Mueller H., Funk J., Graf G.

Universitäts-Augenklinik Freiburg, Killianstr. 5, 79106 Freiburg (Direktor. Prof. Dr. med. H. Witschel)

Objective: Since 1994, patients with ocular hypertension or early glaucoma are monitored using a confocal laser scanning tomograph (Heidelberg Retina Tomograph, HRT). We calculated the fluctuation of the HRTmeasurements and the frequency of significant progressive or regressive optic disc changes.
Methods: We retrospectively analyzed the data of 686 eyes (359 Patients) with at least 4 measurements and a minimum follow-up of 3 years. The variance fraction V of the following disc parameters was calculated: c/dratio, "classification", cup shape measure, height variation contour, rim area and rim volume. In addition, a regression analysis of each parameter was performed of each eye and the result was tested for significance (p=0,05).
Results: The c/d-ratio (V=0,09) showed the best reproducibility, followed by rim area (V=0,10), classification (V=0,13), cup shape measure (V=0,14), rim volume (V=0,14) and height variation contour (V=0,33). A statistically significant regression of the excavation was found in 10 eyes, 37 eyes showed a significant progression.
Conclusion: The reproducibility of most of the HRT measurements is sufficient for clinical purposes. According to our analysis, the c/d-ratio was found to be the most stable parameter. As statistically expected, some of the eyes (n=10, 1.5%) showed a significant regression of the optic disc excavation, which is probably an artifact. Also, as again to be expected, the amount of eyes with progression of the optic disc nerve excavation (n=37, 5.4%) was higher. Presumably the progression of the optic nerve excavation reflects a real deterioration at least in some of our patients.

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