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Spatial summation in the glaucomatous macula: a link with retinal ganglion cell damage

Montesano, Giovanni, Redmond, Tony ORCID:, Mulholland, Pádraig J., Garway-Heath, David F., Ometto, Giovanni, Romano, Dario, Antonacci, Federica, Tanga, Lucia, Carnevale, Carmela, Rossetti, Luca M., Crabb, David P. and Oddone, Francesco 2023. Spatial summation in the glaucomatous macula: a link with retinal ganglion cell damage. Investigative Ophthalmology & Visual Science 64 (14) , 36. 10.1167/iovs.64.14.36

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Purpose: to test whether functional loss in the glaucomatous macula is characterised 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 glaucoma patients and 20 age-similar controls was tested with a 10-2 grid with stimuli of five different area sizes. Structural estimates of point-wise RGC density were obtained from Optical Coherence Tomography 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 glaucoma patients and agematched 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 change in RA). Root Mean Squared Error (RMSE) of the model fits to perimetric sensitivity were compared. 95%-Confidence Intervals were bootstrapped. The dynamic range of the functional and structural RGC density estimates was denoted by their 1st and the 99th percentile. Results: the RMSE was 2.09 [1.92-2.26] under H1 and 2.49 [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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Optometry and Vision Sciences
Publisher: Association for Research in Vision and Ophthalmology
ISSN: 0146-0404
Date of First Compliant Deposit: 3 October 2023
Date of Acceptance: 3 October 2023
Last Modified: 18 Jul 2024 21:42

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