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

Montesano, G; Redmond, T; Mulholland, PJ; Garway-Heath, DF; Ometto, G; Romano, D; Antonacci, F; ... Oddone, F; + view all (2023) Spatial Summation in the Glaucomatous Macula: A Link With Retinal Ganglion Cell Damage. Investigative Ophthalmology & Visual Science , 64 (36) 10.1167/iovs.64.14.36. Green open access

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Abstract

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.

Type: Article
Title: Spatial Summation in the Glaucomatous Macula: A Link With Retinal Ganglion Cell Damage
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1167/iovs.64.14.36
Publisher version: https://doi.org/10.1167/iovs.64.14.36
Language: English
Additional information: Copyright © 2023 The Authors. This work is licensed under a Creative Commons Attribution 4.0 International License.
Keywords: Adult, Humans, Bayes Theorem, Glaucoma, Retinal Ganglion Cells, Tomography, Optical Coherence, Visual Field Tests, Visual Fields, Macular Degeneration
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/10183879
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