Formes cliniques de glaucome maculaire en tomographie en cohérence optique

Glaucomatous damage of the macular area is varied: it can be sector-based or diffused, possibly with peripheral damage. The author has developed an original manual method for mapping the retinal ganglion layer as well as a 1200 μm circular section around the fovea, using a Topcon 3D OCT 1000, which reveals the glaucomatous structural damage of the macula. Several examples show that the most reliable tool for early examination of the condition of the macula is the OCT of the ganglion cell complex at the perifoveolar raised edge. It is much more reliable than the papillary OCT of optical fibers, which does not give significant information on macular damage, and visual field examination, which is often too late. The role of the ganglion cell complex OCT is specified: to confirm visual field defects, if they do exist, and more importantly, to anticipate them; to establish a specified relation between structure and function. Although OCT of the ganglion cell complex is useful in all cases to estimate the severity of glaucoma, this study shows that it has become essential in cases of isolated macular damage. This is the only examination that can detect this in a timely manner and prevent the appearance of a nonreversible juxtafoveolar scotoma and the risk of blindness.