Spatial Summation in the Glaucomatous Macula: A Link With Retinal Ganglion Cell Damage.

Autor:	Montesano G; City, University of London, Optometry and Visual Sciences, London, United Kingdom.; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom., Redmond T; School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom., Mulholland PJ; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.; Centre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom., Garway-Heath DF; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom., Ometto G; City, University of London, Optometry and Visual Sciences, London, United Kingdom., Romano D; ASST Santi Paolo e Carlo, Eye Clinic - University of Milan, Milan, Italy., Antonacci F; ASST Santi Paolo e Carlo, Eye Clinic - University of Milan, Milan, Italy., Tanga L; IRCCS Fondazione Bietti, Rome, Italy., Carnevale C; IRCCS Fondazione Bietti, Rome, Italy., Rossetti LM; ASST Santi Paolo e Carlo, Eye Clinic - University of Milan, Milan, Italy., Crabb DP; City, University of London, Optometry and Visual Sciences, London, United Kingdom., Oddone F; IRCCS Fondazione Bietti, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Investigative ophthalmology & visual science [Invest Ophthalmol Vis Sci] 2023 Nov 01; Vol. 64 (14), pp. 36.
DOI:	10.1167/iovs.64.14.36
Abstrakt:	Purpose: The purpose of this study was to test whether functional loss in the glaucomatous macula is characterized by an enlargement of Ricco's area (RA) through the application of a computational model linking retinal ganglion cell (RGC) damage to perimetric sensitivity. Methods: One eye from each of 29 visually healthy subjects <40 years old, 30 patients with glaucoma, and 20 age-similar controls was tested with a 10-2 grid with stimuli of 5 different area sizes. Structural estimates of point-wise RGC density were obtained from optical coherence tomography (OCT) scans. Structural and functional data from the young healthy cohort were used to estimate the parameters of a computational spatial summation model to generate a template. The template was fitted with a Bayesian hierarchical model to estimate the latent RGC density in patients with glaucoma and age-matched controls. We tested two alternative hypotheses: fitting the data by translating the template horizontally (H1: change in RA) or vertically (H2: loss of sensitivity without a change in RA). Root mean squared error (RMSE) of the model fits to perimetric sensitivity were compared. Ninety-five percent confidence intervals were bootstrapped. The dynamic range of the functional and structural RGC density estimates was denoted by their 1st and 99th percentiles. Results: The RMSE was 2.09 (95% CI = 1.92-2.26) under H1 and 2.49 (95% CI = 2.24-2.72) under H2 (P < 0.001). The average dynamic range for the structural RGC density estimates was only 11% that of the functional estimates. Conclusions: Macular sensitivity loss in glaucoma is better described by a model in which RA changes with RGC loss. Structural measurements have limited dynamic range.
Databáze:	MEDLINE
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