PURPOSE. We identified candidate optical coherence tomography (OCT) markers for early glaucoma diagnosis. Time variation of retinal nerve fiber layer (RNFL) thickness, phase retardation, birefringence, and reflectance using polarization sensitive optical coherence tomography (PS-OCT) were measured in three non-human primates with induced glaucoma in one eye. We characterized time variation of RNFL thickness, phase retardation, birefringence, and reflectance with elevated intraocular pressure (IOP).
METHODS.One eye of each of three non-human primates was laser treated to increase IOP. Each primate was followed for a 30-week period. PS-OCT measurements were recorded at weekly intervals. Reflectance index (RI) is introduced to characterize RNFL reflectance. Associations between elevated IOP and RNFL thickness, phase retardation, birefringence, and reflectance were characterized in seven regions (entire retina, inner and outer rings, and nasal, temporal, superior and inferior quadrants) by linear and non-linear mixed-effects models.RESULTS. Elevated IOP was achieved in three non-human primate eyes with an average increase of 13 mm Hg over the study period. Elevated IOP was associated with decreased RNFL thickness in the nasal region (P ¼ 0.0002), decreased RNFL phase retardation in the superior (P ¼ 0.046) and inferior (P ¼ 0.021) regions, decreased RNFL birefringence in the nasal (P ¼ 0.002) and inferior (P ¼ 0.029) regions, and loss of RNFL reflectance in the outer rings (P ¼ 0.018). When averaged over the entire retinal area, only RNFL reflectance showed a significant decrease (P ¼ 0.028).CONCLUSIONS. Of the measured parameters, decreased RNFL reflectance was the most robust correlate with glaucomatous damage. Candidate cellular mechanisms are considered for decreased RNFL reflectance, including mitochondrial dysfunction and retinal ganglion cell apoptosis. (Invest Ophthalmol Vis Sci. 2012;53:4380-4395) DOI:10.1167/iovs.11-9130 G laucoma is an optic neuropathy characterized by the progressive death of retinal ganglion cells and loss of associated axons in the retinal nerve fiber layer (RNFL). Without early diagnosis and therapeutic intervention, glaucoma eventually results in visual field abnormalities and vision loss. Studies indicate that as many as 40% of the axons may die before the visual field is affected, 1 suggesting an opportunity for the development of diagnostic tools that can prevent visual field loss in conjunction with application of neuroprotective strategies. As axons in the RNFL are lost, an associated RNFL thinning is observed.
2-4Optical coherence tomography (OCT) is an imaging modality that provides high-resolution (2-15 lm) cross-sectional images of the retina at video rate, and can quantify macroscopic changes in the optic nerve head (ONH) and RNFL. Inasmuch as previous studies have demonstrated a link between decreased RNFL thickness measured with OCT and glaucoma, 3 OCT measurements of RNFL thickness have become a routine component of glaucoma screening, diagnosis, and monitoring protocols...