Doctors should consider the impact of serous retinal detachment when using ganglion cell layer complex analysis (GCA) measurement to diagnose and manage patients with retinal contour changes, a new study suggests.
Researchers investigated the effects of the condition on GCA through spectral-domain optical coherence tomography (SD-OCT) in central serous chorioretinopathy (CSC) patients. Investigators reviewed the GCA of both acute episodes and after resolution of fluid.
During the acute stage of CSC with retinal elevation, the SD-OCT estimate of ganglion cell layer complex thickness was reduced, researchers noted. They found thickness returned to normal after resolution of the event and measurement error was at least partially responsible for this outcome. The reduction in ganglion cell layer complex thickness did not represent atrophy and was not predictive of a poor outcome, researchers said.
The study included a retrospective review of the records of 30 patients who visited the hospital with a first episode of CSC. Investigators analyzed SD-OCT GCA maps captured at the first visit of serous retinal elevation and after the absorption of subretinal fluid. For repeatability analysis, the study implemented intraclass correlation and repeatability coefficient from two consecutive measurements five minutes apart in 12 patients.
At the initial visit, the study reported the average thickness of ganglion cell layer complex was thinner than the measurement of the fellow eye (67.4 ± 27.4μm). However, after the absorption of subretinal fluid, it normalized to 87.0 ± 6.7μm—a statistically significant difference, researchers said. Investigators also found the intraclass correlation and repeatability coefficient were low during the period of serous elevation but normalized after fluid resorption. Abnormalities of GCA resulted from the segmentation error of ganglion cell layer and inner plexiform layer during the acute phase of CSC, the study noted.
“Serous retinal detachment can affect the GCA and repeatability measurements of the GCA. Clinicians should consider this finding when using the GCA measurement in the diagnosis and management of the patients with retinal contour changes such as retinal elevation including CSC,” the researchers wrote in their paper.
|Nam KY, Kim JY. Serous retinal detachment causes a transient reduction on spectral domain OCT estimates of ganglion cell layer thickness. Optom Vis Sci. February 7, 2019. [Epub ahead of print].|