Abstract
Purpose
To assess the effect of atypical pattern of retardation (APR) on retinal nerve fibre layer (RNFL) measurements made by scanning laser polarimetry (SLP) with variable corneal compensation (GDx-VCC) in glaucomatous eyes.
Methods
One eye each of 30 glaucomatous patients (average mean deviation (MD): −6.4±4.8) with APR on GDx-VCC retardation map were selected. In total, 34 glaucomatous, age- and severity-matched eyes (average MD: −7.0±5.3) and 36 age-matched healthy subjects, both with a normal pattern of retardation (NPR) represented control groups. APR on retardation maps was characterized by alternating peripapillary circumferential bands of low and high retardation, or high retardation areas arranged in a spokelike pattern, or high retardation nasal and temporal splotchy areas. Typical scan score (TSS) was extracted for each included eye. GDx-VCC parameters (mean±SD) in the two groups of glaucomatous eyes were compared with healthy eyes' corresponding values (Mann–Whitney U-test). Areas under receiver operating characteristic (AUROC) curves were generated to assess the APR effect on the parameters' diagnostic ability.
Results
All parameters discriminated adequately between healthy and glaucomatous eyes with NPR (AUROCs ≥0.9 for nine parameters). On the contrary, considering healthy and glaucomatous eyes with APR, four thickness parameters could not separate the two groups and AUROCs ≥0.85 appeared only for Inferior and Superior Ratio, NFI, Max Modulation.
Conclusion
APR may void the effect of custom compensation and provide spurious RNFL thickness measurements. When a printout of glaucomatous eyes with APR is evaluated, it is proper to rely on ratios, modulation parameters, and NFI, since the diagnostic ability of thickness parameters is significantly reduced.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Weinreb RN, Dreher AW, Coleman A, Quigley H, Shaw B, Reiter K . Histopathologic validation of Fourier-ellipsometry measurements of retinal nerve fiber layer thickness. Arch Ophthalmol 1990; 108: 557–560.
Pederson JE, Anderson DR . The mode of progressive optic disc cupping in ocular hypertension and glaucoma. Arch Ophthalmol 1980; 98: 490–495.
Quigley HA, Addicks EM, Green RW . Optic nerve damage in human glaucoma. III. Quantitative correlation of nerve fiber loss and visual defect in glaucoma, ischemic neuropathy, papilledema, and toxic neuropathy. Arch Ophthalmol 1982; 100: 135–146.
Sommer A, Katz J, Quigley HA, Miller NR, Robin AL, Richter RC et al. Clinically detectable nerve fiber layer atrophy precedes the onset of glaucomatous field loss. Arch Ophthalmol 1991; 109: 77–83.
Reus NJ, Colen TP, Lemij HG . Visualization of localized retinal nerve fiber layer defects with the GDx with individualized and with fixed compensation of anterior segment birefringence. Ophthalmology 2003; 110: 1512–1516.
Weinreb RN, Bowd C, Zangwill LM . Glaucoma detection using scanning laser polarimetry with variable corneal polarization compensation. Arch Ophthalmol 2002; 120: 218–224.
Choplin NT, Zhou Q, Knighton RW . Effect of individualized compensation for anterior segment birefringence on retinal nerve fiber layer assessment as determined by scanning laser polarimetry. Ophthalmology 2003; 110: 719–725.
Bowd C, Zangwill LM, Weinreb RN . Association between scanning laser laser polarimetry measurements using variable corneal polarization compensation and visual field sensitivity in glaucomatous eyes. Arch Ophthalmol 2003; 121: 961–966.
Medeiros FA, Zangwill LM, Bowd C, Bernd AS, Weinreb RN . Fourier analysis of scanning laser polarimetry measurements with variable corneal compensation in glaucoma. Invest Ophthalmol Vis Sci 2003; 44: 2606–2612.
Reus NJ, Lemij HG . The relationship between standard automated perimetry and GDx VCC measurements. Invest Ophthalmol Vis Sci 2004; 45: 840–845.
Schlottmann PG, De Cilla S, Greenfield DS, Caprioli J, Garway-Heath DF . Relationship between visual field sensitivity and retinal nerve fiber layer thickness as measured by scanning laser polarimetry. Invest Ophthalmol Vis Sci 2004; 45: 1823–1829.
Tannenbaum D, Hoffmann D, Lemij HG, Garway-Heath DF, Greenfield DS, Caprioli J . Variable corneal compensation improves the discrimination between normal and glaucomatous eyes with the scanning laser polarimeter. Ophthalmology 2004; 111: 259–264.
Reus NJ, Lemij HG . Diagnostic accuracy of the GDx VCC for glaucoma. Ophthalmology 2004; 111: 1860–1865.
Medeiros FA, Zangwill LM, Bowd C, Weinreb RN . Comparison of the GDx VCC scanning laser polarimeter, HRT II confocal scanning laser ophthalmoscope, and stratus OCT optical coherence tomography for the detection of glaucoma. Arch Ophthalmol 2004; 122: 827–837.
Reus NJ, Lemij HG . Scanning laser polarimetry of the retinal nerve fiber layer in perimetrically unaffected eyes of glaucoma patients. Ophthalmology 2004; 111: 2199–2203.
Bagga H, Greenfield DS . Quantitative assessment of atypical birefringence images using scanning laser polarimetry with variable corneal compensation. Am J Ophthalmol 2005; 139: 437–446.
Burns SA, Elsner AE, Mellem-Kairala MB, Simmons RB . Improved contrast of subretinal structures using polarization analysis. Invest Ophthalmol Vis Sci 2003; 44: 4061–4068.
Hodapp E, Parrish II RK, Anderson DR . Clinical Decisions in Glaucoma. Mosby-Year Book: St Louis, 1993, pp 52–61.
DeLong ER, DeLong DM, Clarke-Pearson D . Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 1988; 44: 837–845.
Bowd C, Zangwill LM, Berry CC, Blumenthal EZ, Vasile C, Sanchez-Galeana C et al. Detecting early glaucoma by assessment of retinal nerve fiber layer thickness and visual function. Invest Ophthalmol Vis Sci 2001; 42: 1993–2003.
Zangwill LM, Bowd C, Berry CC, Williams J, Blumenthal EZ, Sanchez-Galeana CA et al. Discriminating between normal and glaucomatous eyes using the Heidelberg retina tomograph, GDx nerve fiber analyzer, and optical coherence tomography. Arch Ophthalmol 2001; 119: 985–993.
Greenfield DS, Knighton RW, Feuer WJ, Schiffman JC, Zangwill LM, Weinreb RN . Correction for corneal polarization axis improves the discriminating power of scanning laser polarimetry. Am J Ophthalmol 2002; 134: 27–33.
Author information
Authors and Affiliations
Corresponding author
Additional information
None of the authors have any financial or proprietary interest with products cited in the text
Rights and permissions
About this article
Cite this article
Da Pozzo, S., Marchesan, R., Canziani, T. et al. Atypical pattern of retardation on GDx-VCC and its effect on retinal nerve fibre layer evaluation in glaucomatous eyes. Eye 20, 769–775 (2006). https://doi.org/10.1038/sj.eye.6701997
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.eye.6701997
Keywords
This article is cited by
-
The glaucoma detection capability of spectral-domain OCT and GDx-VCC deviation maps in early glaucoma patients with localized visual field defects
Graefe's Archive for Clinical and Experimental Ophthalmology (2013)
-
Test–retest variability in structural parameters measured with glaucoma imaging devices
Japanese Journal of Ophthalmology (2013)
-
Clinical characteristics of eyes demonstrating atypical patterns in scanning laser polarimetry
Eye (2008)
-
Correlation between optic disc area and retinal nerve fiber layer thickness: a study on scanning laser polarimetry with variable corneal compensation
Graefe's Archive for Clinical and Experimental Ophthalmology (2007)
-
Effect of posterior capsular opacification removal on scanning laser polarimetry measurements
Graefe's Archive for Clinical and Experimental Ophthalmology (2006)
