DIAGNOSTIC VALUE OF OPTICAL COHERENCE TOMOGRAPHY IN THE ASSESSMENT OF RETINAL GANGLION CELL COMPLEX IN PATIENTS WITH GLAUCOMA AND MYOPIA

Abstract

Purpose – to determine the nature of changes in the ganglion cell complex (GCC) in combination with glaucoma and high myopia.

Material and methods

Using optical coherence tomography (OCT), 55 patients were examined, divided into four groups: glaucoma + myopia, glaucoma, myopia, emmetropia.
All patients underwent a standard ophthalmological examination, including visometry, biomicroscopy, gonioscopy, tonometry, refractometry, paximetry, ophthalmoscopy, and determination of the anterior-posterior (AP) axis of the eye. Morphological changes in the retina and optic nerve were assessed using ophthalmoscopy and OCT (DRI OCT Triton). In this case, the main criteria characterizing pathological changes in the optic disc, according to OCT data, were the size of the excavation and the thickness of the nerve fiber layer.

Results

Analysis of the neuroretinal complex state according to OCT data in a group of patients with myopia showed a decrease in the thickness of nerve fibers by an average of 7%. When distributing patients depending on the length of the eyeball, it was revealed that the indicators characterizing the thickness of the retinal GCC were within the physiological norm. A comparative analysis of the neuroretinal complex state according to OCT data was performed in patients with glaucoma against the background of myopia and patients with glaucoma. The corneal thickness in the glaucoma + myopia group of patients averaged 531.2 ± 28.84 μm. Intraocular pressure (IOP) in this group of patients averaged 12.8±3.5 mm Hg. In patients with glaucoma the average IOP was 17.3 ± 4.09 mm Hg.

Conclusion

In patients with myopia, a consistent decrease in the thickness of the retinal GCC is observed as the axial length of the eye lengthens, but within the physiological norm. In cases where the AP axis exceeds 25-26 mm, it is important to consider that the initial decrease in the thickness of the iris can be caused not only by the glaucomatous process, but also by changes in the retina characteristic of myopia.