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Review
. 2011 Mar;25(3):269-77.
doi: 10.1038/eye.2010.202. Epub 2011 Jan 7.

Assessment of rates of structural change in glaucoma using imaging technologies

K Mansouri  1 , M T Leite, F A Medeiros, C K Leung, R N Weinreb
Affiliations
Review

Assessment of rates of structural change in glaucoma using imaging technologies

K Mansouri et al. Eye (Lond). 2011 Mar.

Abstract

Purpose: To review the ability of current imaging technologies to provide estimates of rates of structural change in glaucoma patients.

Patients and methods: Review of literature.

Results: Imaging technologies, such as confocal scanning laser ophthalmoscopy (CSLO), scanning laser polarimetry (SLP), and optical coherence tomography (OCT), provide quantifiable and reproducible measurements of the optic disc and parapapillary retinal nerve fibre layer (RNFL). Rates of change as quantified by the rim area (RA) (for CSLO) and RNFL thickness (for SLP and OCT) are related to glaucoma progression as detected by conventional methods (eg, visual fields and optic disc photography). Evidence shows that rates of RNFL and RA loss are significantly faster in progressing compared with non-progressing glaucoma patients.

Conclusion: Measurements of rates of optic disc and RNFL change are becoming increasingly precise and individualized. Currently available imaging technologies have the ability to detect and quantify progression in glaucoma, and their measurements may be suitable end points in glaucoma clinical trials.

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Figures

Figure 1
Figure 1
Disc and field progression in subject 9. (a) Visual field grey scale at the conclusion of the study; the hatched squares indicate the test points flagged as progressing according to the standard PLR criteria; (b) HRT baseline mean topography; (c) HRT mean topography at the conclusion of the study period. (d–g) Scatterplots with regression line for sectoral RA against time. (From Strouthidis et al).
Figure 2
Figure 2
Radar plot illustrating the rates of change in SLP with ECC retinal nerve fibre layer measurements according to the sectors around the optic disc. Eyes that showed progression on visual fields and/or optic disc stereophotographs had greater loss of the RNFL in the inferior and superior sectors. I, inferior; N, nasal; S, superior; T, temporal. (From Medeiros et al).
Figure 3
Figure 3
Scatterplot illustrating the relationship between rates of change in the SLP with ECC parameter temporal–superior–nasal–inferior–temporal average and IOP. Rates of change are shown for eyes that progressed by visual fields and/or stereophotographs (progressors) as well as for eyes that did not (non-progressors). (From Medeiros et al).
Figure 4
Figure 4
ROC curves of rates of change for discriminating progressors from non-progressors of the three parameters with largest areas under the ROC curves in each scanning area and the average RNFL thickness. (From Medeiros et al).
See this image and copyright information in PMC

References

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