Abstract
Abstract: :
Purpose: To detect glaucomatous progression with serial confocal scanning laser ophthalmoscopy. Methods: Twenty eyes of 17 patients from UCLA and the University of Leuven with 294 images acquired with the Heidelberg Retinal Tomograph (HRT) were included in this study. All patients had 4 or more imaging sessions performed during a minimum of 3 year follow up (mean 5.98 ± 1.0 SD, min 3.9, max 7.7 years). The optic disc and peripapillary nerve fiber layer (NFL) of each HRT image were divided into 12 sectors; 6 inside the disc margin and 6 outside the disc margin within a 500 micron radius circumferential to the disc margin. The NFL heights in each sector were calculated for three individual topographic images for each session. Linear regressions of the average height in each sector and the corresponding p values were calculated for each eye series. To account for 12 simultaneous p values, probability levels of 0.00416 and 0.000833 were used instead of 0.05 and 0.01. Results: Eight eye series (40%) showed negative slopes indicating NFL loss in at least one sector and showed significant progression at p < 0.004 and two eye series showed significant progression at p < .0008 in at least one sector. Of all eyes in all series, NFL loss was detected most frequently in the polar regions outside the disc margin: nasal-superior and temporal-superior, followed by temporal and nasal-inferior sectors outside the disc margin, and the temporal-superior sector inside the disc margin. Of all sectors in all eye series, 9.6% showed significant NFL loss at p < 0.004 and 3.3% at p < 0.0008. Conclusion: Sector analysis of NFL heights from serial confocal scanning laser ophthalmoscopy shows promise as a method to identify and measure glaucomatous progression. Further research with additional long-term HRT data will be performed to confirm the usefulness of this approach.
Keywords: 432 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 498 optic disc