Ganglion Cell Complex Thickness May Foretell Glaucoma Deterioration

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Ophtalmological practice, Geneva, Switzerland, Carrying out OCT angiography to detect the presence of neovascularisation, angiography with autofluorescence and optical coherence tomography. (Photo by: BSIP/Universal Images Group via Getty Images)
Macular optical coherence tomography imaging aids in identifying glaucomatous changes in GCC thickness.

Ganglion cell complex (GCC) thickness may be the best measure for identifying structural progression in patients with moderate to severe glaucoma, according to research published in the American Journal of Ophthalmology. 

The prospective cohort study included 112 eyes of 112 participants with moderate to severe glaucoma at baseline. The average (SD) age and baseline 10-2 visual field mean deviation (MD) were 66.9 (8.5) years and -8.9 (5.9) dB, respectively. The average (SD) follow-up time was 3.6 (0.44) years. 

Full macular thickness (FMT) (54.9%) revealed the most significant negative slopes followed by GCC (36.5%), outer retina layers (ORL) (35.6%), ganglion cell/inner plexiform layer (GCIPL) (30.6%), and ganglion cell layer (GCL) (19.8%). 

Inner macular measures were less effective at detecting progression among patients with severe glaucoma, compared with GCC (22.6%), which detected the highest proportion (GCIPL: 18.6%; GCL: 10.8%). 

Although FMT observed a greater proportion of significantly reduced superpixels, GCC thickness consisted of more “clinically relevant information” for identifying structural change in the macular region, according to the researchers.

“We strongly recommend that GCC thickness measurements be made available for detection of disease progression on all OCT platforms,” according to researchers. “The addition of GCC measurements to the current algorithms for detection of change would facilitate and optimize detection of structural deterioration in glaucoma eyes.” 

Study limitations include a relatively short follow-up time. 


Mohammadzadeh V, Su E, Rabiolo A, et al. Ganglion cell complex: The optimal measure for detection of structural progression in the macula. Am J Ophthalmol. Published online December 20, 2021. doi:10.1016/j.ajo.2021.12.009