Does macular ganglion cell topography correlate better with the pattern of visual field loss than peripapillary retinal nerve fiber layer analysis in patients with neuro-ophthalmic disease?

Purpose: A retrospective observational case series of patients with neuro-ophthalmic disease in whom; macular ganglion cell layer (m-GCL) thickness determined by mapping on spectral domain optical coherence tomography (SD-OCT) was correlated with the pattern of vision loss. Methods: Five representative cases with diagnosis of optic neuritis, non-arteritic anterior ischemic optic neuropathy (NAION), idiopathic intracranial hypertension (IIH), pituitary adenoma with chiasmal compression, and posterior cerebral artery (PCA) infarct were selected retrospectively. All had undergone a complete ocular evaluation, visual fields, SD-OCT, and neuro-imaging. Results: m-GCL thickness and deviation maps correlated much better with visual field defects in all cases than the pp-RNFL analysis. Conclusion: m-GCL analysis could bring a direct correlation to visual field loss, a better understanding of the disease mechanisms, and can be an effective tool in diagnosing and monitoring retinal structural changes in neuro-ophthalmic conditions; especially when visual fields are not feasible.