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Digital Planimetry for Long-term Follow-up in Patients with Low Tension Glaucoma
1Nguyen N. X., 1Meindl C., 1Horn F. K., 1Langenbucher A., 2Dzialach M., 1Mardin C. Y.,
1Friedrich-Alexander-Universität, Augenklinik (Erlangen)
2Friedrich-Alexander-Universität, Augenklinik, ERG-Labor (Erlangen)
Purpose: Aim of the study was to evaluate the validity of quantitative planimetry of the optic disc with a new digital method1 and to assess the correlation of the measurements with morphological changes in eyes with low-tension glaucoma.
Material and Methods: The study included 40 eyes of 40 patients (age 61±12 yrs.) with low tension glaucoma with a mean follow-up of 4.9±2.1 (range 3-9) yrs. All patients underwent annually complete ophthalmological examinations including 15° color optic disc photographs and automated visual fields. Optic disc slides were first examined for morphological signs of progression in comparison to baseline examination. In 18 eyes morphological examination showed signs of progression, and in 22 eyes no morphological changes of the optic disc were detected. Digital planimetry of the first and the last optic disc photos was taken from an independent examiner in a masked fashion without knowledge of the morphological examination.
Results: The digital-planimetrically measured optic dis area did not vary between the first and the last photos (3.06*0.74mm² vs 3.06*0.72mm², p=0.98). The mean differences between measured values for optic disc area between two examinations were 0,027±0,071mm² and the reliability coefficient (Cronbachs Alpha) was 0.99. Neuroretinal rim area decreased statistical highly significantly in eyes with morphologigal progression 0.17* 0.15mm² (p<0.0001). In eyes without morphological changes neuroretinal rim area decreased at 0.06±0.13mm² (p=0.01).
Conclusions: The variation of measurements of the optic disc area can be minimized by consideration and adjustment of the individual image magnification of the photos using digital planimetry. This method allows the quantitative assement even of slight changes of the neuroretinal rim area and is a sensible examination for follow-up of glaucoma patients to evaluate early morphological progression.
1. Nguyen et al. Klin Monatsbl Augenheilkd 2001; 218: 727-732 Supported by DFG (SFB 539)