BACKGROUNDFundus changes associated with high myopia (HM) may mask those associated with primary open-angle glaucoma (POAG). This study aim to determine the characteristics of RNFL thickness changes in patients with both POAG and HM and compare these to changes in patients with only HM. The diagnostic capabilities of both OCT and GDxVCC in this subset of patients are also evaluated.

METHODSTwenty-two eyes with POAG and HM (spherical equivalent (SE) between -6.0 and -12.0 D) were evaluated, and 22 eyes with HM were used for comparison. Characteristic retinal nerve fiber layer (RNFL) thickness profiles in patients with POAG and HM were examined using optical coherence tomography (OCT) and scanning laser polarimetry with variable corneal compensation (GDxVCC), and the diagnostic capabilities of these imaging modalities were compared. RNFL parameters evaluated included superior average (Savg-GDx), inferior average (Iavg-GDx), temporal-superior-nasal- inferior-temporal (TSNIT) average, and nerve fiber indicator (NFI) on GDxVCC and superior average (Savg-OCT), inferior average (Iavg-OCT), nasal average (Navg-OCT), temporal average (Tavg-OCT), and average thickness (AvgThick-OCT) on OCT (fast RNFL scan). Visual field testing was performed and defects were evaluated using mean defect (MD) and pattern standard deviation (PSD).

RESULTSThe RNFL parameters (P < 0.05) significantly different between groups included Savg-GDx, Iavg-GDx, TSNIT average, NFI, Savg-OCT, Iavg-OCT, Tavg-OCT, and AvgThick-OCT. Significant correlations existed between TSNIT average and AvgThick-OCT (r = 0.778), TSNIT average and MD (r = 0.749), AvgThick-OCT and MD (r = 0.647), TSNIT average and PSD (r = -0.756), and AvgThick-OCT and PSD (r = -0.784). The area under the receiver operating characteristic curve (AUROC) values of TSNIT average, Savg-GDx, Iavg-GDx, NFI, Savg-OCT, Iavg-OCT, Navg-OCT, Tavg-OCT, and AvgThick-OCT were 0.947, 0.962, 0.973, 0.994, 0.909, 0.917, 0.511, 0.906, and 0.913, respectively. The NFI AUROC was the highest value.

CONCLUSIONSRNFL thickness was significantly lower in all but the nasal quadrant in patients with POAG and HM, compared to patients with only HM. Measurements with OCT and GDxVCC were well-correlated, and both modalities detected RNFL thickness changes. However, GDxVCC was better than OCT in detecting POAG in HM patients.

Adult ; Female ; Glaucoma, Open-Angle ; pathology ; Humans ; Male ; Myopia ; pathology ; Nerve Fibers ; pathology ; Retinal Neurons ; pathology ; Scanning Laser Polarimetry ; methods ; Tomography, Optical Coherence ; methods

PURPOSE: To evaluate the use of scanning laser polarimetry (SLP, GDx VCC) to measure the retinal nerve fiber layer (RNFL) thickness in order to evaluate the progression of glaucoma. METHODS: Test-retest measurement variability was determined in 47 glaucomatous eyes. One eye each from 152 glaucomatous patients with at least 4 years of follow-up was enrolled. Visual field (VF) loss progression was determined by both event analysis (EA, Humphrey guided progression analysis) and trend analysis (TA, linear regression analysis of the visual field index). SLP progression was defined as a reduction of RNFL exceeding the predetermined repeatability coefficient in three consecutive exams, as compared to the baseline measure (EA). The slope of RNFL thickness change over time was determined by linear regression analysis (TA). RESULTS: Twenty-two eyes (14.5%) progressed according to the VF EA, 16 (10.5%) by VF TA, 37 (24.3%) by SLP EA and 19 (12.5%) by SLP TA. Agreement between VF and SLP progression was poor in both EA and TA (VF EA vs. SLP EA, k = 0.110; VF TA vs. SLP TA, k = 0.129). The mean (+/-standard deviation) progression rate of RNFL thickness as measured by SLP TA did not significantly differ between VF EA progressors and non-progressors (-0.224 +/- 0.148 microm/yr vs. -0.218 +/- 0.151 microm/yr, p = 0.874). SLP TA and EA showed similar levels of sensitivity when VF progression was considered as the reference standard. CONCLUSIONS: RNFL thickness as measurement by SLP was shown to be capable of detecting glaucoma progression. Both EA and TA of SLP showed poor agreement with VF outcomes in detecting glaucoma progression.
Disease Progression ; Female ; Glaucoma/*diagnosis ; Humans ; Male ; Middle Aged ; Retinal Ganglion Cells/*pathology ; Retrospective Studies ; Scanning Laser Polarimetry/*methods ; Severity of Illness Index

PURPOSE: To investigate the visual field (VF) and retinal nerve fiber layer (RNFL) status of the fellow eyes in patients with unilateral retinal vein occlusion (RVO). METHODS: Fifty patients with unilateral RVO and 35 normal control subjects wereconsecutively recruited. Humphrey VF parameters and RNFL status using scanning laser polarimetry with variable corneal compensation (GDx-VCC) were compared between the fellow eyes of the patients with unilateral RVO and control eyes. We also assessed the risk factors for the development of glaucomatous damage in the fellow eyes of unilateral RVO patients. RESULTS: Twelve fellow eyes out of 50 patients with unilateral RVO showed glaucomatous VF and RNFL changes assessed by GDx-VCC. VF indices and RNFL thickness parameters in the study group were significantly lower than those in the control group (p<0.05). Increased age and vertical cup-to-disc ratio were significantly associated with severity of VF and RNFL damage in the fellow eye of unilateral RVO patients (p<0.05). CONCLUSIONS: The fellow eyes in patients with unilateral RVO showed significantly worse VF indices and lower RNFL thickness than normal control eyes. The glaucomatous change should be carefully monitored in the fellow eyes of unilateral RVO patients.
Compensation and Redress ; Eye ; Glaucoma ; Humans ; Nerve Fibers ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde ; Risk Factors ; Scanning Laser Polarimetry ; Visual Fields

PURPOSE: To evaluate and compare correlations between structural and functional loss in glaucoma as assessed by optical coherence tomography (OCT), scanning laser polarimetry (GDx VCC, as this was the model used in this study), standard automated perimetry (SAP), and the Humphrey Matrix (Matrix). METHODS: Ninety glaucomatous eyes identified with SAP and 112 eyes diagnosed using Matrix were independently classified into six subgroups, either S1/M1 (MD>-6dB), S2/M2 (-12 Adult ; Aged ; Automation ; Female ; Glaucoma/*diagnosis ; Humans ; Male ; Middle Aged ; Nerve Fibers/pathology ; *Perimetry ; Retina/pathology ; *Scanning Laser Polarimetry ; *Tomography, Optical Coherence

PURPOSE: To compare the ability of scanning laser polarimetry with variable corneal compensation (GDx-VCC) and Stratus optical coherence tomography (OCT) to detect photographic retinal nerve fiber layer (RNFL) defects. METHODS: This retrospective cross-sectional study included 45 eyes of 45 consecutive glaucoma patients with RNFL defects in red-free fundus photographs. The superior and inferior temporal quadrants in each eye were included for data analysis separately. The location and presence of RNFL defects seen in red-free fundus photographs were compared with those seen in GDx-VCC deviation maps and OCT RNFL analysis maps for each quadrant. RESULTS: Of the 90 quadrants (45 eyes), 31 (34%) had no apparent RNFL defects, 29 (32%) had focal RNFL defects, and 30 (33%) had diffuse RNFL defects in red-free fundus photographs. The highest agreement between GDx-VCC and red-free photography was 73% when we defined GDx-VCC RNFL defects as a cluster of three or more color-coded squares (p<5%) along the traveling line of the retinal nerve fiber in the GDx-VCC deviation map (kappa value, 0.388; 95% confidence interval (CI), 0.195 to 0.582). The highest agreement between OCT and red-free photography was 85% (kappa value, 0.666; 95% CI, 0.506 to 0.825) when a value of 5% outside the normal limit for the OCT analysis map was used as a cut-off value for OCT RNFL defects. CONCLUSIONS: According to the kappa values, the agreement between GDx-VCC deviation maps and red-free photography was poor, whereas the agreement between OCT analysis maps and red-free photography was good.
Adult ; Aged ; Cross-Sectional Studies ; Diagnostic Techniques, Ophthalmological ; Female ; Fundus Oculi ; Humans ; Male ; Middle Aged ; Nerve Fibers/*pathology ; Retina/*pathology ; Retrospective Studies ; *Scanning Laser Polarimetry ; *Tomography, Optical Coherence ; Young Adult

PURPOSE: To compare the abilities of optical coherence tomography (Stratus OCT) and scanning laser polarimetry with variable corneal compensation (GDx VCC) in detecting localized retinal nerve fiber layer (RNFL) defects of red free photography METHODS: Thirty six normal subject and 50 patients with localized RNFL defects were included in this study. Only one eye per subject was considered. The peripapillary RNFL was divided into 12 clock-hour sectors and localized RNFL defects were evaluated in these 12 sectors. To compare the diagnostic performance of Stratus OCT and GDx VCC based on the findings of red-free photography, we calculated the sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of each analyzer using a criterion of 1 > or = clock hours abnormal at the <5% level. RESULTS: The sensitivity (78.6%), specificity (94.4%), and AUC (0.872) of Stratus OCT were not significantly different from those of GDx VCC (83.3%, 94.4%, and 0.882, respectively) (McNemar test, p=0.75, 1.00, and 0.82, respectively). However, the sensitivity (64.0%) of Stratus OCT for superior RNFL defect was significantly lower than that (84.8%) for inferior defect (Fisher's exact test, p=0.02). CONCLUSIONS: The sensitivity of the sector average of Stratus OCT and the deviation map of GDx VCC were fair in discriminating localized RNFL defects, and the specificity of those were excellent. In addition, the diagnostic performance was not significantly different between two analyzers.
Area Under Curve ; Compensation and Redress ; Eye ; Humans ; Nerve Fibers ; Photography ; Retinaldehyde ; ROC Curve ; Scanning Laser Polarimetry ; Sensitivity and Specificity ; Tomography, Optical Coherence

PURPOSE: To evaluate the changes in retinal nerve fiber layer (RNFL) thickness according to the degree of myopia in patients with glaucoma and ocular hypertension. METHODS: Ninety-eight patients (165 eyes) diagnosed with glaucoma or ocular hypertension underwent optical coherence tomography (OCT) and scanning laser polarimetry using variable corneal compensation (GDx-VCC) to analyze the correlation between the degree of myopia and the thickness of the RNFL. A partial correlation coefficient analysis was performed to adjust for various factors such as age, laterality, intraocular pressure, and the mean deviation from visual field test, which can influence the RNFL thickness. RESULTS: The average, nasal, superior, and inferior sectorial RNFL thicknesses measured by OCT significantly decreased with increasing myopia (p<0.05). However, RNFL thickness measured by GDx-VCC was not significantly correlated with the degree of myopia. CONCLUSIONS: The RNFL thickness measured by OCT decreased with increasing myopia in eyes with glaucoma and ocular hypertension.
Compensation and Redress ; Eye ; Glaucoma ; Humans ; Intraocular Pressure ; Myopia ; Nerve Fibers ; Ocular Hypertension ; Retinaldehyde ; Scanning Laser Polarimetry ; Tomography, Optical Coherence ; Visual Field Tests

PURPOSE: To investigate the relationship between the SLP-VCC parameters and the SLP-ECC parameters in the eyes with typical retardation pattern (TRP) and atypical retardation pattern (ARP), and the sensitivities and specificities of the SLP-VCC parameters and the SLP-ECC parameters in the eye with TRP and ARP. METHODS: In this prospective study, 72 eyes with TRP images (30 glaucomatous and 42 normal eyes) and 53 eyes with ARP images (28 glaucomatous and 25 normal eyes) were recruited. For each group, we analyzed relationship between each parameters of GDx-VCC and GDx-ECC and the diagnostic ability of GDx-ECC by using the ROC curve. RESULTS: In the eyes with TRP, TSNIT average was significantly lower by GDx-ECC than GDx-VCC in the control group. Inferior average was significantly higher by GDx-ECC than GDx-VCC in both glaucomatous and normal group. TSNIT standard deviation was significantly higher by GDx-ECC than GDx-VCC in both groups. NFI was significantly lower by GDx-ECC than GDx-VCC in both groups. TSS (typical scan score) was significantly higher by GDx-ECC than GDx-VCC in both groups. In the eyes with ARP, TSNIT average was significantly lower by GDx-ECC than GDx-VCC in both groups. Superior and Inferior average was not different between GDx-ECC and GDx-VCC. TSNIT standard deviation was significantly higher by GDx-ECC than GDx-VCC in both groups. NFI was not different between groups. TSS was significantly higher by GDx-ECC than GDx-VCC in both groups. Comparison of ROC curve for the SLP parameters revealed no difference between VCC and ECC. TSNIT standard deviation, however, showed relatively high value in GDx-ECC compared with GDx-VCC. CONCLUSIONS: GDx-ECC has comparable diagnostic ability in discriminating glaucomatous and normal eyes with GDx-VCC and TSNIT standard deviation by the GDx-ECC algorithm could be a useful parameter in discriminating glaucomatous and normal eyes.
Compensation and Redress* ; Prospective Studies ; ROC Curve ; Scanning Laser Polarimetry*

PURPOSE: Eyes with small optic disc may be infirm to glaucomatous damage but suitable and objective methods for monitoring glaucomatous optic nerve damage in small optic disc are limited. The purpose of this study was to evaluate the usefulness of the retinal nerve fiber layer (RNFL) analysis using scanning laser polarimetry in patients with small optic disc. METHODS: 63 patients with small optic disc were recruited in this study. Eyes with average disc diameter 1.617 mm or less which was 33 percentile by topographic scanning system in our normal population study were enrolled. There were 26 patients with normal tension glaucoma and 37 patients with normal visual fields. Each patient underwent RNFL analysis using GDx VCC. Measurements of axial length, intraocular pressure, refractive error, disc diameter and cup/disc ratio were fulfilled. Findings were compared with independent t-test between 2 groups. GDx VCC parameters were analyzed with multiple logistic regression analysis. RESULTS: No differences in age, axial length, intraocular pressure, refractive error and disc diameter were apparent between the two groups. However, significant differences were detected in GDx VCC parameters including TSNIT average, Superior average, TSNIT standard deviation, NFI, Superior ratio, Inferior ratio, Sup/nasal, Maximum modualation, Superior maximum and Normalized superior area (p<0.001). The RNFL damage of superior area was prominent. CONCLUSIONS: In the patients with small optic disc, it is hard to detect the pathologic glaucomatous change by their disc morphologies. Therefore, RNFL analysis could be useful for a glaucoma screening of the patients with small optic disc.
Glaucoma ; Humans ; Intraocular Pressure ; Logistic Models ; Low Tension Glaucoma ; Mass Screening ; Nerve Fibers* ; Optic Nerve ; Refractive Errors ; Retinaldehyde* ; Scanning Laser Polarimetry ; Visual Fields

PURPOSE: This study was designed to assess the diagnostic value of scanning laser polarimetry with variable corneal compensation (GDx-VCC) in the diagnosis of preperimetric glaucoma. METHODS: The study included 132 eyes of 132 patients with normal intraocular pressure, including 38 normal eyes, 60 eyes with pre-perimetric glaucoma, and 34 eyes with early glaucoma. The parameters of GDx-VCC were analyzed and compared in these groups using ANOVA. The parameter with the most powerful diagnostic value was defermirred by an ROC curve, and it's sensitivity and specificity were calculated. RESULTS: Among GDx-VCC parameters, NFI was the most valuable parameter that could detect pre-perimetric glaucoma in normal eyes. A cut-off value of 12 was the optimal NFI value, which offered the highest sensitivity and specificity in discriminating between normal and pre-perimetric glaucomatous eyes. However, there were no statistically significant differences in GDx-VCC parameters between pre-perimetric and early glaucomatous eyes. A statistically significant correlation was found between NFI and visual field indices in early glaucomatous eyes. CONCLUSIONS: GDx-VCC can be useful as a screening test for early detection of pre-perimetric and early glaucoma with normal intraocular pressure.
Compensation and Redress ; Diagnosis ; Glaucoma ; Humans ; Intraocular Pressure ; Mass Screening ; ROC Curve ; Scanning Laser Polarimetry ; Sensitivity and Specificity ; Visual Fields