Can We Corroborate Peripapillary RNFL Analysis with Macular GCIPL Analysis? Our 2-Year Experience at a Single-Centre Tertiary Healthcare Hospital Using Two OCT Machines and a Review of Literature

Figures & data

Figure 1 Representative screen-capture for GCL analysis on the Spectralis SD-OCT.

Figure 2 Representative screen-capture for GCIPL analysis on the Cirrus SD-OCT.

Table 1 Comparison of Demographic Factors Between Groups

	Group I	Group II	Group III
AGE in yrs
Mean ± SD	55.04 ± 8.32	54.76 ± 7.95	54.24 ± 7.66	p = 0.293
Range (Min-Max)	42–69	41–69	41–69
Sex
Males	242	238	248
Females	218	222	212	p = 0.729

Table 2 Comparison of RNFL Thickness Parameters Between the Groups by Cirrus HD-OCT

RNFL in um	Group I	Group II	Group III
Average RNFL
Mean ± SD	107.09 ± 6.21	92.78 ± 10.37	77.43 ± 10.61
Range (Min-Max)	95–130	68–115	60–103
p value	p < 0.001 (Gr. I vs Gr. II)	p < 0.001 (Gr. II vs Gr. III)	p < 0.001 (Gr. I vs Gr. III)
Superior RNFL
Mean ± SD	225.65 ± 10.57	214.13 ± 18.46	173.2 ± 32.75
Range (Min-Max)	201–257	200–226	128–293
p value	p = 0.025 (Gr. I vs Gr. II)	p < 0.001 (Gr. II vs Gr. III)	p < 0.001 (Gr. I vs Gr. III)
Nasal RNFL
Mean ± SD	88.09 ± 7.22	87.39 ± 10.57	86.98 ± 10.34
Range (Min-Max)	75–112	54–90	37–86
p value	p = 0.560 (Gr. I vs Gr. II)	p = 0.159 (Gr. II vs Gr. III)	p = 0.905 (Gr. I vs Gr. III)
Inferior RNFL
Mean ± SD	227.78 ± 10.26	201.76 ± 18.12	186.54 ± 13.36
Range (Min-Max)	202–253	197–266	133–262
p value	p < 0.001 (Gr. I vs Gr. II)	p < 0.001 (Gr. II vs Gr. III)	p < 0.001 (Gr. I vs Gr. III)
Temporal RNFL
Mean ± SD	85.87 ± 9.12	86.35 ± 10.66	73.13 ± 10.95
Range (Min-Max)	78–114	52–92	38–88
p value	p = 0.956 (Gr. I vs Gr. II)	p = 0.091 (Gr. II vs Gr. III)	p = 0.104 (Gr. I vs Gr. III)

Table 3 Comparison of GCIPL Thickness Parameters Between the Groups by Cirrus HD-OCT

GCIPL in um	Group I	Group II	Group III
Average GCIPL
Mean ± SD	161.52 ± 7.27	153.73 ± 4.99	143.72 ± 7.19
Range (Min-Max)	134.3–170.5	144.9–166.1	130.1–169.6
p value	p < 0.001 (Gr. I vs Gr. II)	p < 0.001 (Gr. II vs Gr. III)	p < 0.001 (Gr. I vs Gr. III)
Superior GCIPL
Mean ± SD	188.21 ± 7.16	178.34 ± 6.52	153.89 ± 8.22
Range (Min-Max)	168–216	159–201	143–172
p value	p < 0.001 (Gr. I vs Gr. II)	p < 0.001 (Gr. II vs Gr. III)	p < 0.001 (Gr. I vs Gr. III)
Nasal GCIPL
Mean ± SD	109.21 ± 6.44	95.74 ± 6.44	80.14 ± 6.53
Range (Min-Max)	89.5–119.0	81.5–112.5	61.5–99.0
p value	p = 0.368 (Gr. I vs Gr. II)	p = 0.211 (Gr. II vs Gr. III)	p = 0.493 (Gr. I vs Gr. III)
Inferior GCIPL
Mean ± SD	194.39 ± 10.32	190.87 ± 11.22	189.85 ± 13.61
Range (Min-Max)	166–211	165–220	159–219
p value	p < 0.001 (Gr. I vs Gr. II)	p < 0.001 (Gr. II vs Gr. III)	p < 0.001 (Gr. I vs Gr. III)
Temporal GCIPL
Mean ± SD	109.17 ± 7.16	98.22 ± 6.52	76.08 ± 8.22
Range (Min-Max)	85.5–118.5	83–107.5	66–103
p value	p = 0.841 (Gr. I vs Gr. II)	p = 0.133 (Gr. II vs Gr. III)	p = 0.493 (Gr. I vs Gr. III)

Table 4 Comparison of Macular Volume Between the Groups by Cirrus HD-OCT

Macular Volume in um^3	Group I	Group II	Group III
Mean ± SD	8.75 ± 0.18	8.34 ± 0.18	8.04 ± 0.23
Range (Min–Max)	8.23–9.08	7.83–8.68	7.67–8.68	p < 0.001

Table 5 Comparison of AUROCs Between the Groups

Comparison	AUROC	Sn (%)	Sp (%)	PPV (%)	NPV (%)	Accuracy (%)
Group I vs II	p < 0.001
AVG GCIPL	0.867	80.4	84.8	84.1	81.3	82.6
AVG RNFL	0.884	73.9	95.7	94.4	78.6	84.8
SUP. GCIPL	0.864	76.1	84.8	83.3	78.0	80.4
SUP. RNFL	0.697	56.5	89.1	83.9	67.2	72.8
INF. GCIPL	0.94	89.1	91.3	91.1	89.4	92.6
INF. RNFL	1.00	100	100	100	100	100
Group II vs III	p < 0.001
AVG GCIPL	0.896	82.6	89.1	88.4	83.7	85.9
AVG RNFL	0.849	87	56.1	66.4	81.1	71.5
SUP. GCIPL	0.97	91.5	63	71.2	88.1	77.3
SUP. RNFL	0.88	71.6	100	100	78.2	85.9
INF. GCIPL	0.952	91.3	89.1	89.4	91.1	90.2
INF. RNFL	1.00	100	100	100	100	100
Group I vs III	p < 0.001
AVG GCIPL	0.937	89.1	95.7	95.3	89.8	92.4
AVG RNFL	0.992	93.5	100	100	93.9	96.7
SUP. GCIPL	0.997	93.5	100	100	93.9	96.7
SUP. RNFL	0.947	91.5	100	100	92.2	95.8
INF. GCIPL	0.992	97.8	95.7	95.7	97.8	96.7
INF. RNFL	1.00	100	100	100	100	100

Figure 3 AUROCs for average, superior and inferior RNFL + GCIPL parameters between the groups.

Table 6 Review of Literature for Studies Pertaining to Role of GCC in Pre-Perimetric and Perimetric Glaucoma

Sr. No	Study Year	Study Group	Sample Size	Sample Population	OCT Machine Used	Limitation
1.	Feb 2013	Kim NR et al18	51	NTG + POAG + Controls	RT-Vue 100 FD-OCT	Small sample size; Pre-perimetric not assessed
2.	Mar 2013	Firat PG et al19	52	NTG + POAG + Controls	Undefined SD-OCT	Small sample size; Pre-perimetric not assessed
3.	Dec 2013	Na JH et al20	105	Pre-perimetric glaucoma + Controls	RT-Vue 100 FD-OCT	Small sample size; Controls lost to attrition
4.	Jan 2015	Bhagat P et al21	62	Pre-perimetric + Perimetric + Controls	Topcon model 2000 version 7.1 SD-OCT	Small sample size
5.	July 2015	Oli A et al22	33	Pre-perimetric + Perimetric + Controls	Cirrus HD OCT	Small sample size; Power of study weak
6.	Nov 2015	Fujimura F et al23	12	Pre-Perimetric + Perimetric (only sup. hemifield) + Controls	Cirrus HD OCT (Ver. 6.0 Zeiss)	Small sample size; heterogenous sample
7.	Dec 2015	Tiryaki Demir S et al24	72	Early POAG + OHT + Controls	RT-Vue 100 FD-OCT	Small sample size; Pre-perimetric not assessed; No longterm followup serial GCC scans
8.	May 2016	Barua N et al25	78	POAG + OHT + Controls	RT-Vue v6.3 FD-OCT	Small sample size; Pre-perimetric not assessed
9.	Oct 2016	Cennamo G et al26	41	Pre-Perimetric + Mild POAG + Mod POAG + Severe POAG	Undefined SD-OCT	Small sample size; No control group
10.	Mar 2017	Kita Y et al27	48	Pre-perimetric + Perimetric + Controls	RS-3000 Advance SD-OCT	Small sample size; Myopia and mod-severe visual field damage excluded; sample population only Japanese
11.	July 2016	Khanal S et al29	30	NTG + POAG		Small sample size; Pre-perimetric not assessed
12.	Mar 2018	Kaushik S et al30	47	POAG + Suspects + Controls	Cirrus SD-OCT v3.0.0.64	No longterm followup serial GCC scans

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