Objective: To study the diagnostic value of ganglion cell complex(GCC) thickness and peripapillary retinal nerve fiber layer(pRNFL) thickness in primary open-angle glaucoma(POAG) by joint indicators. Methods: A total of 118 eyes of 118 patients who received treatment in our hospital from February 2016 to December 2017 were selected as the study subjects, among which there were 44 normal eyes(normal group), 36 early primary open-angle glaucoma(EPOAG) eyes(EPOAG group) and 38 advanced primary open-angle glaucoma(APOAG) eyes(APOAG group). GCC mode and optic nerve head(ONH) mode of spectral domain optical coherence tomography(SD-OCT) are applied to scan all the subjects. The area under the curve(AUC) of macular GCC thickness and pRNFL thickness were compared for all subjects to assess their diagnostic ability. Results: The thickness of GCC and pRNFL in all areas of the normal group was higher than that of the EPOAG group and APOAG group, and the difference was statistically significant(P<0.05). The thickness of GCC and pRNFL in all areas of EPOAG group were higher than that of APOAG group, and the difference was statistically significant(P<0.05). The complete cycle GCC thickness was positively correlated with pRNFL thickness in all subjects(P<0.05). In the EPOAG group, there was no statistically significant difference in diagnostic efficacy between the complete cycle, upper and lower thickness of GCC and pRNFL(P>0.05); In APOAG group, there was no statistically significant difference in diagnostic efficacy between the complete cycle, upper and lower thickness of GCC and pRNFL(P>0.05); Taking complete cycle pRNFL thickness as a reference, the diagnostic ability of complete cycle GCC thickness and complete cycle pRNFL thickness in the EPOAG group was not significantly improved after being combined in three different ways, namely joint regression, connection in series and in parallel(P>0.05); In APOAG group, the diagnostic ability of complete cycle GCC thickness and complete cycle pRNFL thickness showed no significant improvement after joint regression and connection in parallel(P>0.05); In the APOAG group, the sensitivity of complete cycle GCC thickness and complete cycle pRNFL thickness were significantly increased after parallel connection, and the difference was statistically significant(P<0.05). Conclusion: GCC thickness and pRNFL thickness have high diagnostic value in various stages of primary open-angle glaucoma, and the combination of complete cycle GCC thickness and complete cycle pRNFL thickness may improve the diagnostic sensitivity in advanced primary open-angle glaucoma.
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