Analyse du complexe cellulaire ganglionnaire maculaire (GCC) en tomographie par cohérence optique (SD-OCT) dans le glaucome

Early detection of ganglion cell loss is possible with new algorithms for the assessment of the Macular Ganglion Cell Complex (GCC) by SD-OCT. The various data acquisition protocols used by the various versions of software, as well as their accuracy and reproducibility, must be taken into account. Current results show similar ability to detect glaucoma as compared to Retinal Nerve Fiber Layer thickness (RNFL), with some limitations, possible artifacts, and interpretation pitfalls which must be taken into account. The role of the significance map and of various indices (Focal Loss Volume, Global Loss Volume, GCIPL minimum…); data obtained in the setting of various clinical entities (tilted disc, peripapillary atrophy, large and small optic discs, high myopia…); and detection of progression, especially in advanced glaucoma, underline the role of macular GCC analysis as a complementary method to peripapillary RNFL thickness. The diagnostic precision and better reproducibility of these new software protocols offer new perspectives in the detection and management of progression in various stages of the management of glaucomatous optic neuropathy.