Scanning laser polarimetry slp is a quantitative method measuring the rnfl thickness surrounding the optic disc. Scanning laser polarimetry has recently been reported 1 to have a diagnostic accuracy for glaucoma of 96% sensitivity and 93% specificity. Pdf the quality of reporting of diagnostic accuracy. After the intraocular pressure increase, there were changes in scanning laser polarimetry results and progression of visual field defects at standard a chromatic automated perimetry. Diagnostic accuracy of scanning laser polarimetry with. Scanning laser polarimetry historybackground andor general information glaucoma glaucoma is a leading cause of blindness, and a disease for which treatment methods clearly are available and in common use. All patients were examined using laser polarimetry and automated visual field testing. Detection of glaucoma using scanning laser polarimetry with enhanced corneal compensation. Glaucoma progression detection by retinal nerve fiber layer. As the lens ages, its protein composition becomes altered, with an increased concentration of highmolecularweight lens protein.
Scanning laser polarimetry data from 94 consecutive subjects 40 healthy subjects and 54 patients with glaucoma older than 50 years who met the diagnostic inclusion criteria were evaluated at the hamilton glaucoma center, university of california, san diego. When damage to optic nerve fibers occurs, blind spots. Jun 16, 2014 imaging techniques in glaucoma slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. One hundred and ten normal and 114 glaucomatous subjects. Imaging polarimetry in macular disease with scanning laser. Diagnose glaucoma by proposed image processing methods. Conclusions scanning laser polarimetry using eyespecific corneal polarization compensation can provide meaningful rnfl thickness measurements in monkey eyes. Measurement of retinal nerve fibre layer by scanning laser. Scanning laser polarimetry was carried out at 6 months after remission of the acute attack. The main birefringent intraocular tissues are the cornea, lens and the retina. However a dutch study found that while there is a correlation between standard automated perimetry and gdx vcc measurements in patients with glaucoma, suggesting that gdx vcc measurements relate well with functional loss in. Detection of glaucoma with scanning laser polarimetry glaucoma. To determine the ability of frequency doubling technology fdt and scanning laser polarimetry with variable corneal compensation gdxvcc to detect glaucoma when used individually and in combination.
The retinal nerve fibre layer thickness rnflt was measured in each of four 90 degree quadrants, superior s, temporal t, inferior i, and nasal n, at 1. Osa confocal scanning laser ophthalmoscopy improvement by. To assess the intrasession repeatability and intersession reproducibility of peripapillary retinal nerve fiber layer rnfl thickness parameters measured by scanning laser polarimetry slp with enhanced corneal compensation ecc in healthy and glaucomatous eyes. Objectiveto determine which retinal nerve fiber layer rnfl measures obtained with scanning laser polarimetry are most useful in detecting early to moderate. To compare the results of scanning laser polarimetry of the retinal nerve fiber layer obtained by using the gdx scanning laser system in primary open angle glaucoma poag and nonglaucomatous brazilian subjects over 40 years, also analyzing the differences between the data obtained from right and left eyes. Can automated imaging for optic disc and retinal nerve fiber. Comparison of confocal scanning laser ophthalmoscopy. Phacolytic glaucoma is an inflammatory glaucoma caused by the leakage of lens protein through the capsule of a mature or hypermature cataract fig 410. Slp provides rnfl thickness measurements based upon the birefringence of the retinal ganglion cell axons. Notes on diagnosing preperimetric glaucoma with the confocal scanning laser ophthalmoscopy med vjesn 2009. If you continue browsing the site, you agree to the use of cookies on this website. Scanning laser polarimetry of the retinal nerve fibre layer. Swedish council on health technology assessment, 2015. A study was conducted to determine the sensitivity and specificity of masked experts in classifying results obtained from normal eyes, glaucomatous eyes, and eyes suspicious for glaucoma using the nerve fiber analyzer gdx laser diagnostic technologies, san diego, ca, a scanning polarimeter.
The method is based on the incorporation of a polarimeter into the setup. Aims to investigate the effects of artefacts on scanning laser polarimetry of the retinal nerve fibre layer. Detection of glaucoma using scanning laser polarimetry with. Measurement of glaucomatous nerve fiber layer damage using. The reflected light is detected by a confocal photodiode that is conjugate to the retinal plane, and the digitized image is stored in a computer. The retinal nerve fibre layer rnfl thickness values. Scanning laser polarimetry is an imaging technology that is utilized to measure peripapillary rnfl thickness. Notes on diagnosing preperimetric glaucoma with the confocal. Fifty patients with poag and 56 patients with pacg were examined using scanning laser polarimetry with variable corneal compensation gdx vcc. The relationship between optical coherence tomography and.
Combining frequency doubling technology perimetry and. Scanning laser polarimetry using the gdx vcc offers a unique tool for imaging of rnfl changes in glaucoma. Birefringence and depolarization were observed in the area with deep retinal lesions in macular disease. Optical coherence tomography and scanning laser polarimetry slp are the techniques that utilize the. In recent years, scanning laser polarimetry slp has emerged as a promising imaging technique to quantitatively assess retinal nerve. Scanning laser polarimetry in monkey eyes using variable. Glaucoma is a disease of the optic nerve the part of the eye that carries the images we see to the brain. To evaluate the ability of scanning laser polarimetry with variable corneal compensation to detect progressive retinal nerve fiber layer rnfl loss in glaucoma patients and patients suspected of having the disease. Scanning laser polarimetry slp uses the birefringent properties of the rnfl to estimate its thickness. Aims to evaluate the clinical value of scanning laser polarimetry with the nerve fibre analyser type ii in primary open angle glaucoma poag and capsular glaucoma. To compare scanning laser polarimetry slp measurements of retinal nerve fiber layer rnfl thickness in perimetrically unaffected eyes of glaucoma patients with those in their fellow eyes with field loss and eyes of healthy subjects. Optical coherence tomography and scanning laser polarimetry slp are the. Scanning laser polarimetry slp, a technology for glaucoma diagnosis, uses.
Pdf evaluation of retinal nerve fiber layer using scanning laser. The aim was to compare the ability of confocal scanning laser ophthalmoscopy cslo, scanning laser polarimetry slp, and optical coherence tomography oct to discriminate eyes with ocular hypertension oht, glaucoma suspect eyes gs or early glaucomatous eyes eg from normal eyes. Scanning laser polarimetry is the use of polarised light to measure the thickness of the retinal nerve fiber layer as part of a glaucoma workup. This is the first edition of the ico guidelines for glaucoma eye care february 2016. Observed differences in retardation between healthy and experimental glaucoma eyes suggest that slp may be useful for detecting and monitoring rnfl loss in experimental primate glaucoma. Optic nerve and retinal nerve fiber imaging eyewiki. To study the effect of cataract extraction on the retinal nerve fiber layer rnfl thickness, and assessment by scanning laser polarimetry slp, with variable corneal compensation gdx vcc, at the glaucoma service of a tertiary care center in north india.
Effects of artefacts on scanning laser polarimetry of retinal. To compare the ability of confocal scanning laser tomography cslt, scanning laser polarimetry slp and optical coherence tomography oct in recognising localised retinal nerve fibre layer rnfl defects. Methods scanning laser polarimetry was performed on one eye of 30 patients suffering from poag, 25 patients suffering from capsular glaucoma, and on 35 healthy control subjects. Measurement of thickness of retinal nerve fiber layer by scanning laser polarimetry and highpass resolution perimetry in patients with primary openangle or normaltension glaucoma. Jun 15, 2003 scanning laser polarimetry is a technique for assessing the thickness of the retinal nerve fiber layer in vivo. Scanning laser polarimetry slp, also known as gdx, is an imaging technology based on the retardation of light that has doublepassed the birefringent fibers of the retinal nerve fiber layer rnfl. Scanning laser polarimetry and progression progression of glaucoma earlier than can be achieved using sap, because the techniques involve an assessment of structural loss 414. Medflow aao selective laser trabeculoplasty for glaucoma. Scanning laser polarimetry with variable corneal compensation to detect preperimetric glaucoma using logistic regression analysis. Recently, tjonfosang and lemij 10 reported the sensitivity of scanning laser polarimetry for detecting glaucoma in a group of patients with a wide range of visual field mean deviation md. The optic nerve is made up of many nerve fibers, like an electric cable containing numerous wires.
This technique represented in the gdx from carl zeiss meditec, jena, germany is based on polarimetry and. The commercially available scanning laser ophthalmoscope is made by. This article focuses on scanning laser polarimetry, the first computerassisted imaging technique for this application. Preperimetric glaucoma assessment with scanning laser polarimetry gdx vcc. Ophthalmologic techniques that evaluate the posterior. One randomly selected eye of 82 healthy individuals and 60 glaucoma subjects was evaluated. Analyses of nerve fiber layer measurements obtained from. Pdf scanning laser polarimetry in patients with acute. A simple model of slp suggests an algorithm for calculating birefringence that, unlike previous methods, uses all of the data available in the images to achieve better signaltonoise ratio and lower sensitivity to depolarization.
After the spatially resolved mueller matrix of a sample was calculated, images for incident light with different states of polarization were reconstructed, and both the best and. An increase in superior and inferior nerve fiber loss was observed with scanning laser polarimetry, which is compatible with the changes in the visual field. Pdf comparison between gdx vcc scanning laser polarimetry. Though the technology has been available for several years, recent advances have resulted in improved imaging capabilities that may enhance clinicians ability to identify and follow the progression of glaucoma. Scanning laser polarimetry and detection of progression after. Recently, scanning laser polarimetry was used to selectively emphasize the different layers of the retina. Van vliet, title modeling of scanning laser polarimetry images of the human retina for progression detection of glaucoma, year. Local coverage determination for scanning computerized. The nerve fiber layer and scanning laser polarimetry. The gdx, scanning laser polarimetry, studies the rnfl. To detect differences in retinal nerve fibre layer rnfl measurements between patients with acute angleclosure glaucoma aacg and normal subjects using scanning laser polarimetry. They calculated mean retardation in 6 selected areas of 256 pixels from each of 4 quadrants superior, inferior, temporal, and nasal.
Your doctor has found that the pressure in your eye is higher than desired and recommends lowering of the eye pressure. The scanning laser ophthalmoscope differs from scanning laser polarimetry in that the slo measures the topography, or estimates the height of the retina, while scanning laser polarimetry directly measures the thickness of the retinal nerve fiber layer by use of polarization. Pdf to compare the abilities of scanning laser polarimetry with the. In retinal scanning laser polarimetry slp, the cornea, lens, and retina are all treated as linear retarders optical elements that introduce retardation to an illuminating beam. Scanning laser polarimetry slp is one such imaging device. Phacolytic glaucoma american academy of ophthalmology. To investigate whether correction for atypical birefringence pattern abp using scanning laser polarimetry with enhanced corneal compensation slpecc reduces the severity of abp compared with variable corneal compensation slpvcc, and improves the correlation with visual function. Laser diagnostic technologies that is composed of a nearinfrared diode scanning laser ophthalmoscope with a polarization modulator, a corneal. T anuj dada, reetika sharma, dewang angmo, gautam sinha, shibal bhartiy a, sanjay k mishra. Scanning laser polarimetry with variable and enhanced. Mdltmicropulse diode laser trabeculoplasty your doctor has recommended that you undergo a laser surgery called micropulse diode laser trabeculoplasty for your eye. A linear retarder has a slow axis and a fast axis, and the two axes are orthogonal to each other. Pdf detection of glaucoma using scanning laser polarimetry.
The instrument gdx, laser diagnostics technologies, san diego, ca uses a nearinfrared diode polarized light which by passing through the birefringent rnfl undergoes a change of polarization i. A confocal slo uses a nearinfrared diode laser 675 nm beam that rapidly scans the posterior pole in a raster fashionsimilar to the way in which a television creates an image on a monitor. To confirm the origin of these polarization changes, layer by layer analysis is required. Analytical methods for scanning laser polarimetry osa. Preperimetric glaucoma assessment with scanning laser. We compared the agreement of the location of visual field defects with changes in the nerve fiber layer. Repeatability and reproducibility of retinal nerve fiber. Scanning laser polarimetry of the retinal nerve fibre. The optic disc photograph of the right eye of monkey assessment of the retinal nerve fiber layer of the normal and glaucomatous monkey with scanning laser polarimetry. Scanning laser polarimetry slp is a confocal scanning laser ophthalmoscope with an integrated polarimeter that measures the amount of retardation phase shift of a polarized, nearinfrared laser beam as it passes through the retinal nerve fiber layer rnfl 6, 12, 1822. The hrt, confocal scanning laser tomography, examines several optic disk and peripapillar area parameters. History scanning laser polarimetry was developed at the university of california, san diego, and introduced as a commercial instrument by laser diagnostic technologies san diego, ca. Pdf scanning laser polarimetry with variable corneal. Scanning laser polarimetry and confocal scanning laser.
Accuracy of scanning laser polarimetry in the diagnosis of. Scanning computerized ophthalmic diagnostic imaging scodi allows for. Group s included 283 normal eyes and 39 preperimetric glaucoma eyes with rnfl superior or diffuse defects in the fiber layer. Hence, the measurement of rnfl thickness has come up. A new technique for improving the signaltonoise ratio and the contrast in images recorded with a confocal scanning laser system is presented. Scanning laser polarimetry slp is an imaging technology designed to provide objective assessment of the thickness of the retinal nerve fiber layer rnfl, with. All subjects underwent ophthalmologic examination, static automated perimetry humphrey 242 swedish interactive threshold algorithm sita standard, optic nerve stereoscopic photographs, redfree digital rnfl photographs and gdx vcc examination.
Methods six eyes of six normal volunteers and an artificial nerve fibre layer were examined using the nerve fibre analyser ii. Scanning laser polarimetry of the retinal nerve fiber. This study was conducted to evaluate the quality of reporting of published studies using the slp for diagnosing glaucoma. The higher the nfi, the more likely the patient has glaucoma. New analysis tools to address the problem of early detection of the eye blinding disease glaucoma are presented. The first commercial scanning laser polarimeter was the the nerve fiber layer and scanning laser polarimetry the history and utility of this technology.
Scanning laser polarimetry and detection of progression. Scanning laser polarimetry slp is a technique designed to evaluate the rnfl based on the. Scanning laser polarimetry, retinal birefringence, light retardation, retinal nerve fiber layer, glaucoma, anterior segment birefringence. Technology today the nerve fiber layer and scanning. Polarimetry with variable corneal compensation the.
Detection of glaucoma with scanning laser polarimetry. Scanning laser polarimetry and progression of visual field. Comparison between confocal scanning laser tomography. Scanning laser polarimetry an overview sciencedirect.
One hundred ten normal and 114 glaucomatous subjects were tested with fdt c205 screening protocol and the gdxvcc. Structurefunction correlations using scanning laser. Scanning laser polarimetry slp is another technology for early glaucoma diagnosis. These devices allow obtaining objective and quantitative data concerning rnfl and optic nerve head. One eye each of 36 subjects 12 normal, 12 suspected glaucoma, and 12 glaucoma was scanned using a single gdx unit with variable corneal compensator gdxvcc. Technology today the nerve fiber layer and scanning laser. The thickness maps of the retinal nerve fiber layer rnfl corresponding to 184 eyes 92 normal and 92 glaucoma patients were obtained from a scanning laser polarimeter. The various parameters between the attacked and the fellow eyes were compared using the student ttest.
Scanning laser polarimetry is a technique for assessing the thickness of the retinal nerve fiber layer in vivo. These results are often considered along with other findings to make diagnostic and therapeutic decisions. Scanning laser polarimetry in patients with acute attack. Detection of glaucoma using scanning laser polarimetry. Scanning laser polarimetry slp has been proposed as a useful diagnostic test for glaucoma. This has important implications for glaucoma screening because improved methods of screening could substantially affect the morbidity associated with this disease. This article will discuss information on evaluation of the intrabulbar structure of the optic nerve as it relates to glaucoma, with particular emphasis on three imaging devices, confocal scanning laser ophthalmoscopy, optical coherence tomography, and scanning laser polarimetry. Optical coherence tomography and scanning laser polarimetry slp are the techniques that utilize the evaluation of rnfl for the evaluation of glaucoma. Effect of cataract surgery on retinal nerve fiber layer. Glaucoma diagnosis using scanning laser polarimetry. Osa analytical methods for scanning laser polarimetry. Laser treatment for glaucoma introducion lasers have been used in the treatment of glaucoma for many years and as there are a number of di. A total of 95 glaucomatous patients mean deviation 3. Twentysix patients 24 female and 2 male, mean age 66.
The relationship between optical coherence tomography and scanning laser polarimetry measurements in glaucoma yun suk chung, md1,2, yong ho sohn, md2 department of ophthalmology, hallym university college of medicine1, anyang, korea department of ophthalmology, kims eye hospital, myunggok eye research institute. Although the techniques may differ, they are used for the earlier detection of glaucoma before damage to the nerve fiber layer. They are designed to be a working document to be adapted for local use, and we hope that the guidelines are easy to read and translate. Glaucoma detection using scanning laser polarimetry with.
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