Advertisement

Ten-year results: detection of long-term progressive optic disc changes with confocal laser tomography

  • Heiko Philippin
  • Anke Unsoeld
  • Philip Maier
  • Sebastian Walter
  • Michael Bach
  • Jens Funk
Clinical Investigation

Abstract

Background

The detection of a slowly progressive loss of optic nerve fibres in patients with ocular hypertension is a very important task for confocal laser tomography. We compared changes of the parameters of the Heidelberg Retina Tomograph (HRT) with changes of static visual field measurements.

Methods

Since 1994, patients with ocular hypertension have been monitored prospectively every 6 months with visual field measurements (Octopus 123, dG1x) as well as examinations of the optic disc using the HRT. A progressive excavation of the optic nerve head was defined as a significant increase or decrease of the linear regression over time. We analysed the HRT parameters cup area (CA), cup volume (CV), cup shape measure (CSM), rim volume (RV), retinal nerve fibre thickness (RNFLT) and contour height variation (CHV) each circular and for six different sectors of 109 eyes (60 patients). A glaucomatous visual field defect and therewith the conversion from ocular hypertension (OHT) to open angle glaucoma (OAG) was defined as reproducible defect-cluster >20 dB of two or three single points at the same location.

Results

Nine of 109 eyes converted from OHT to OAG. A significant linear increase of the circular parameters occurred in two (CA), four (CSM), two (CV) and a decrease in three (CHV), two (RV) and four (RNFLT) eyes. The sectoral analysis increased the results of CA and CV in the temporal superior and temporal inferior sectors (ts/ti): five/four (CA), two/three (CV). Cup shape measure showed in the temporal superior, temporal inferior (ti) and nasal inferior (ni) sectors slightly increased hits [five (ts), five (ti), five (ni)].

Conclusions

The linear model for the progression of the optic disc parameters detected only a small amount of the converters. The hit rate could be increased with the sectoral based analysis. Cup shape measure showed the highest rate.

Keywords

Optic Disc Ocular Hypertension Primary Open Angle Glaucoma Primary Open Angle Glaucoma Heidelberg Retina Tomograph 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Artes PH, Chauhan BC (2005) Longitudinal changes in the visual field and optic disc in glaucoma. Prog Retin Eye Res 24:333–354PubMedCrossRefGoogle Scholar
  2. 2.
    Bathija R, Zangwill L, Berry CC, Sample PA, Weinreb RN (1998) Detection of early glaucomatous structural damage with confocal scanning laser tomography. J Glaucoma 7:121–127PubMedGoogle Scholar
  3. 3.
    Bomer TG, Meyer JH, Bach M, Funk J (1996) Pattern electroretinogram and computerized optic nerve-head analysis in ocular hypertension—interim results after 2.5 years. Ger J Ophthalmol 5:26–30PubMedGoogle Scholar
  4. 4.
    Brigatti L, Weitzman M, Caprioli J (1995) Regional test-retest variability of confocal scanning laser tomography. Am J Ophthalmol 120:433–440PubMedGoogle Scholar
  5. 5.
    Chauhan BC, LeBlanc RP, McCormick TA, Rogers JB (1994) Test-retest variability of topographic measurements with confocal scanning laser tomography in patients with glaucoma and control subjects. Am J Ophthalmol 118:9–15PubMedGoogle Scholar
  6. 6.
    Chauhan BC, McCormick TA, Nicolela MT, LeBlanc RP (2001) Optic disc and visual field changes in a prospective longitudinal study of patients with glaucoma: comparison of scanning laser tomography with conventional perimetry and optic disc photography. Arch Ophthalmol 119:1492–1499PubMedGoogle Scholar
  7. 7.
    Ford BA, Artes PH, McCormick TA, Nicolela MT, LeBlanc RP, Chauhan BC (2003) Comparison of data analysis tools for detection of glaucoma with the Heidelberg Retina Tomograph. Ophthalmology 110:1145–1150PubMedCrossRefGoogle Scholar
  8. 8.
    Funk J, Mueller H (2003) Comparison of long-term fluctuations: laser scanning tomography versus automated perimetry. Graefe Arch Clin Exp Ophthalmol 241:721–724CrossRefGoogle Scholar
  9. 9.
    Iester M, De Ferrari R, Zanini M (1999) Topographic analysis to discriminate glaucomatous from normal optic nerve heads with a confocal scanning laser: new optic disk analysis without any observer input. Surv Ophthalmol 44(Suppl 1):33–40CrossRefGoogle Scholar
  10. 10.
    Iester M, Mikelberg FS, Courtright P, Burk RO, Caprioli J, Jonas JB, Weinreb RN, Zangwill L (2001) Interobserver variability of optic disk variables measured by confocal scanning laser tomography. Am J Ophthalmol 132:57–62PubMedCrossRefGoogle Scholar
  11. 11.
    Janknecht P, Funk J (1994) Optic nerve head analyser and Heidelberg retina tomograph: accuracy and reproducibility of topographic measurements in a model eye and in volunteers. Br J Ophthalmol 78:760–768PubMedCrossRefGoogle Scholar
  12. 12.
    Kamal DS, Garway-Heath DF, Hitchings RA, Fitzke FW (2000) Use of sequential Heidelberg retina tomograph images to identify changes at the optic disc in ocular hypertensive patients at risk of developing glaucoma. Br J Ophthalmol 84:993–998PubMedCrossRefGoogle Scholar
  13. 13.
    Kamal DS, Viswanathan AC, Garway-Heath DF, Hitchings RA, Poinoosawmy D, Bunce C (1999) Detection of optic disc change with the Heidelberg retina tomograph before confirmed visual field change in ocular hypertensives converting to early glaucoma. Br J Ophthalmol 83:290–294PubMedCrossRefGoogle Scholar
  14. 14.
    Mistlberger A, Liebmann JM, Greenfield DS, Pons ME, Hoh ST, Ishikawa H, Ritch R (1999) Heidelberg retina tomography and optical coherence tomography in normal, ocular-hypertensive, and glaucomatous eyes. Ophthalmology 106:2027–2032PubMedCrossRefGoogle Scholar
  15. 15.
    Uchida H, Brigatti L, Caprioli J (1996) Detection of structural damage from glaucoma with confocal laser image analysis. Invest Ophthalmol Vis Sci 37:2393–2401PubMedGoogle Scholar
  16. 16.
    Vihanninjoki K, Teesalu P, Burk RO, Laara E, Tuulonen A, Airaksinen PJ (2000) Search for an optimal combination of structural and functional parameters for the diagnosis of glaucoma. Multivariate analysis of confocal scanning laser tomograph, blue-on-yellow visual field and retinal nerve fiber layer data. Graefe Arch Clin Exp Ophthalmol 238:477–481CrossRefGoogle Scholar
  17. 17.
    Wollstein G, Garway-Heath DF, Fontana L, Hitchings RA (2000) Identifying early glaucomatous changes. Comparison between expert clinical assessment of optic disc photographs and confocal scanning ophthalmoscopy. Ophthalmology 107:2272–2277PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Heiko Philippin
    • 1
  • Anke Unsoeld
    • 1
  • Philip Maier
    • 1
  • Sebastian Walter
    • 1
  • Michael Bach
    • 1
  • Jens Funk
    • 1
  1. 1.Department of OphthalmologyUniversity of FreiburgFreiburgGermany

Personalised recommendations