What question did this study set out to answer?

Evaluate the diagnostic performance of retinal metrics in differentiating healthy eyes from different glaucoma types.

March 26, 2026Open Access

Comparison of Macular Ganglion Cell–Inner Plexiform Layer Thickness and Sectoral Ratio Asymmetry Among Different Glaucoma Types

Key Points

Evaluate the diagnostic performance of retinal metrics in differentiating healthy eyes from different glaucoma types.
Retrospective analysis of 204 eyes from 204 patients across four groups: healthy controls, PACG, POAG, and SOAG.
Participants underwent spectral-domain optical coherence tomography (OCT).
Measured peripapillary RNFL thickness and GCIPL thickness, including asymmetry ratios.
Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis.
Average RNFL thickness showed the highest diagnostic performance for differentiating POAG from healthy controls (AUC = 0.82).
No parameter reached an AUC of ≥0.80 for PACG or SOAG comparisons.
GCIPL asymmetry ratios had limited discriminative ability.
POAG vs SOAG comparisons yielded AUC values up to 0.66, while PACG vs SOAG comparisons showed minimal discrimination.

Abstract

Background: In this study, we aimed to evaluate and compare the diagnostic performance of peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell–inner plexiform layer (GCIPL) thickness, and GCIPL asymmetry parameters in differentiating healthy eyes from primary angle-closure glaucoma (PACG), primary open-angle glaucoma (POAG), and secondary open-angle glaucoma (SOAG). Methods: This retrospective study included 204 eyes of 204 patients categorized into four groups: healthy controls (n = 46), PACG (n = 53), POAG (n = 58), and SOAG (n = 47). All participants underwent spectral-domain optical coherence tomography (OCT). Peripapillary RNFL thickness, sectoral and average GCIPL thickness, and GCIPL-derived asymmetry ratios were analyzed. Diagnostic performance was assessed using receiver operating characteristic (ROC) analysis. Results: Diagnostic accuracy varied according to glaucoma subtype. In distinguishing POAG from healthy controls, the average RNFL thickness (area under the ROC curve AUC = 0.82) demonstrated the highest diagnostic performance, followed by the superotemporal, inferotemporal, and average GCIPL thickness parameters. In contrast, no parameter reached an AUC of ≥0.80 in the PACG or SOAG comparisons. GCIPL asymmetry ratios exhibited limited discriminative ability across most analyses. Subtype differentiation was modest; POAG versus SOAG comparisons yielded AUC values up to 0.66, whereas PACG versus SOAG comparisons demonstrated minimal discrimination (AUC range: 0.47–0.63). Conclusions: Peripapillary RNFL and localized temporal GCIPL thickness measurements provide the highest diagnostic accuracy for identifying POAG. Diagnostic performance is reduced in PACG and SOAG, and the OCT parameters show limited ability to differentiate between glaucoma subtypes. GCIPL asymmetry indices do not enhance diagnostic discrimination beyond direct thickness measurements.

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Cite This Study

Çetin et al. (Tue,) studied this question.

synapsesocial.com/papers/69c4ccc9fdc3bde4489185d5 https://doi.org/https://doi.org/10.3390/diagnostics16070959

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