Scanning Laser Polarimetry and Optical Coherence Tomography for Detection of Retinal Nerve Fiber Layer Defects

• Published in: Korean journal of ophthalmology Vol. 23; no. 3; pp. 169 - 175
• Main Authors: Oh, Jong-Hyun, Kim, Yong Yeon
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Ophthalmological Society 01.09.2009; 대한안과학회
• Subjects: Adult; Aged; Cross-Sectional Studies; Diagnostic Techniques, Ophthalmological; Female; Fundus Oculi; Humans; Male; Middle Aged; Nerve Fibers - pathology; Original; Retina - pathology; Retrospective Studies; Scanning Laser Polarimetry; Tomography, Optical Coherence; Young Adult; 안과학; Retinal nerve fiber layer defects; Optical coherence tomography; Scanning laser polarimetry; Red-free fundus photography
• ISSN: 1011-8942; 2092-9382; 2092-9382
• DOI: 10.3341/kjo.2009.23.3.169

To compare the ability of scanning laser polarimetry with variable corneal compensation (GDx-VCC) and Stratus optical coherence tomography (OCT) to detect photographic retinal nerve fiber layer (RNFL) defects. This retrospective cross-sectional study included 45 eyes of 45 consecutive glaucoma patients with RNFL defects in red-free fundus photographs. The superior and inferior temporal quadrants in each eye were included for data analysis separately. The location and presence of RNFL defects seen in red-free fundus photographs were compared with those seen in GDx-VCC deviation maps and OCT RNFL analysis maps for each quadrant. Of the 90 quadrants (45 eyes), 31 (34%) had no apparent RNFL defects, 29 (32%) had focal RNFL defects, and 30 (33%) had diffuse RNFL defects in red-free fundus photographs. The highest agreement between GDx-VCC and red-free photography was 73% when we defined GDx-VCC RNFL defects as a cluster of three or more color-coded squares (p<5%) along the traveling line of the retinal nerve fiber in the GDx-VCC deviation map (kappa value, 0.388; 95% confidence interval (CI), 0.195 to 0.582). The highest agreement between OCT and red-free photography was 85% (kappa value, 0.666; 95% CI, 0.506 to 0.825) when a value of 5% outside the normal limit for the OCT analysis map was used as a cut-off value for OCT RNFL defects. According to the kappa values, the agreement between GDx-VCC deviation maps and red-free photography was poor, whereas the agreement between OCT analysis maps and red-free photography was good.