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Glaukomdiagnostik und Verlaufskontrolle mit dem Heidelberg Retina Tomograph

Glaucoma diagnosis and follow-up using the Heidelberg Retina Tomograph

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Zusammenfassung

Die konfokale Scanning-Laser-Ophthalmoskopie mittels der Heidelberg Retina Tomographie (HRT) bietet ein Diagnoseverfahren, welches schnelle, nichtinvasive topographische Informationen über den Sehnervenkopf, den neuroretinalen Randsaum und über die retinale Nervenfaserschichtdicke liefert. Der HRT ist aktuell eines der führenden Systeme für die Diagnose und Verlaufskontrolle eines Glaukoms. Die Implementation von diversen Auswertestrategien wie der Moorfields Regressionsanalyse (MRA) und des Glaucoma Probability Scores (GPS) sowie Diskriminanzanalysen helfen dem Kliniker, ein Glaukomauge von einem gesunden Auge zu unterscheiden. Für die Verlaufskontrolle können neben der Änderung der stereometrischen Parameter die Topographic Change Analysis (TCA) und die Trendanalyse verwendet werden. Außerdem bietet der Flickervergleich wertvolle Möglichkeiten, um topographische Änderungen im Vergleich zur Basisuntersuchung zu evaluieren. Die wichtige klinische Untersuchung wird bei richtiger Anwendung des Verfahrens und entsprechender Erfahrung mit der Interpretation sinnvoll ergänzt.

Abstract

The Heidelberg Retina Tomograph (HRT) is a glaucoma diagnosis system that provides fast, noninvasive topographic information about the optic nerve head, the neuroretinal rim, and the thickness of the nerve fiber layer. With these capabilities, it is one of the leading laser systems for detecting glaucoma. Statistical methods such as the Moorfields regression analysis and the glaucoma probability score, as well as discriminant functions implemented in the instrument, support the clinician in discriminating between glaucoma and healthy eyes. The primary method for assessing glaucomatous change using the HRT is topographic change analysis, a technique that compares the variability within a baseline examination to that between baseline and follow-up examinations. The stereometric trend analysis reports changes in normalized topographic parameters over time. Furthermore, the flicker comparison enables the detection of small topographic changes over time. The use of HRT does not replace clinical examination but facilitates the assessment and management of glaucoma according to the observer’s experience.

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  1. Universitäts-Augenklinik Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland

    E.M. Hoffmann, J. Lamparter, T. Schmidt & A. Schulze

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  1. E.M. Hoffmann
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  2. J. Lamparter
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  3. T. Schmidt
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  4. A. Schulze
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Correspondence to E.M. Hoffmann.

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Hoffmann, E., Lamparter, J., Schmidt, T. et al. Glaukomdiagnostik und Verlaufskontrolle mit dem Heidelberg Retina Tomograph. Ophthalmologe 106, 687–695 (2009). https://doi.org/10.1007/s00347-009-1998-x

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