Direct Ganglion Cell Assessment with the RTVue: The Ganglion Cell Complex Analysis

Glaucoma is a multi-factorial optic neuropathy characterized by a loss of retinal ganglion cells with resulting visual impairment. The macula region contains over 50% of all retinal ganglion cells and is likely an ideal region to detect early cell loss and changes over time because of the high density of cells. Retinal ganglion cells encompass three layers in the retina, 1) the retinal nerve fiber layer (NFL) is made up of the ganglion cell axons, 2) the ganglion cell layer (GCL) is made up of the ganglion cell bodies, and 3) the inner-plexiform layer (IPL) is made up of the ganglion cell dendrites. All three layers, collectively known as the ganglion cell complex (GCC), become thinner as the ganglion cells die from glaucoma. The RTVue directly measures the thickness of these 3 layers and provides a unique analysis of the percent loss of these layers compared to an extensive normative database. The results are presented as significant loss from normal which makes clinical interpretation straightforward.