Macular Cube Scans Reveal Diagnoses That Ganglion Cell Analysis Alone May Miss

Reviewing the full macular cube scans from ocular coherence tomography (OCT) imaging reveals nonglaucomatous macular pathology that is missed when reviewing ganglion cell analysis (GCA) alone, according to research published in JAMA Ophthalmology.

Researchers conducted a retrospective cross-sectional analysis to determine the frequency and type of nonglaucomatous macular findings observable in the full macular cube scan but not the GCA printout. They used data from consecutive patients undergoing ganglion cell complex imaging during routine glaucoma evaluations at a tertiary care academic center.

The study included 201 eyes of 105 patients (mean age, 67 years; 60% women, 40% men). The investigators reported suspected glaucoma in 31.7% of eyes, open-angle glaucoma in 62.4% of eyes, closed-angle glaucoma in 3.0% of eyes, and other glaucoma in 3.0% of eyes. 

The team found nonglaucomatous macular pathology in 32.2% of eyes with macular cube scans and reported that 38.5% of these cases included findings that were not visible on the GCA printout. They reported that 64.0% of those cases had macular pathology that required further evaluation.

“These additional findings may alter clinical care decisions based on the discovery of nonglaucomatous macular pathology or by demonstrating artifacts that may influence interpretations of stability or progression,” explained the researchers. “Clinicians should consider reviewing all the data that are captured to ensure they provide optimal patient care, although it is unknown if this missed pathology affects clinical outcomes at this time.”

Limitations of the study included the retrospective design, potential selection bias, and review of the full macular cube findings at the time of the clinical examination.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.