Early Detection of Structural Retinal Changes in Young Offspring of Glaucoma Patients Using Spectral Domain Optical Coherence Tomography

Abstract Purpose: To evaluate and compare retinal nerve fibre layer (RNFL) thickness and ganglion cell complex (GCC) parameters using Spectral domain optical coherence tomography (SD-OCT) in young offspring of glaucoma patients versus age-matched controls. Methods: This prospective cross-sectional study was conducted from 1 May to 31 October 2023, at a tertiary eye care centre in central India. A total of 61 participants were enrolled, comprising 30 subjects (60 eyes) in Group 1 (young offspring of glaucoma patients aged between 18 and 25 years) and 31 subjects (62 eyes) in Group 2 (age-matched controls without a family history of glaucoma). All participants underwent SD-OCT to assess RNFL thickness and GCC measurements. Results: Group 1 demonstrated significantly reduced RNFL thickness in the superonasal (124.20 ± 23.11 μm, P = 0.02) and inferonasal quadrants (114.90 ± 21.65 μm, P = 0.003) compared to Group 2. Similarly, mean GCC (89.52 ± 6.32 μm, P = 0.03) and superior GCC (89.02 ± 6.17 μm, P = 0.01) were significantly thinner in Group 1, indicating early structural retinal changes. Conclusion: SD-OCT enables detection of subtle structural alterations in RNFL and GCC before the onset of functional deficits in glaucoma. Screening young individuals with a positive family history of glaucoma using SD-OCT may facilitate early diagnosis and timely intervention, potentially reducing long-term visual morbidity.