[Macular segmentation in neuro-ophthalmology: descriptive or predictive?].

Examining the macula by means of segmentation with optic coherence tomography (OCT) has expanded our analytical capacity when compared with the conventional examination of the peripapillary retina nervous fiber layer (RNFL), to the extent that at present, in addition to evaluating macular axons (macular nervous fiber layer), we are able to evaluate the neuronal sub-populations comprising said layer (ganglion cell layer, internal and external nuclear layer).1 Version 6.0 of OCT-Cirrus (Carl Zeiss Meditec, Dublin, CA, USA) enables the quantification of the joint thickness of the ganglion cell and internal plexiform layers (GCL/IPL) by means of a 6 mm × 6 mm Q which contains an electric ring centered on the macula. This provides the thickness of 6 sectors (3 upper and 3 lower) and 2 overall values (average and minimum). It also includes a database that facilitates the interpretation of obtained results with the additional advantage of analyzing macular explorations carried out with previous versions of the device. The distribution of ganglion cells in the macula is more regular and has less variation between individuals than the peripapillary RNFL, linked to anatomic optic disk variations, with excellent reproducibility2 and therefore lower incidence of false positives. In the context of patients with multiple sclerosis (MS) with and without optic neuritis it has been demonstrated that, in addition to the well known significant loss of peripapillary RNFL, there is a significant thinning of the macular RNFL and