Research Of MGCC And Peripheral Rnfl Thickness Change In Early Primary Angle Closure Glaucoma By Spectralis OCT

Objective:To obtain the difference among the thickness of circumpapillary retinalnever fiber layer(cp RNFL),Macular retinal(MR),macular retinal nerve fiber layer(m RNFL),macular ganglion cell layer(m GCL),macular inner plexiform layer(ml PL),macular ganglion cell complex(m GCC),m GCL+IPL and the rate of ganglion cell complex thickness to total retinal thickness ratio(G/T)in healthy men and patients with early primary angle closure glaucoma using Heidelberg frequency domain optical coherence tomography(Spectralis optical coherence tomography,Spectralis OCT),and then analyize the value of these parameters in the diagnosis of early primary angle closure glaucoma.Methods:Clinical cross-sectional study.Collected history data of our hospital ophthalmology patients,physical examination and hospital staff from July 2016 to December 2016.And according to the inclusion criteria and exclusion criteria,a total of 29 cases(50 eyes)was ultimately collected,which were divided into 2 groups:20 cases(39 eyes)in the normal group;9 patients(11 eyes)in the early primary angle closure glaucoma.All subjects underwent systematical eye examinations,including best corrected visual acuity(BCVA),computer optometry,intraocular pressure,slit-lamp examination,ultrasound biomicroscopy(UBM),corneal thickness measurement,Perimetry and Spectralis OCT examination etc..When used Spectralis OCT to check all the research subjects,the Glaucoma mode depending on the optic disc surrounding retinal optic fiber(RNFL)scanning and macular multilayer scanning were choosed.Comparing the differences of those parameters between two groups,using the area under the receiver-operating characteristic curve(AROC)analysis diagnostic ability of each parameter.Difference is statistically significant(P<005).Results:Comparing the general situation between two groups:20 cases(39 eyes)in the normal group,which included 9 cases(18 eyes)of male,11 cases(21 eyes)of female,and aged 23-52(38.7 ±10.9);9 patients(11 eyes)in the early primary angle closure glaucoma,which included 3 cases(5 eyes)of male,6 cases(6 eyes)female,and aged 41-76(55.8±10.2).Differences on gender and age composition ratio between two groups was no statistical significance(P>0.05).Comparing cp RNFL thickness between two groups:In addition to the subnasal cp RNFL thickness is statistical significance(P<0.05)between two groups;temporal,supratemporal,subtemporal,supranasal,subnasal and the average cp RNFL thickness is no statistically significant difference(P>0.05)between two groups.Comparing MR thickness between two groups:the MR thickness of temporal of outer ring showing statistical significance(p<0.05)between two groups,while there is no statistical significance in other quadrants(P>0.05).Comparing m RNFL thickness between two groups:the m RNFL thickness of superior of inner ring showing statistical significance(P<0.05),while other quadrants have no statistical significance(P>0.05).Comparing m GCL thickness between two groups:inferior,nasal of inner ring and temporal,nasal of outer ring m GCL thickness have statistical significance(P<0.05)between two groups;while other quadrants have no statistical significance(P>0.05).Comparing ml PL thickness between groups: uperior,nasal of inner ring and temporal,nasal of outer ring have statistical significance(P<0.05)between the normal group and the early primary angle closure glaucoma group and other quadrants have no statistical significance(P>0.05).Comparing m GCC thickness between groups:temporal,nasal of inner ring have statistical significance(P<0.05)between the normal group and the early primary angle closure glaucoma group,while other quadrants have no statistical significance(P>0.05).Comparing m GCL+IPL thickness between groups:uperior,nasal of inner ring and inferior of outer ring have statistical significance(P<0.05)between two groups and other quadrants have no statistical significance(P>0.05).Comparing the ratio of G/T between two groups,the results showed that: the ratio of G/T in the 8 quadrants of normal people are 34.2 + 1.9%,32.6 + 1.2%,36.4 + 3.3%,34 + 1.5%,35.4 + 2.1%,31.6 + 1.2%,36.4 + 2.1%,38.4 + 1.9%;uperior.Temporal,nasal of inner ring and temporal of outer ring have statistical significance(P<0.05)between two groups and other quadrants have no statistical significance(P>0.05).AROC between the normal group and the early primary angle closure glaucoma group:the temporal cp RNFL thickness AROC value(0.815)was statistical significance(P=0.002 < 0.05),the rest of the quadrant cp RNFL AROC values have no statistical significance(P>0.05);in addition to the uperior of of inner ring MR AROC value(0.731)showing statistical significance(P<0.05)between two groups and other quadrants have no statistical significance(P>0.05);temporal,inferior and nasal of inner ring m RNFL AROC values have no statistical significance(P>0.05)between two groups and other quadrants have statistical significance(P<0.05);the uperior of of inner ring m GCL AROC value(0.803)showing statistical significance(P<0.05)between two groups and other quadrants have no statistical significance(P>0.05);the uperior of of inner ring m IPL AROC value(0.765)showing statistical significance(P=0.008<0.05)between two groups and other quadrants have no statistical significance(P>0.05);the uperior of of inner ring m GCL+IPL AROC value(0.797)showing statistical significance(P=0.003<0.05)and other quadrants have no statistical significance(P>0.05);the uperior of of inner ring and nasal of outer ring m GCC AROC value are respectively 0.854、0.741,showing statistical significance(P>0.05)between two groups,and other quadrants have no statistical significance(P>0.05).The temporal,uperior of of inner ring and uperior,inferior,nasal of outer ring G/T value AROC values are respectively 0.869,0.744,0.726,0.734,0.732,showing statistical significance between two groups(P < 0.05);and the rest of the quadrant G/T values of AROC have no statistical significance(P>0.05).Meanwhile,uperior of of inner ring G/T value AROC is the highest(0.869),followed by uperior of of inner ring and uperior,temporal of outer ring,uperior of of inner ring m GCC thicknes,emporal m RNFL thicknes.Conclusion:1.cp RNFL,MR,m RNFL,m GCL,m IPL,m GCL+IPL,m GCC thickness in early primary angle closure glaucoma patients showing local thinning and G/T ratio becomes smaller.2.The ratio of G/T has an advantage in the diagnosis of early primary angle closure glaucoma,its AROUC value is significantly higher than that of cp RNFL and m GCC thickness,especially uperior of of inner ring G/T.