PURPOSE To investigate the spatial characteristics and patterns of progressive macular ganglion cell-inner plexiform layer (GCIPL) thinning in glaucomatous eyes assessed by OCT Guided Progression Analysis (GPA). DESIGN Longitudinal, retrospective, observational study. PARTICIPANTS Two hundred ninety-two eyes of 192 patients with primary open-angle glaucoma with a mean follow-up of 6.0 years (range, 3.2-8.1 years) were included. METHODS Macular GCIPL imaging and visual field (VF) examination were performed at 6-month intervals for 3 years or more. Progressive GCIPL thinning was evaluated by a Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA) GPA device. Spatial characteristics of progressive GCIPL thinning were assessed by the GCIPL thickness change map. The pattern of progressive GCIPL thinning was evaluated by comparing the baseline GCIPL thickness deviation map and the final GCIPL thickness change map. Visual field progression was determined by Early Manifest Glaucoma Trial criteria and linear regression of the VF index. MAIN OUTCOME MEASURES Spatial characteristics and patterns of progressive GCIPL thinning. RESULTS Seventy-two eyes of 62 participants (24.7% [72/292]) showed progressive GCIPL thinning in the GCIPL thickness change map. Progressive GCIPL thinning was detected most frequently (25.0%) at 2.08 mm from the fovea, and it extended in an arcuate shape in the inferotemporal region (250°-339°). Compared with the baseline GCIPL defects, the progressive GCIPL thinning extended toward the fovea and optic disc. The most common pattern of progressive GCIPL thinning was widening of GCIPL defects (42 eyes [58.3%]), followed by deepening of GCIPL defects (19 eyes [26.4%]) and newly developed GCIPL defects (15 eyes [20.8%]). Visual field progression was accompanied by progressive GCIPL thinning in 41 of 72 eyes (56.9%). Progressive GCIPL thinning preceded (61.0% [25/41]) or occurred concomitantly with (21.9% [9/41]) VF progression. CONCLUSIONS The use of OCT GPA maps offers an effective approach to evaluate the topographic patterns of progressive GCIPL thinning in glaucomatous eyes. Progression of GCIPL thinning occurred before apparent progression on standard automated perimetry in most glaucomatous eyes. Understanding specific patterns and sequences of macular damage may provide important insights in the monitoring of glaucomatous progression.

中文翻译：

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用OCT检测青光眼中渐进性神经节细胞内柱状样层变薄的模式。

目的通过OCT引导进展分析（GPA）评估青光眼中进行性黄斑神经节细胞内丛状层（GCIPL）变薄的空间特征和模式。设计纵向，回顾性，观察性研究。研究对象192例原发性开角型青光眼患者的292眼，平均随访时间为6.0年（范围3.2-8.1年）。方法黄斑GCIPL成像和视野（VF）检查每隔6个月进行3年或更长时间。通过Cirrus HD-OCT（Carl Zeiss Meditec，都柏林，加利福尼亚）GPA设备评估了渐进式GCIPL稀化。通过GCIPL厚度变化图评估了进行中的GCIPL变薄的空间特征。通过比较基线GCIPL厚度偏差图和最终GCIPL厚度变化图来评估渐进式GCIPL变薄的模式。视野进展是通过早期清单性青光眼试验标准和VF指数的线性回归确定的。主要观察指标GCIPL逐渐变薄的空间特征和模式。结果62名参与者的72只眼（24.7％[72/292]）在GCIPL厚度变化图中显示出进行性GCIPL变薄。在距中央凹2.08 mm处，进行性GCIPL变薄最常见（25.0％），并且在颞下区域（250°-339°）呈弓形延伸。与基线GCIPL缺损相比，渐进性GCIPL变薄扩展到中央凹和视盘。进行性GCIPL减薄的最常见模式是扩大GCIPL缺损（42眼[58.3％]），然后加深GCIPL缺损（19眼[26.4％]）和新出现的GCIPL缺损（15眼[20.8％]）。视野进展伴随着渐进性GCIPL变薄在72眼中的41眼（56.9％）中。渐进性GCIPL变薄先于（61.0％[25/41]）或同时发生（21.9％[9/41]）VF进展。结论OCT GPA图的使用提供了一种有效的方法来评估青光眼中渐进性GCIPL变薄的地形图。在大多数青光眼眼中，在标准自动视野检查法上出现明显进展之前，发生了GCIPL变薄的进展。了解黄斑损伤的具体模式和顺序可能为监测青光眼的进展提供重要的见识。