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Purpose To evaluate the diagnostic accuracy of retinal nerve fibre layer thickness (RNFLT), ganglion cell complex (GCC), and optic disc measurements made with the RTVue-100 Fourier-domain optical coherence tomography (OCT) to detect glaucoma in a Caucasian referral population. Methods One randomly selected eye of 286 Caucasian patients (93 healthy, 36 ocular hypertensive, 46 preperimetric glaucoma, and 111 perimetric glaucoma eyes) was evaluated. Results Using the software-provided classification, for the total population sensitivity did not exceed 73.6% for the optic nerve head parameters, and 62.7% for the other parameters. Specificity was high (94.6-100%) for most RNFLT and GCC parameters, but low (72.0-76.3%) for the optic disc parameters. Positive predictive value varied between 98.1 and 100% for the main RNFLT parameters, 92.6 and 100% for the 16 RNFLT sectors, 92.4 and 99.0% for the GCC parameters, but did not exceed 86.3% for any of the optic disc parameters. Positive likelihood ratio (PLR) was higher than 10 for average, inferior and superior RNFLT (25.5 to infinite), 12 of the 16 RNFLT sectors (12.6 to infinite), and three of the four GCC parameters (40.0 to 48.6). No optic disc parameter had a PLR higher than 3.0. Conclusions RNFLT and GCC parameters of the RTVue-100 Fourier-domain OCT showed moderate sensitive but high specificity, positive predictive value and PLR for detection of glaucoma. The optic disc parameters had lower diagnostic accuracy than the RNFLT and GCC parameters.

Aim: To investigate the potential advantage of an enhanced corneal compensation algorithm (ECC) compared with variable corneal compensation (VCC) in the analysis of scanning laser polarimetric (SLP) images with atypical retardation pattern (ARP). Methods: SLP-VCC images with ARP (typical scan score (TSS) ,80) of one eye of each of 27 glaucoma patients and 19 healthy subjects were compared with the corresponding SLP-ECC images obtained at the same session. Results: ARP was present in 10.4% of the normals and 15.5% of the glaucoma patients imaged with SLP-VCC over 9 months. In both groups TSS was higher for ECC than for VCC (p,0.001). In glaucoma TSNIT, superior and inferior average thickness values were significantly lower, and TSNIT (measuring ellipse around the optic nerve head in the four (temporal, superior, nasal, inferior) quadrants) standard deviation was significantly higher with ECC than with VCC (p,0.001). In the normal group nerve fibre indicator (NFI) was lower with ECC than with VCC (p = 0.007). TSNIT average was smaller and TSNIT standard deviation was higher with ECC (p,0.001). Superior and inferior average thickness did not differ between VCC and ECC in the normal group. Conclusions: The new ECC software substantially improves polarimetric image analysis on eyes showing atypical polarisation pattern. S canning laser polarimetry (SLP) with variable corneal compensation (VCC) has become a widely used noninvasive clinical method to measure the retinal nerve fibre layer thickness (RNFLT) and to detect glaucoma.1-5 As VCC compensates for the true anterior segment retardation, measurements with SLP-VCC are more exact than those obtainable with the earlier instrument which had a fixed corneal polarisation compensator.

In the last decade topically applied prostaglandin F2alpha analogues (bimatoprost, latanoprost, travoprost and unoprostone) have become widely used as a means to reduce elevated intraocular pressure in patients with glaucoma and ocular hypertension. These molecules all have similar side-effect profiles, which include both side effects that occur frequently (e.g., conjunctiva hyperaemia, increase of iris pigmentation and eyelash changes) and rare adverse reactions (e.g., periocular pigmentation, damage to the blood-aqueous barrier and cystoid macular oedema). Conjunctiva hyperaemia, eyelash changes and cystoid macular oedema are reversible, but certain other side effects, such as increased iris pigmentation, are not. However, the systemic side-effect profile is favourable for all the prostaglandin analogues, and some of the local side effects are only of cosmetic significance. Numerous clinical studies suggest that discontinuing treatment with prostaglandin analogues on account of their side effects is rare in clinical practice.