AUTHOR=Ma Yi , Li Shengjie , Shao Mingxi , Cao Wenjun , Sun Xinghuai 

TITLE=Platelet Parameters and Their Relationships With the Thickness of the Retinal Nerve Fiber Layer and Ganglion Cell Complex in Primary Open-Angle Glaucoma

JOURNAL=Frontiers in Neurology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.867465

DOI=10.3389/fneur.2022.867465

ISSN=1664-2295

ABSTRACT=Objective.Glaucoma is a neurodegenerative disease of the visual system. Platelet parameters are correlated with visual field mean deviation (MD) in glaucoma but there is a lack of relative data on their relationship with structural changes in the retina. The study aimed to explore the relationship between platelet parameters and retinal nerve fiber layer (RNEL), ganglion cell complex (GCC) thickness and cup/disc area ratio, evaluated by optical coherence tomography (OCT) in primary open-angle glaucoma (POAG).Methods.A total of 118 consecutive POAG patients and 120 age- and sex-matched control subjects were included in this retrospective study. Demographic data, platelet parameters in blood tests, visual field and OCT results were evaluated. The RNFL was divided into the temporal, superior, nasal and inferior quadrants. Based on the visual field MD, the patients were stratified into mild (MD ≤ 6.0 dB), moderate (6dB < MD ≤12 dB), and severe (MD >12.0 dB) subgroups.Results.POAG patients had significantly lower platelet (PLT) levels and significantly higher platelet distribution width (PDW) and mean platelet volume (MPV) levels than controls. As the visual field MD increased, structural evaluation by OCT identified loss of disc rim area, average GCC thickness, and average RNFL thickness (all P<0.001), as well as increased PDW(P<0.001) and MPV(P=0.004) levels in POAG patients. Spearman’s rank correlation analysis showed that PDW levels were significantly correlated with OCT parameters RNFL thickness (r=-0.370, P<0.001), GCC thickness (r=-0.294, P=0.001) and cup/disc area ratio (r=0.322, P<0.001), as well as visual field MD (r=0.607, P<0.001), mean sensitivity (MS) (r=-0.570, P<0.001). Significantly correlations were also found between MPV and RNFL thickness (r=-0.321, P<0.001), GCC thickness (r=-0.194, P=0.041), cup/disc area ratio (r=0.237, P=0.010). All quadrants showed similar negative correlations between PDW, MPV and RNFL thickness. Multiple linear regression analyses showed significant association between PDW and RNFL thickness (𝛽=-0.331, P<0.001); PDW and GCC thickness (𝛽=-0.288, P=0.002); MPV and RNFL thickness (𝛽=-0.313, P=0.001); MPV and GCC thickness (𝛽=-0.188, P=0.048).Conclusions.Our study found significantly negative association between PDW, MPV levels and RNFL, GCC thickness, as well as positive association between PDW, MPV levels and cup/disc area ratio in POAG patients, suggesting that platelet activation may contribute to glaucomatous optic neuropathy.