Tomography

• Lee WH
• Jo YJ
• Kim JY

• KMID: 2427966
• DOI: http://doi.org/10.3341/kjo.2018.0030

Abstract

PURPOSE
We measured the thicknesses of the ganglion cell and inner plexiform layer (GCIPL), the macula, and the retinal nerve fiber layer (RNFL) using spectral-domain optical coherence tomography in patients with idiopathic macula holes to analyze the repeatability of these measurements and compare them with those of the fellow eye.
METHODS
We evaluated 85 patients who visited our retinal clinic. The patients were divided into two groups according to their macular hole size: group A had a size of <400 µm, while group B had a size of ≥400 µm. Repeatability was determined by comparing the thicknesses of the GCIPL, macula, and RNFL with those of the normal fellow eye.
RESULTS
The average central macular thickness in patients with macular holes was significantly thicker than that in the normal fellow eye (343.8 ± 78.6 vs. 252.6 ± 62.3 µm, p < 0.001). The average thickness of the GCIPL in patients with macular holes was significantly thinner than that in the normal fellow eye (56.1 ± 23.4 vs. 77.1 ± 12.8 µm, p < 0.001). There was no significant difference in the average RNFL thickness between eyes with macular holes and fellow eyes (92.4 ± 10.0 vs. 95.5 ± 10.7 µm, p = 0.070). There were also no significant differences in the thicknesses of the GCIPL and RNFL among the two groups (p = 0.786 and p = 0.516). The intraclass correlation coefficients for the macula and RNFL were 0.994 and 0.974, respectively, in patients with macular holes, while that for the GCIPL was 0.700.
CONCLUSIONS
Macular contour change with macular hole results in low repeatability and a tendency of thinner measurement regarding GCIPL thickness determined via spectral-domain optical coherence tomography. The impact of changes in the macular shape caused by macular holes should be taken into consideration when measuring the GCIPL thickness in patients with various eye diseases such as glaucoma and in those with neuro-ophthalmic disorders.

Keyword

Macular holes; Repeatability; Retina; Spectral-domain optical coherence tomography

MeSH Terms

Eye Diseases
Ganglion Cysts*
Glaucoma
Humans
Nerve Fibers*
Retina
Retinal Perforations*
Retinaldehyde*
Tomography, Optical Coherence*
Retinaldehyde

Figure

• 

  Fig. 1 Macular and optic disc analysis of the right eye. (A) A macular cube 512 × 128 combination scan mode, (B) an optic disc cube 200 × 200 scan mode, and (C) ganglion cell and inner plexiform layer analysis. OS = outer superior; OT = outer temporal; OI = outer inferior = ON = outer nasal; IS = inner superior; IT = inner temporal; II = inner inferior; IN = inner nasal; C = central; S = superior; T = temporal; I = inferior; N = nasal; RNFL = retinal nerve fiber layer; TEMP = temporal; SUP = superior; NAS = nasal; INF = inferior; ST = superotemporal; IT = inferotemporal; IN = inferonasal; SN = superonasal; GCL = ganglion cell layer; IPL = inner plexiform layer.

• 

  Fig. 2 Autosegmention of the ganglion cell and inner plexiform layer (GCIPL) layer. (A) Normal autosegmentation in the normal contralateral eye, (B) segmentation errors in the affected eye (right: group A, left: group C). The measured GCIPL thickness is thinner than the real GCIPL thickness in macular hole patients. Boundaries: purple, retinal nerve fiber layer–retinal ganglion cell boundary; yellow, inner plexiform layer–inner nuclear layer boundary.

• 

  Fig. 3 Blan-Altman plot showing the repeatability of measurements of the central macular thickness (CMT), retinal nerve fiber layer (RNFL), and ganglion cell and inner plexiform layer (GCIPL). The solid line indicates the average mean difference, while the dotted lines lineate the 95% confidence limits of agreement. (A) Bland-Altman plot for the measurements of CMT. The mean difference is 0.71. The 95% limits of agreement are −8.05 to 9.47. (B) Bland-Altman plot for the measurements of RNFL average thickness. The mean difference is 0.24. The 95% limits of agreement are −1.15 to 1.62. (C) Bland-Altman plot for the measurements of GCIPL thickness. The mean difference is −5.15. The 95% limits of agreement are −21.67 to 11.37. M1 = first measurement; M2 = second measurement.

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