Comparison between confocal scanning laser tomography, scanning laser polarimetry and optical coherence tomography on the ability to detect localised retinal nerve fibre layer defects in glaucoma patients

Windisch, B. K.; Harasymowycz, P J; Sée, J.; Chauhan, Balwantray C.; Belliveau, Anne C.; Hutchison, Donna M.; Nicolela, Marcelo T.

doi:10.1136/bjo.2008.141945

Cited by 10 publications

(7 citation statements)

References 14 publications

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“…Because of our small number of glaucomatous eyes, diagnostic accuracies of the examinations were lower than in many studies where the proportion of glaucomatous eyes has been higher and classification has been predefined by VF and ONH findings (14, 16, 22, 28-29-30). In our study, as in others (32), the tests disagreed in classifying eyes as glaucomatous and healthy. Adding more tests may result in a greater number of eyes with glaucoma suspicion, or may result in better certainty as to whether an eye has glaucoma.…”

Section: Discussionsupporting

confidence: 80%

Diagnostic Accuracy of Glaucoma Tests in Everyday Practice

Lindbohm

Vesti

Puska

et al. 2017

Ophthalmology @ Point of Care

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of CARE can be visualized with red-free photographs of the RNFL (3). However, diagnosing glaucoma in the early or moderate stage can be challenging. Appearance of the healthy ONH varies, and discrimination between healthy and glaucomatous ONH may be difficult in early glaucoma (4). Visual field testing is the only way to measure the functional damages glaucoma causes, but the success of VF testing depends on the patient's subjective performance, and is vulnerable to many possible artefacts (5). Sometimes VF defects appear only after structural damage is already detectable (6). Interpretation of RNFL red-free photographs is also difficult. Slit-like defects may be easily detectable, but diffuse defects of the RNFL may go undetected. Retinal nerve fiber layer red-free photography is also dependent on the clarity of the optical media and on sufficient pigmentation of the retinal pigment epithelium (3). In glaucoma diagnostics, new diagnostic methods offer benefits. Scanning laser polarimetry (SLP) and optical coherence tomography (OCT) allow quantitative measurements of the RNFL thickness around the ONH (7). The advantages of SLP and OCT measurements are that they are noninvasive, are quick to perform, and allow comparison of their measurements against normative databases. Thus, they have become

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Section: Discussionsupporting

confidence: 80%

Diagnostic Accuracy of Glaucoma Tests in Everyday Practice

Lindbohm

Vesti

Puska

et al. 2017

Ophthalmology @ Point of Care

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“…10 Windisch and colleagues evaluated the ability of OCT, scanning laser polarimetry, and confocal scanning laser ophthalmoscopy to detect localized nerve fiber layer defects seen on color photographs. 30 They found that scanning laser polarimetry had a higher proportion of correctly identified defects, but also had a higher number of false-positive results. Taken as a whole, the previous works suggest that advanced imaging technologies can be useful in diagnosing and managing glaucoma but that confocal scanning laser ophthalmoscopy may have poorer performance than scanning laser polarimetry and OCT.…”

Section: Discussionmentioning

confidence: 99%

Advanced Imaging for Glaucoma Study: Design, Baseline Characteristics, and Inter-site Comparison

Zhang

Francis

et al. 2015

American Journal of Ophthalmology

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Purpose To report the baseline characteristics of the participants in the Advanced Imaging for Glaucoma Study. To compare the participating sites for variations among subjects and the performance of imaging instruments. Design Multi-center longitudinal observational cohort study Methods A total of 788 participants (1,329 eyes) were enrolled from three academic referral centers. There were 145 participants (289 eyes) in the normal group, 394 participants (663 eyes) in the glaucoma suspect/preperimetric glaucoma group, and 249 participants (377 eyes) in the perimetric glaucoma group. Participants underwent a full clinical exam, standard automated perimetry, and imaging with time-domain and Fourier-domain optical coherence tomography (OCT), scanning laser polarimetry, and confocal scanning laser ophthalmoscopy. Main Outcome Measures The baseline average, population standard deviation, and repeatability of imaging-derived anatomic variables were reported for each technology and center. Results Compared to the normal participants, glaucoma suspect/preperimetric glaucoma and perimetric glaucoma groups had significantly reduced anatomic measurements. Repeatability of nerve fiber layer thickness was best for Fourier-domain OCT (overall coefficient of variation < 2%), followed by time-domain OCT (coefficient of variation 2-2.9%), scanning laser polarimetry (coefficient of variation 2.6-4.5%), and confocal scanning laser ophthalmoscopy rim area (coefficient of variation 4.2-7.6%). A mixed-effects model showed that the differences between sites was less than 25 percent of the variation within groups and less than the differences between the normal and glaucoma suspect/preperimetric glaucoma group. Conclusions Site-to-site variation was smaller than both the variation within groups and the changes due to glaucoma. Therefore pooling of participants between sites is appropriate.

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“…Scanning laser polarimetry with variable corneal compensation (GDx-VCC) and enhanced corneal compensation (GDx-ECC) is a well-established imaging method for retinal nerve fiber layer thickness (RNFLT) measurements, and has been shown to have good diagnostic accuracy to detect glaucoma in several investigations (16-19), though not in all studies (20). GDx-VCC and GDx-ECC provide similar results when the signal-to-noise ratio is close to optimal, but when neutralization of measurement artifacts is necessary, the diagnostic accuracy of GDx-ECC has consistently been found to be superior to that of GDx-VCC (17-19, 21-25).…”

Section: Introductionmentioning

confidence: 99%