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Impressum
Validity of retinal nerve fiber layer measurements using laser scanning polarimetry in patients with different stages of morphologic glaucomatous optic nerve damage.
Nguyen N. X., Horn F. K., Hayler J., Wakili N., Mardin C. Y.
Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany (Chairmann: Prof. Dr. Dr. h.c. GOH Naumann)
Background: To evaluate diagnostic value of polarimetric measurements
of the retinal nerve fiber layer thickness (RNFL) in different stages
of glaucomatous optic nerve damage.
Patients and Methods: The study included 92 eyes of 52 controls
(41±14.0 years) and a heterogenius group of 232 eyes of 135 patients
(54±10.0 years; 68 patients with POAG, 56 LTG and 11 patients with
SOAG). All control subjects and patients underwent complete ophthalmological
examinations including scanning laser polarimetry examination of the RNFL
using the GDx (Laser Diagnostic Technologies, San Diego, CA) and 15°
color stereo optic disc photographs. Only subjects and patients with disc
area less than 3.4 mm2 were included in the study. The total glaucoma
group were divided into 4 subgroups according to the morphological criteria
of neuroretinal rim (stage1: n=103; stage2: n=65, stage3:
n=40 and stage4: n=19)
Results: Differences in mean polarimetric retardation between controls
and eyes with glaucoma were significant for all parameters (p<0.01).
Most significant differences between controls and eyes with glaucomatous
optic nerve damage were found with the "number" variable assigned
by the neural network (p=0.0001). With progredient stage of glaucomatous
optic nerve damage separation of the variable "the number" increased
significantly. At a prefixed specificity of 90% (stage0) the sensitivity
of the group with different stage of morphological glaucomatous optic
nerve damage increased from 32% for stage1 to 90% for stage4.
Conclusion: Polarimetric measurement of the RNFL thickness is significantly
associated with morphological glaucomatous optic nerve damages. Considering
the fast performance, easy handling and low maintanance cost, RNFL polarimetry
can be included in routine examination of glaucoma patients and this technique
may be usefull for screenning population of glaucoma. Supported by a grant
from DFG (SFB 539)