Purpose: To compare macular thickness measurements using time-domain optical coherence tomography (OCT) and Fourier-domain OCT. Methods: Thirty-two eyes from 32 normal patients underwent complete ophthalmic evaluation. Macular scanning using the StratusOCT and the RTVue-100 OCT were performed for a total of three times each on the same visit. The average retinal thicknesses of the nine macular sectors as defined by the Early Treatment Diabetic Retinopathy Study, along with the foveal center point and macular volume, were recorded. The SD, the coefficient of variation, and the intraclass correlation coefficient were calculated for each parameter studied. Comparisons were made between the two OCTs in terms of retinal thicknesses measurements, their reproducibility, and macular regional differences. Correlations between retinal thickness and demographic variables (age and gender) were also investigated. Due to known differences in segmentation algorithms of the two OCTs, software calipers were used to measure the distance from the internal limiting membrane to the photoreceptor inner segment–outer segment junction at the foveal center point on all RTVue scans to allow a more fair comparison. Results: The RTVue yielded greater retinal thickness measurements in nearly all macular subfields compared with the StratusOCT. Even after accounting for differences in segmentation algorithms, significant disparities were still evident with the RTVue measurements less than those of the StratusOCT at the foveal center. On both machines, the macula was thinnest at the fovea and thickest within the 3 mm ring. There were some consistent regional variations in macular thickness evident on both OCTs. Compared with the StratusOCT, the RTVue generally had lower coefficients of variation and higher intraclass coefficients, suggesting better reproducibility. Age and gender also appeared to be important determinants in some macular thickness parameters. Conclusion: Compared with StratusOCT, the RTVue fourier-domain OCT yields greater retinal thickness measurements with greater reproducibility, presumably due to different segmentation algorithms, increased sampling density, and greater resolution. However, regional differences across the macula can be consistently observed with both devices.

Primary open angle glaucoma (POAG) is the leading cause of irreversible blindness. Dysfunction of the trabecular meshwork (TM), resulting in decreased outflow of aqueous humor and increased intraocular pressure (IOP), plays an important role in the pathogenesis of POAG. However, the underlying mechanisms still remain unclear. In this study, we demonstrated that the eIF2-α/ATF4/CHOP branch of unfolded protein response (UPR) was activated in human trabecular meshwork cells (HTMCs) upon tert-butyl hydroperoxide (TBHP) exposure. Inhibition of ATF4 ameliorated TBHP-induced apoptosis and inflammatory cytokine production, while ectopic expression of ATF4 increased the expression of endothelial leukocyte adhesion molecule (ELAM)-1 and IL-8 in HTMCs. Furthermore, we found that ATF4 inhibition reduced tunicamycin-induced caspase-3 activation, ROS production, ELAM-1 expression, and HTMCs phagocytosis impairment. By an in vivo study in mice, we showed that overexpression of ATF4 in the TM induced C/EBP homologous protein (CHOP) expression and TM cells apoptosis, contributing to inflammatory cytokine production, and probably IOP elevation. More importantly, upregulation of ATF4 and CHOP, and colocalization of ATF4 with ELAM-1 were found in the TM of POAG patients. These results suggest that ATF4 is a critical mediator of oxidative stress and ER stress-induced TM cell dysfunction and apoptosis in POAG.

Purpose: To describe morphologic features of traumatic macular holes on optical coherence tomography and to correlate them with clinical findings. Methods: Seventy-three consecutive patients diagnosed with full-thickness traumatic macular holes involving the fovea underwent complete ophthalmic evaluation followed by horizontal and vertical line scans using the Stratus optical coherence tomography. Retinal thickness at the edges of the holes, apical and basal diameters, and various clinical parameters were recorded. The approximate apical and basal areas and eccentricities of the holes were calculated. Morphologic parameters were correlated with clinical findings. Results: On the basis of optical coherence tomography findings, traumatic macular holes were classified into five morphologic types with varying average retinal thicknesses, apical areas, and basal areas. Patients who presented >90 days after injury had greater average retinal thickness (P = 0.03) and apex areas (P = 0.002) compared with those who presented within 90 days. Older patients developed more circular holes, i.e., less eccentricity of the apex (P = 0.04) and base (P = 0.01). Interestingly, none of the morphologic parameters investigated in the current study correlated with visual acuity. Patients who presented later in the clinical course or who had greater average retinal thicknesses tended to have better vision (P = 0.11 and P = 0.07, respectively). Conclusions: Optical coherence tomography evaluation may yield important insights into the pathogenesis and clinical findings of traumatic macular holes.

Background and Objective: To investigate whether image quality is an important determinant of retinal nerve fiber layer (RNFL) and macular thickness measurements on Fourier-domain optical coherence tomography (OCT). Patients and Methods: Seventy-five and 56 normal subjects were recruited in RNFL and macular thickness arms of the study, respectively. Each participant was scanned three times using both the 3D OCT-1000 (version 3.01, Mark II; Topcon Corporation, Tokyo, Japan) and the Cirrus OCT (version 3.0, Model 4000; Carl Zeiss Meditec, Inc., Dublin, CA). The scans for each participant were arranged in order of increasing image qualities, which were correlated with RNFL and macular thicknesses. Subgroup analyses were performed with identical versus different and high versus low image quality metrics. Results: Higher image quality was significantly correlated with greater RNFL thickness measurements on the 3D OCT-1000, and when the signal strength was less than 7 on the Cirrus device. Image quality metrics were negatively correlated with measured macular thicknesses on Cirrus OCT but not on 3D OCT-1000. Conclusion: Image quality metrics should be considered when evaluating thickness measurements derived from Fourier-domain OCT devices.

The purpose is to assess the diagnostic ability for early glaucoma of macular ganglion cell–inner plexiform layer (GCIPL) thickness in a Chinese population including glaucoma suspects. A total of 367 eyes with primary open-angle glaucoma (168 early glaucoma, 78 moderate glaucoma, and 121 advanced glaucoma), 52 eyes with ocular hypertension (OHT), 59 eyes with enlarged cup-to-disc ratio (C/D), and 225 normal eyes were included. GCIPL thickness (average, minimum, superotemporal, superior, superonasal, inferonasal, inferior, and inferotemporal), retinal nerve fiber layer (RNFL) thickness, and optic nerve head (ONH) parameters were measured using Cirrus high-definition optical coherence tomography (OCT) and compared. The diagnostic ability of OCT parameters was assessed by area under receiver operating characteristic curve (AUROC) in 3 distinguishing groups: normal eyes and eyes with early glaucoma, normal eyes and eyes with glaucoma regardless of disease stage, and nonglaucomatous eyes (normal eyes, eyes with OHT, and enlarged C/D) and early glaucomatous eyes. Glaucomatous eyes showed a significant reduction in GCIPL thickness compared with nonglaucomatous eyes. In all 3 distinguishing groups, best-performing parameters of GCIPL thickness, RNFL thickness, and ONH parameters were minimum GCIPL thickness (expressed in AUROC, 0.899, 0.952, and 0.900, respectively), average RNFL thickness (0.904, 0.953, and 0.892, respectively), and rim area (0.861, 0.925, and 0.824, respectively). There was no statistical significance of AUROC between minimum GCIPL thickness and average RNFL thickness (all P > .05). GCIPL thickness could discriminate early glaucoma from normal and glaucoma suspects with good sensitivity and specificity. The glaucoma diagnostic ability of GCIPL thickness was comparable to that of RNFL thickness.