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Optical coherence tomography of the macular ganglion cell complex is increasingly important for detecting structural change in glaucoma, particularly when visual-field testing is noisy or early disease limits perimetric sensitivity. This 2024 retrospective study evaluated 205 eyes followed for a mean of 5.7 years and compared visual-field progression with OCT assessment of the macular ganglion cell complex and peripapillary retinal nerve fibre layer. The investigators found that visual fields identified more progression in moderate-to-advanced glaucoma, while RNFL measurements were more informative in mild disease until the floor effect limited their usefulness. Macular GCC analysis showed the highest agreement with visual-field progression across severity levels in the study population. For HCPs, the practical message is to treat structural and functional testing as complementary rather than competing tools. Serial OCT can provide objective evidence of change when visual fields are unreliable, while visual fields remain essential for understanding functional impact. AIOC's glaucoma programme specifically highlights automated perimetry and early OCT ganglion-cell detection, making this evidence directly relevant to those sessions.
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Optical coherence tomography of the macular ganglion cell complex is increasingly important for detecting structural change in glaucoma, particularly when visual-field testing is noisy or early disease limits perimetric sensitivity. This 2024 retrospective study evaluated 205 eyes followed for a mean of 5.7 years and compared visual-field progression with OCT assessment of the macular ganglion cell complex and peripapillary retinal nerve fibre layer. The investigators found that visual fields identified more progression in moderate-to-advanced glaucoma, while RNFL measurements were more informative in mild disease until the floor effect limited their usefulness. Macular GCC analysis showed the highest agreement with visual-field progression across severity levels in the study population. For HCPs, the practical message is to treat structural and functional testing as complementary rather than competing tools. Serial OCT can provide objective evidence of change when visual fields are unreliable, while visual fields remain essential for understanding functional impact. AIOC's glaucoma programme specifically highlights automated perimetry and early OCT ganglion-cell detection, making this evidence directly relevant to those sessions.
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