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Study Explores Potential New Biomarker for Glaucoma

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Macular ganglion cell-inner plexiform layer thickness may be a superior biomarker for glaucoma, according to Anthony P Khawaja MBBS, clinical research fellow at the University of Cambridge in England. He presented results from a prospective cohort study involving >42,000 individuals during the American Academy of Ophthalmology’s 2018 annual meeting in Chicago. Given the trial’s large cohort, the results were eagerly received. Similar evaluations typically include 100 to 300 individuals.

Participants—from the large UK Biobank study–ranged between 40 and 70 years of age, with an average age of ~56. Investigators analyzed spectral domain OCT macular images, looking for associations with average macular retinal nerve fiber layer (mRNFL) or ganglion cell complex (GCC) thickness. They also evaluated the ganglion cell layer combined with the inner plexiform layer (GCIPL). Among the results:

  • Thinner mRNFL and GCC was seen in older individuals, males, blacks, Hispanics, those with higher BMI, frequent alcohol intake, individuals who were more socially deprived, and those who achieved a lower education level.
  • Associations were generally stronger for GCC/GCIPL than mRFNL, and strongest for GCC.
  • Higher IOP was associated with a thinner GCC but not mRNFL.  
  • Reported variables explained most of the GCIPL variance vs the other two measures.

Dr. Khawaja noted that the cohort has been genotyped and will soon be fully sequenced. A report that includes the genotyping data is expected to be available in Spring 2019.



Khawaja A, Chua S, Ko F, et al. Differential associations with macular nerve fiber layer and ganglion cell complex thickness in a large cohort. Talk presented at: AAO 2018 annual meeting; October 26-30, 2018; Chicago.

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