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Impressum
Introduction of an examiner independent laser scanning tomographic parameter for evaluation of optic disc changes over time in patients with glaucoma - A pilot study using the Heidelberg Retina Tomograph®
Serguhn S., Spiegel D.
Klinik und Poliklinik für Augenheilkunde, Universität Regensburg
Purpose: Assessment of laser scanning tomographic optic disc parameters
requires an examiner for outlining the optic disc margin. The purpose
of the study is to introduce a new parameter "total volume inside
contour" (TVIC), which does not require an experienced examiner for
outlining the optic disc margin, and compare this new parameter to the
established FSM parameter.
Methods: In 10 early glaucomatous eyes of 10 patients visual field
and optic disc topography were examined twice within a follow up of at
least 1 year. Mean visual field deviation was examined using standard
full threshold prog. 30-2 of Humphrey`s Field Analyzer® (Humphrey
Systems, USA). Visual fields showed a stable tendency over time according
to the GLT-study criterias. Laser scanning tomography was performed using
the HRT (Heidelberg Engineering, Germany; software 2.01). TVIC, which
represents the difference between the volume above a retinal reference
plane versus the cup volume under a reference plane, and FSM were evaluated.
The difference over time of TVIC and FSM between a one year follow up
examination and a baseline examination were calculated.
Results: TVIC showed in 2 eyes an substantial improvement and in
3 eyes a tendency of improvement. In 5 eyes a worsening was registered,
of which 3 eyes showed a substantial worsening of more than 0,3mm³,
which was not found with FSM. In 3 eyes a corresponding change over time
of FSM and TVIC was observed (correlation coefficient=0.641; p=0.23; n=10).
Conclusions: TVIC should provide additional diagnostic information
for the follow up in patients with glaucoma. Because the optic disc margin
has not to be outlined, a less experienced examiner would be able to perform
optic disc analysis. The evaluated deviation of TVIC over time may be
caused by a differing quality of the HRT images, a large study and a change
in the acquisition of the imaging might be necessary.