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Andreas Schulze, Julia Lamparter, Norbert Pfeiffer, Esther M. Hoffmann; Influence Of Pupil Dilation On Fourier-domain Optical Coherence Tomography (FD-OCT) Measurements In Glaucoma And Normal Subjects. Invest. Ophthalmol. Vis. Sci. 2012;53(14):680.
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Fourier Domain optical coherence tomography is a new technology for high resolution imaging of the optic nerve head and the retinal nerve fiber layer (RNFL). According to the manufacturer, no pupil dilation is required for measurement which is more comfortable for the patient. In daily clinical routine, however some patients have dilated pupils, some do not. The aim of this study was to investigate the influence of pupil dilation on FD-OCT optic disc topographic and RNFL measurements.
100 patients with glaucoma and 50 normal subjects were included. Glaucoma diagnosis was defined clinically by typical optic disc changes with or without visual field defects (maximum mean deviation 9 dB). Healthy subjects had normal disc appearance, intraocular pressure < 21 mmHg und at least one normal reliable result on standard automated perimetry. Optic disc topographic measurements and RNFL measurements were performed consecutively on one day using FD-OCT RTVue-100 (Optovue, Fremont, CA, USA). Differences in optic disc topographic parameters and RNFL values for each sector between dilated and non-dilated eyes were analyzed using Bland-Altman-plots.
The mean age of glaucoma patients was 65.0 ± 9.8 years (normal subjects 63.5 ± 10.0 years) with mean deviation in visual field testing of -2.8 ± 2.5 dB (-0.6 ± 1.9 dB in normal subjects). The mean pupil diameter without dilation was 4.0 ± 0.7 mm and with dilation 7.8 ±1.0 mm. In miosis all OCT measurements could be performed in normal subjects. 95 of 100 glaucoma patients were measurable in miosis. 5 glaucoma patients that could not be measured had a reduced signal strength index with a poor image quality. In mydriasis all measurements could be performed in both groups. Bland-Altman-plots showed comparable results of each optic disc topographic parameter and RNFL measurements for each sector between miosis and mydriasis. The mean difference of each parameter was between -0.65 (RNFL inferior sector) to 0.05 (GCC GLV) with low limits of variation. The parameters disc area, rim volume and ganglion cell complex parameters showed a higher rate of fluctuation for small and high parameters.
FD-OCT measurements of optic nerve head and RNFL parameters with or without pupil dilation were comparable.
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