Change in the mGC-IPL in Patients with a History of APAC According to SD-OCT

Hyo Seok Lee; Yong Seok Park; Sang Woo Park

doi:10.3341/jkos.2014.55.8.1167

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Lee, Park, and Park: Change in the mGC-IPL in Patients with a History of APAC According to SD-OCT

Original Article

J Korean Ophthalmol Soc 2014;55(8):1167-1173.

Published online: 31 August 2014

DOI: https://doi.org/10.3341/jkos.2014.55.8.1167

Change in the mGC-IPL in Patients with a History of APAC According to SD-OCT

Hyo Seok Lee, MD, Yong Seok Park, MD, Sang Woo Park, MD, PhD

Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea

Address reprint requests to Sang Woo Park, MD, PhD, Department of Ophthalmology, Chonnam National University Hospital, #42 Jebong-ro, Dong-gu, Gwangju 501-757, Korea, Tel: 82-62-220-6758, Fax: 82-62-227-1642, E-mail: exo70@naver.com

Received 8 March 2014 Revised 12 May 2014 Accepted 17 July 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was conducted to measure macular ganglion cell-inner plexiform layer (mGC-IPL) thickness in patients with a history of unilateral single attack of acute primary angle closure (APAC) and to compare it with that of unaffected fellow eyes 8 weeks after resolution using spectrum domain optical coherence tomography (SD-OCT).

Methods

Medical records of 24 patients with history of first episode of unilateral APAC were reviewed retrospectively. Eight weeks after APAC, mGC-IPL thickness and peripapillary retinal nerve fiber layer thickness were measured with SD-OCT and analyzed in eyes affected by APAC (group 1) and fellow eyes (group 2).

Results

There were no significant differences between the groups with regard to best corrected visual acuity, spherical equivalent, central corneal thickness, or axial length (p > 0.05). There were no significant differences in mGC-IPL thickness in the superotemporal, superior, or superonasal sectors (p > 0.05). However, average, inferonasal, inferior, and inferotemporal sectors of group 1 were significantly thinner than those of group 2 (p = 0.002, 0.002, 0.001, 0.001, respectively). In addition, average mGC-IPL difference between affected eyes and fellow eyes showed a statistically significant correlation with attack duration (correlation coefficient = 0.249, p = 0.019).

Conclusions

Normalization of elevated intraocular pressure as soon as possible after APAC onset is recommended in order to reduce mGC-IPL loss, and measurements of mGC-IPL thickness can be helpful for follow-up of APAC patients.

Keywords: Acute primary angle closure, Ganglion cell-inner plexiform layer

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Figure 1.

Scatter plot of average mGC-IPL difference versus age, IOP at the time of attack, attack duration, spherical equivalent, central corneal thickness and axial length. (A) Correlation between age and average mGC-IPL difference. (B) Correlation between IOP at the time of attack and average mGC-IPL difference. (C) Correlation between attack duration and average mGC-IPL difference. (D) Correlation between spherical equivalent and average mGC-IPL difference. (E) Correlation between central corneal thickness and average mGC-IPL difference. (F) Correlation between axial length and average mGC-IPL difference. MGC-IPL = macular ganglion cell-inner plexiform layer; IOP = intraocular pressure.

Table 1.

Demographics and intraocular pressure of patients

Parameter	Values
Age (years)	63.71 ± 8.26
Sex (M:F)	5:19
Duration of attack (hours)	21.63 ± 8.54
IOP at the time of attack (mm Hg)	48.71 ± 7.50
IOP after resolution of APAC (mm Hg)	13.96 ± 3.65
IOP of fellow eyes (mm Hg)	12.25 ± 1.57

Values are presented as mean ± SD.

IOP = intraocular pressure; APAC = acute primary angle closure.

Table 2.

Clinical characteristics of eyes with APAC (group 1) and fellow eyes (group 2)

Parameter	Group 1	Group 2	p-value
BCVA (log MAR)	0.19 ± 0.24	0.08 ± 0.09	0.117
Refractive error (spherical equivalents, diopter)	0.40 ± 1.48	0.85 ± 1.58	0.269
CCT (μm)	541.25 ± 13.29	538.33 ± 7.02	0.281
Axial length (mm)	22.17 ± 0.58	22.16 ± 0.70	0.853
Average macular thickness (μm)	265.17 ± 3.52	276.29 ± 2.22	<0.001

Values are presented as mean ± SD.

APAC = acute primary angle closure; BCVA = best corrected visual acuity; CCT = central corneal thickness.

Table 3.

Comparison of pRNFL parameter between eyes with APAC (group 1) and fellow eyes (group 2) measured by Cirrus HD-OCT

Parameter	Group 1	Group 2	p-value
Average (μm)	93.15 ± 5.15	102.18 ± 3.50	<0.001
Superior (μm)	105.42 ± 10.41	115.13 ± 9.89	0.002
Nasal (μm)	70.88 ± 8.56	77.63 ± 8.18	0.009
Temporal (μm)	77.83 ± 6.70	84.38 ± 7.02	0.001
Inferior (μm)	118.46 ± 10.77	131.58 ± 9.26	<0.001

Values are presented as mean ± SD.

APAC = acute primary angle closure; pRNFL = peripapillary retinal nerve fiber layer.

Table 4.

Comparison of mGC-IPL parameter between eyes with APAC (group 1) and fellow eyes (group 2) measured by Cirrus HD-OCT

Parameter	Group 1	Group 2	p-value
Average (μm)	79.44 ± 2.50	82.40 ± 2.70	0.002
Superotemporal (μm)	80.67 ± 3.36	83.08 ± 4.12	0.065
Superior (μm)	81.00 ± 3.48	83.54 ± 4.48	0.076
Superonasal (μm)	81.00 ± 5.12	83.04 ± 4.89	0.059
Inferonasal (μm)	78.29 ± 3.95	81.71 ± 3.99	0.002
Inferior (μm)	77.17 ± 1.76	80.67 ± 3.87	0.001
Inferotemporal (μm)	78.50 ± 3.61	82.38 ± 3.56	0.001

Values are presented as mean ± SD.

mGC-IPL = macular ganglion cell-inner plexiform layer; APAC = acute primary angle closure.

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