Thickness in Ganglion Cell-Inner Plexiform Layer on Spectral-Domain Optical Coherence Tomography after Cataract Surgery

Woo Beom Shin; Hyun Kyo Jeong; Ji Hyun Kim; Jun Mo Lee; Sa Min Hong; Chan Yun Kim; Gong Je Seong; Kyoung Soo Park

doi:10.3341/jkos.2015.56.11.1767

Journal List > J Korean Ophthalmol Soc > v.56(11) > 1010145

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Shin, Jeong, Kim, Lee, Hong, Kim, Seong, and Park: Thickness in Ganglion Cell-Inner Plexiform Layer on Spectral-Domain Optical Coherence Tomography after Cataract Surgery

Original Article

J Korean Ophthalmol Soc 2015;56(11):1767-1776.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.11.1767

Thickness in Ganglion Cell-Inner Plexiform Layer on Spectral-Domain Optical Coherence Tomography after Cataract Surgery

Woo Beom Shin, M.D¹, Hyun Kyo Jeong, M.D¹, Ji Hyun Kim, M.D¹, Jun Mo Lee, M.D¹, Sa Min Hong, M.D², Chan Yun Kim, M.D², Gong Je Seong, M.D², Kyoung Soo Park, M.D^1,

¹Siloam Eye Hospital, Seoul, Korea

²Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

Address reprint requests to Kyoung Soo Park, MD Siloam Eye Hospital, #181 Deungchon-ro, Gangseo-gu, Seoul 07668, Korea Tel: 82-2-2650-0880, Fax: 82-2-2650-0895 E-mail: march789@siloam.co.kr

Received 27 March 201529 June 2015 Accepted 21 August 2015

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

To assess changes in ganglion cell-inner plexiform layer (GCIPL) thickness after cataract surgery using spectral-do-main optical coherence tomography (OCT).

Methods

Forty-three eyes of 33 patients, who underwent cataract surgery were imaged with spectral-domain OCT before and after surgery to measure peripapillary retinal nerve fiber layer (RNFL) and GCIPL thickness, signal strength (SS), quadrant, 12 clock-hour RNFL thickness and sectoral GCIPL thickness.

Results

The postoperative SS, RNFL and GCIPL thickness were higher than before surgery ( p < 0.05). Multivariate analysis showed that endothelial cell count and preoperative SS were significantly correlated with SS changes in RNFL parameters and preoperative SS was significantly correlated with SS changes in GCIPL parameters. Univariate analysis indicated that age was significantly correlated with RNFL thickness changes in RNFL parameters and no factor was correlated with GCIPL thickness in GCIPL parameters ( p < 0.05).

Conclusions

Cataracts may decrease peripapillary RNFL and GCIPL thickness measurements and SS on OCT scans. Peripapillary RNFL and GCIPL thickness measurements should be interpreted with caution in eyes with significant cataracts.

Keywords: Cataract surgery, Ganglion cell-inner plexiform layer, Optical coherence tomography, Peripapillary retinal nerve fi-ber layer

References

1. Schuman JS, Hee MR, Puliafito CA. . Quantification of nerve fiber layer thickness in normal and glaucomatous eyes using opti-cal coherence tomography. Arch Ophthalmol. 1995; 113:586–96.

2. Huang D, Swanson EA, Lin CP. . Optical coherence tomo-graphy. Science. 1991; 254:1178–81.

3. Hee MR, Izatt JA, Swanson EA. . Optical coherence tomog-raphy of the human retina. Arch Ophthalmol. 1995; 113:325–32.

4. Guedes V, Schuman JS, Hertzmark E. . Optical coherence to mography measurement of macular and nerve fiber layer thickness in normal and glaucomatous human eyes. Ophthalmology. 2003; 110:177–89.

5. Wollstein G, Schuman JS, Price LL. . Optical coherence to-mography longitudinal evaluation of retinal nerve fiber layer thick-ness in glaucoma. Arch Ophthalmol. 2005; 123:464–70.

6. Sakata LM, Deleon-Ortega J, Sakata V, Girkin CA. Optical coher-ence tomography of the retina and optic nerve-a review. Clin Experiment Ophthalmol. 2009; 37:90–9.

7. Leung CK, Cheung CY, Weinreb RN. . Evaluation of retinal nerve fiber layer progression in glaucoma: a study on optical co-herence tomography guided progression analysis. Invest Ophthal-mol Vis Sci. 2010; 51:217–22.

8. Leung CK, Cheung CY, Weinreb RN. . Retinal nerve fiber lay-er imaging with spectral-domain optical coherence tomography: a variability and diagnostic performance study. Ophthalmology. 2009; 116:1257–63. 1263.e1-2.

9. Lee JR, Jeoung JW, Choi J. . Structure-function relationships in normal and glaucomatous eyes determined by time- and spec-tral-domain optical coherence tomography. Invest Ophthalmol Vis Sci. 2010; 51:6424–30.

10. Garas A, Vargha P, Holló G. Reproducibility of retinal nerve fiber layer and macular thickness measurement with the RTVue-100 op-tical coherence tomograph. Ophthalmology. 2010; 117:738–46.

11. Zeimer R, Asrani S, Zou S. . Quantitative detection of glau-comatous damage at the posterior pole by retinal thickness mapping. A pilot study. Ophthalmology. 1998; 105:224–31.

12. Ishikawa H, Stein DM, Wollstein G. . Macular segmentation with optical coherence tomography. Invest Ophthalmol Vis Sci. 2005; 46:2012–7.

13. Tan O, Li G, Lu AT. . Mapping of macular substructures with optical coherence tomography for glaucoma diagnosis. Ophthal-mology. 2008; 115:949–56.

14. Seong M, Sung KR, Choi EH. . Macular and peripapillary reti-nal nerve fiber layer measurements by spectral domain optical co-herence tomography in normal-tension glaucoma. Invest Ophthal-mol Vis Sci. 2010; 51:1446–52.

15. Stein DM, Wollstein G, Ishikawa H. . Effect of corneal drying on optical coherence tomography. Ophthalmology. 2006; 113:985–91.

16. Savini G, Zanini M, Barboni P. Influence of pupil size and cataract on retinal nerve fiber layer thickness measurements by Stratus OCT. J Glaucoma. 2006; 15:336–40.

17. Smith M, Frost A, Graham CM, Shaw S. Effect of pupillary dilata-tion on glaucoma assessments using optical coherence tomography. Br J Ophthalmol. 2007; 91:1686–90.

18. El-Ashry M, Appaswamy S, Deokule S, Pagliarini S. The effect of phacoemulsification cataract surgery on the measurement of reti-nal nerve fiber layer thickness using optical coherence tomo-graphy. Curr Eye Res. 2006; 31:409–13.

19. Sánchez-Cano A, Pablo LE, Larrosa JM, Polo V. The effect of pha-coemulsification cataract surgery on polarimetry and tomography measurements for glaucoma diagnosis. J Glaucoma. 2010; 19:468–74.

20. Mwanza JC, Bhorade AM, Sekhon N. . Effect of cataract and its removal on signal strength and peripapillary retinal nerve fiber layer optical coherence tomography measurements. J Glaucoma. 2011; 20:37–43.

21. Lee KS, Kim YM, Kim JH. . Changes in optic nerve parameter measurements on spectral-domain optical coherence tomography, after cataract surgery. J Korean Ophthalmol Soc. 2013; 54:1573–80.

22. Nakatani Y, Higashide T, Ohkubo S. . Effect of cataract and its removal on ganglion cell complex thickness and peripapillary reti-nal nerve fiber layer thickness measurements by fourier-domain optical coherence tomography. J Glaucoma. 2013; 22:447–55.

23. Firat PG, Ozsoy E, Demirel S. . Evaluation of peripapillary ret-inal nerve fiber layer, macula and ganglion cell thickness in am-blyopia using spectral optical coherence tomography. Int J Ophthalmol. 2013; 6:90–4.

24. Kim NR, Lee ES, Seong GJ. . Comparing the ganglion cell complex and retinal nerve fibre layer measurements by Fourier do-main OCT to detect glaucoma in high myopia. Br J Ophthalmol. 2011; 95:1115–21.

25. Park SJ, Moon YS, Kim NR. Difference of GCIPL thickness of diabetes and normal eyes in spectral domain OCT. J Korean Ophthalmol Soc. 2014; 55:1476–80.

26. Kim WJ, Kim KN, Kim CS. Comparison of diagnostic power among OCT parameters according to peripapillary atrophy in high myopic glaucoma. J Korean Ophthalmol Soc. 2013; 54:1844–55.

27. Lee HS, Park YS, Park SW. Change in the mGC-IPL in patients with a history of APAC according to SD-OCT. J Korean Ophthalmol Soc. 2014; 55:1167–73.

28. Budenz DL, Anderson DR, Varma R. . Determinants of normal retinal nerve fiber layer thickness measured by Stratus OCT. Ophthalmology. 2007; 114:1046–52.

29. Ray R, Stinnett SS, Jaffe GJ. Evaluation of image artifact produced by optical coherence tomography of retinal pathology. Am J Ophthalmol. 2005; 139:18–29.

30. Modjtahedi S, Chiou C, Modjtahedi B. . Comparison of mac-ular thickness measurement and segmentation error rate between stratus and fourier-domain optical coherence tomography. Ophthalmic Surg Lasers Imaging. 2010; 41:301–10.

31. von Jagow B, Ohrloff C, Kohnen T. Macular thickness after un-eventful cataract surgery determined by optical coherence tomo-graphy. Graefes Arch Clin Exp Ophthalmol. 2007; 245:1765–71.

32. Stifter E, Sacu S, Benesch T, Weghaupt H. Impairment of visual acuity and reading performance and the relationship with cataract type and density. Invest Ophthalmol Vis Sci. 2005; 46:2071–5.

33. Aydin A, Wollstein G, Price LL. . Optical coherence tomog-raphy assessment of retinal nerve fiber layer thickness changes af-ter glaucoma surgery. Ophthalmology. 2003; 110:1506–11.

34. Liu L, Zou J, Huang H. . The influence of corneal astigmatism on retinal nerve fiber layer thickness and optic nerve head parameter measurements by spectral-domain optical coherence tomography. Diagn Pathol. 2012; 7:55.

35. Cagini C, Fiore T, Iaccheri B. . Macular thickness measured by optical coherence tomography in a healthy population before and after uncomplicated cataract phacoemulsification surgery. Curr Eye Res. 2009; 34:1036–41.

36. Biro Z, Balla Z, Kovacs B. Change of foveal and perifoveal thick-ness measured by OCT after phacoemulsification and IOL implantation. Eye (Lond). 2008; 22:8–12.

37. Kusbeci T, Eryigit L, Yavas G, Inan UU. Evaluation of cystoid macular edema using optical coherence tomography and fundus fluorescein angiography after uncomplicated phacoemulsification surgery. Curr Eye Res. 2012; 37:327–33.

38. Ching HY, Wong AC, Wong CC. . Cystoid macular oedema and changes in retinal thickness after phacoemulsification with op-tical coherence tomography. Eye (Lond). 2006; 20:297–303.

39. Gharbiya M, Cruciani F, Cuozzo G. . Macular thickness changes evaluated with spectral domain optical coherence tomog-raphy after uncomplicated phacoemulsification. Eye (Lond). 2013; 27:605–11.

Figure 1.

Changes of RNFL and GCIPL thickness before (A, C) and after (B, D) cataract surgery in the left eye of a 69-year-old man. Signal strength, quadrant, 12 clock-hour, average RNFL thickness, sectoral, aver-age, minimum GCIPL thickness were higher than before surgery. Color codes of 9, 11 clock-hour RNFL thickness were changed after surgery. RNFL = retinal nerve fiber layer; GCIPL = ganglion cell-inner plexiform layer; S = superior; N = nasal; I = inferior; T = temporal; OS = oculus sinister; GCL = gan-glion cell layer; IPL = inner plexiform layer.

Table 1.

Clinical characteristics of patients

Characteristics	Data
Numbers (eyes:patients)	43:33
Age (years)	67.19 ± 6.95
Gender (male:female)	16:17
Eye (right:left:both)	10:13:10
SE (Diopter), preoperative	-0.30 ± 2.18
BCVA (log MAR), preoperative	0.25 ± 0.16
IOP (mm Hg), preoperative	14.28 ± 2.75
Types of lens opacities (cortical:nuclear:posterior)	26:12:5
Axial length (mm)	23.75 ± 1.04
Endothelial cell count (cells/mm²)	2,764.14 ± 335.18
Follow up (days)	59.19 ± 24.13

Values are presented as mean ± SD unless otherwise indicated. SE = spherical equivalent; BCVA = best corrected visual acuity; IOP = intraocular pressure.

Table 2.

Comparison of RNFL parameter between preoperative, postoperative data measured

Parameter	Preoperative	Postoperative	Difference	p-value^*
Signal strength	4.93 ± 1.23	5.99 ± 0.79	1.06 ± 1.22	<0.001
RNFL (μ m)
Superior	109.00 ± 17.58	118.72 ± 18.15	9.72 ± 9.10	<0.001
Nasal	62.72 ± 12.11	67.50 ± 9.27	7.07 ± 9.16	<0.001
Inferior	111.62 ± 18.24	122.81 ± 19.20	11.20 ± 8.20	<0.001
Temporal	64.80 ± 10.66	73.70 ± 13.52	6.61 ± 7.85	0.005
Clock hour
1	95.08 ± 23.07	102.43 ± 22.14	9.87 ± 9.84	<0.001
2	73.12 ± 13.88	78.86 ± 13.14	8.02 ± 6.80	<0.001
3	54.30 ± 11.91	60.77 ± 10.40	6.67 ± 6.52	<0.001
4	58.47 ± 11.03	62.86 ± 11.06	7.35 ± 6.54	<0.001
5	85.35 ± 15.67	94.19 ± 18.50	12.22 ± 11.08	<0.001
6	121.72 ± 25.82	130.50 ± 26.87	8.78 ± 13.86	<0.001
7	129.72 ± 22.59	142.05 ± 26.31	8.94 ± 9.61	<0.001
8	67.09 ± 15.98	75.40 ± 19.30	5.35 ± 14.09	<0.001
9	51.76 ± 7.35	60.71 ± 12.13	8.74 ± 7.82	<0.001
10	73.50 ± 11.35	84.37 ± 15.57	8.59 ± 9.87	<0.001
11	114.00 ± 22.14	126.76 ± 24.17	10.23 ± 12.98	<0.001
12	116.76 ± 23.47	125.81 ± 24.42	9.06 ± 13.95	<0.001
Average	87.48 ± 10.37	95.52 ± 11.85	8.05 ± 7.06	<0.001

Values are presented as mean ± SD unless otherwise indicated.

RNFL = retinal nerve fiber layer.

p-value was calculated by paired t-test.

Table 3.

Comparison of GCIPL parameter between preoperative, postoperative data measured ^*

Parameter	Preoperative	Postoperative	Difference	p-value^*
Signal strength	5.67 ± 1.23	6.76 ± 0.95	1.08 ± 1.30	<0.001
Average thickness (μ m)	79.37 ± 6.26	84.90 ± 7.92	5.52 ± 3.92	<0.001
Superotemporal thickness (μ m)	80.21 ± 6.35	86.65 ± 7.62	7.77 ± 11.25	<0.001
Superior thickness (μ m)	80.54 ± 6.76	85.88 ± 7.71	5.35 ± 2.79	<0.001
Superonasal thickness (μ m)	79.28 ± 11.05	86.01 ± 10.91	5.41 ± 5.77	0.001
Inferonasal thickness (μ m)	77.34 ± 7.19	83.35 ± 12.86	5.70 ± 9.79	<0.001
Inferior thickness (μ m)	76.47 ± 8.79	82.35 ± 7.31	5.88 ± 6.21	<0.001
Inferotemporal thickness (μ m)	80.09 ± 7.52	86.19 ± 8.68	6.41 ± 6.17	<0.001

Values are presented as mean ± SD unless otherwise indicated.

GCIPL = ganglion cell-inner plexiform layer.

^* p-value was calculated by paired t-test.

Table 4.

Factors associated with SS changes in RNFL parameter

Variables	Regression coefficient	p-value^*
Age (years)	0.10	0.51
LOCS score	0.11	0.50
Endothelial cell count (cells/mm²)	-0.32	0.03
Axial length (mm)	-0.06	0.73
BCVA (log MAR), preoperative	0.36	0.02
IOP (mm Hg), preoperative	-0.31	0.04
SE (Diopter), preoperative	-0.14	0.37
SS, preoperative	-0.79	<0.001

SS = signal strength; RNFL = retinal nerve fiber layer; LOCS = lens opacification classification system; BCVA = best corrected visual acuity; IOP = intraocular pressure; SE = spherical equivalent.

^* p-value was calculated by univariate analysis.

Table 5.

Factors associated with SS changes in GCIPL parameter

Variables	Regression coefficient	p-value^*
Age (years)	-0.11	0.49
LOCS score	0.14	0.37
Endothelial cell count (cells/mm²)	-0.30	0.047
Axial length (mm)	-0.09	0.56
BCVA (log MAR), preoperative	0.43	0.004
IOP (mm Hg), preoperative	-0.33	0.03
SE (Diopter), preoperative	-0.01	0.94
SS, preoperative	-0.72	<0.001

SS = signal strength; GCIPL = ganglion cell-inner plexiform layer; LOCS = lens opacification classification system; BCVA = best corrected visual acuity; IOP = intraocular pressure; SE = spherical equivalent.

^* p-value was calculated by univariate analysis.

Table 6.

Factors associated with average RNFL thickness changes in RNFL parameter

Variables	Regression coefficient	p-value^*
Age (years)	-0.39	0.01
LOCS score	0.02	0.92
Endothelial cell count (cells/mm²)	-0.03	0.85
Axial length (mm)	0.25	0.11
BCVA (log MAR), preoperative	0.04	0.81
IOP (mm Hg), preoperative	0.01	0.95
SE (Diopter), preoperative	-0.04	0.79
SS, preoperative	0.06	0.72

RNFL = retinal nerve fiber layer; LOCS = lens opacification classification system; BCVA = best corrected visual acuity; IOP = intraocular pressure; SE = spherical equivalent; SS = signal strength.

^* p-value was calculated by univariate analysis

Table 7.

Factors associated with average GCIPL thickness changes in GCIPL parameter

Variables	Regression coefficient	p-value^*
Age (years)	-0.25	0.11
LOCS score	-0.02	0.89
Endothelial cell count (cells/mm²)	-0.06	0.71
Axial length (mm)	-0.07	0.65
BCVA (log MAR), preoperative	-0.08	0.62
IOP (mm Hg), preoperative	0.08	0.61
SE (Diopter), preoperative	0.25	0.10
SS, preoperative	0.12	0.45

GCIPL = ganglion cell-inner plexiform layer; LOCS = lens opacification classification system; BCVA = best corrected visual acuity; IOP = intraocular pressure; SE = spherical equivalent; SS = signal strength.

^* p-value was calculated by univariate analysis.

Table 8.

Factors associated with SS changes

Variables	In RNFL parameter		In GCIPL parameter
	Regression coefficient	p-value^*	Regression coefficient	p-value^*
Endothelial cell count (cells/mm²)	-0.32	0.03	-0.30	0.27
BCVA (log MAR), preoperative	0.34	0.71	0.37	0.37
IOP (mm Hg), preoperative	-0.31	0.61	-0.32	0.56
SS, preoperative	-0.79	<0.001	-0.72	<0.001

SS = signal strength; RNFL = retinal nerve fiber layer; GCIPL = ganglion cell-inner plexiform layer; BCVA = best corrected visual acuity; IOP = intraocular pressure.

^* p-value was calculated by multivariate analysis.

TOOLS

Similar articles