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PURPOSE: To assess the effect of atypical pattern of retardation (APR) on retinal nerve fibre layer (RNFL) measurements made by scanning laser polarimetry (SLP) with variable corneal compensation (GDx-VCC) in glaucomatous eyes. METHODS: One eye each of 30 glaucomatous patients (average mean deviation (MD): -6.4 ± 4.8) with APR on GDx-VCC retardation map were selected. In total, 34 glaucomatous, age- and severity-matched eyes (average MD: -7.0 ± 5.3) and 36 age-matched healthy subjects, both with a normal pattern of retardation (NPR) represented control groups. APR on retardation maps was characterized by alternating peripapillary circumferential bands of low and high retardation, or high retardation areas arranged in a spokelike pattern, or high retardation nasal and temporal splotchy areas. Typical scan score (TSS) was extracted for each included eye. GDx-VCC parameters (mean ± SD) in the two groups of glaucomatous eyes were compared with healthy eyes' corresponding values (Mann-Whitney U-test). Areas under receiver operating characteristic (AUROC) curves were generated to assess the APR effect on the parameters' diagnostic ability. RESULTS: All parameters discriminated adequately between healthy and glaucomatous eyes with NPR (AUROCs ≥ 0.9 for nine parameters). On the contrary, considering healthy and glaucomatous eyes with APR, four thickness parameters could not separate the two groups and AUROCs ≥ 0.85 appeared only for Inferior and Superior Ratio, NFI, Max Modulation. CONCLUSION: APR may void the effect of custom compensation and provide spurious RNFL thickness measurements. When a printout of glaucomatous eyes with APR is evaluated, it is proper to rely on ratios, modulation parameters, and NFI, since the diagnostic ability of thickness parameters is significantly reduced.
Dr. S. Da Pozzo, Eye Clinic, University of Trieste, Trieste, Italy. stefano34127@lycos.it
6.9.1 Laser scanning (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis)