Optic Disc Topographic Parameters Research Articles

Influencia de la longitud axial ocular en el grosor de la capa de fibras nerviosas peripapilar medido con tomografía de coherencia óptica

BackgroundOptical coherence tomography (OCT) allows the measurement of the peripapillary optic nerve fiber layer (RNFL) thickness. The effect of ocular axial length (AL) on RNFL thickness measurement may be relevant in the interpretation of OCT results in diagnosing optic nerve diseases. PurposesTo assess the influence of ocular AL on RNFL thickness and on optic disc topographic parameters (optic disc area, rim area and cup volume) measured by OCT, in healthy individuals. MethodA sample of 109 healthy eyes classified into three groups according to AL (A: AL <22mm; B: AL 22–24.5mm; C: AL >24.5mm) was studied. RNFL thickness and optic disc topographic parameters were measured using Swept-Source OCT Triton (Topcon Corporation, Tokyo, Japan) and were compared between groups using a variance analysis. Correlation between the AL and the study variables was performed using a Pearson's correlation coefficient test. ResultsThe RNFL thickness was lower in eyes with higher AL in the superior (r=−0.41; p<0.001), inferior (r=0.58; p<0.001) and nasal (r=−0.43; p<0.001) quadrants, in the mean value of the RNFL (r=−0.49; p<0.001), optic disc area (r=−0.40; p<0.001) and rim area (r=−0.25; p=0.01). ConclusionAL is negatively correlated with RNFL thickness and optic disc topographic parameters measured by Swept-Source OCT Triton (Topcon).

Ocular axial length influence on peripapillary retinal nerve fiber layer thickness measurement with optical coherence tomography

BackgroundOptical coherence tomography (OCT) allows the measurement of the peripapillary optic nerve fiber layer (RNFL) thickness. The effect of ocular axial length (AL) on RNFL thickness measurement may be relevant in the interpretation of OCT results in diagnosing optic nerve diseases. PurposeTo assess the influence of ocular AL on RNFL thickness and on optic disc topographic parameters (optic disc area, rim area and cup volume) measured by OCT, in healthy individuals. MethodsA sample of 109 healthy eyes classified into 3 groups according to AL (A: AL<22mm; B: AL 22−24.5mm; C: AL>24.5mm) was studied. RNFL thickness and optic disc topographic parameters were measured using Swept-Source OCT Triton (Topcon) and were compared between groups using a variance analysis. Correlation between the AL and the study variables was performed using a Pearson's correlation coefficient test. ResultsThe RNFL thickness was lower in eyes with higher AL in the superior (r=−0.41; p<0.001), inferior (r=0.58; p<0.001) and nasal (r=−0.43; p<0.001) quadrants, in the mean value of the RNFL (r=−0.49; p<0.001), optic disc area (r=−0.40; p<0.001) and rim area (r=−0.25; p=0.01). ConclusionsAL is negatively correlated with RNFL thickness and optic disc topographic parameters measured by Swept-Source OCT Triton (Topcon).

Color vision testing versus pattern visual evoked potentials and optical coherence tomography parameters in subclinical optic nerve involvement in multiple sclerosis

Acute idiopathic demyelinating optic neuritis is frequently the initial manifestation of multiple sclerosis (MS). We aimed to discuss the value of color vision testing to detect possible optic nerve involvement in patients with MS who had no history of optic neuritis. We evaluated color vision with Farnsworth-Munsell 100 (FM-100) hue test. Total error scores (TES), partial error scores for the red-green axis (RGS) and blue-yellow axis (BYS) were calculated. Topographic optic disc parameters (RNFL, RA, DA, CV, RV, and vertical C/D ratio), total macular volume (TMV), central macular thickness (CMT), and retinal ganglion cell layer (RGCL) were determined using spectral domain optical coherence tomography (SD-OCT). Choroidal thickness (CT) was measured using enhanced depth imaging optical coherence tomography (EDI-OCT). Pattern visual evoked potentials (PVEP) were also performed. Twenty-eight patients with RRMS (56 eyes) and 25 healthy controls (50 eyes) were included. P100 latencies were significantly delayed and P100 amplitudes were significantly reduced in the patient group compared with the controls (p ≤ 0.05). Statistically significant thinning was found in temporal quadrant in the patient group compared with the controls (p = 0.002). TES RGS, and BYS were all increased in the patient group but this was not statistically significant. We found no correlation between TES, RGS, BYS, and P100 latencies or OCT parameters. In our investigation as to whether color vision testing could be a simple biomarker for showing neurodegeneration of the anterior visual pathway regardless of optic neuritis, PVEP and OCT-assessed RNFL thickness seemed to be a more valuable biomarker than color vision testing.

Validation of formula-predicted glaucomatous optic disc appearances: the Glaucoma Stereo Analysis Study.

The Glaucoma Stereo Analysis Study (GSAS) is a multicentre collaborative study of the characteristics of glaucomatous optic disc morphology using a stereo fundus camera. Using the GSAS dataset, we previously established a formula for predicting different appearances of glaucomatous optic discs, although the formula lacked validation in an independent dataset. In this study, the formula was validated in another testing dataset. Testing dataset contained three-dimensionally analysed optic disc topographic parameters from 93 eyes with primary open-angle glaucoma; six topographic parameters (temporal and nasal rim-disc ratios, mean cup depth, height variation contour, disc tilt angle and rim decentring absolute value) were used for predicting different appearances of glaucomatous optic discs. The agreement between grader-classified optic disc types, that is, focal ischemic (FI), generalized enlargement, myopic glaucomatous (MY), and senile sclerotic (SS) and formula-predicted optic disc types, that is, pFI, pGE, pMY and pSS, were assessed. Based on this formula, the eyes were classified with pFI (21 eyes, 22.6%), pGE (27 eyes, 29.0%), pMY (26 eyes, 28.0%) and pSS (19 eyes, 20.4%) when the top predictive element based on the formula was considered as the optic disc appearance in each eye. The six topographic parameters used in the formula differed significantly among the four predicted optic disc types. Substantial agreement (κ=0.7496) was seen for the top two predictive elements based on the formula that agreed with the graders' classification in 76 (81.7%) eyes. Among the four optic disc types, the levels of agreement were relatively lower in the SS type (κ=0.3863-0.5729) compared with the other three optic disc types (κ=0.7898-0.8956) even though the unclassifiable and mixed optic disc types were excluded from the testing dataset. The GSAS classification formula can predict and quantify each component of different optic disc appearances in each eye and provide a novel parameter to describe glaucomatous optic disc characteristics.

Differentiation of glaucomatous optic discs with different appearances using optic disc topography parameters: The Glaucoma Stereo Analysis Study.

The Glaucoma Stereo Analysis Study (GSAS) is a multicenter collaborative study of the characteristics of glaucomatous optic disc morphology using a stereo fundus camera. Using GSAS dataset, the formulas for predicting different glaucomatous optic disc appearances were established. The GSAS dataset containing three-dimensionally-analyzed optic disc topographic parameters from 187 eyes with primary open-angle glaucoma was assessed with discrimination analyses to obtain formulas predictive of glaucomatous optic disc appearances: focal ischemic (FI); generalized enlargement (GE), myopic glaucomatous (MY), and senile sclerotic (SS). Using 38 optic disc parameters-substituted discrimination analyses with a stepwise forward-selection method, six parameters (temporal and nasal rim-disc ratios, mean cup depth, height variation contour, disc tilt angle, and rim decentering absolute) were selected into the formulas. The area under the receiver operating characteristic curves for predicting the four disc types with established formulas were 0.88, 0.91, 0.93, and 0.86 for FI, MY, SS, and GE, respectively. Age, visual acuity, refractive error, glaucoma (normal or high-tension glaucoma), and baseline intraocular pressure differed significantly among the four optic disc types, suggesting the appearances represent different clinical glaucoma phenotypes. Using six optic disc topographic parameters obtained by stereo fundus camera, the GSAS classification formulas predicted and quantified each component of different optic disc appearances in each eye and provided a novel parameter to describe glaucomatous optic disc characteristics.

Heidelberg retinal tomography of the optic disc in the early diagnosis of glaucoma

To analyze anatomical and topographic optic disc parameters with account to the disc area in glaucoma suspects. The study included 302 patients (408 eyes) aged 25 to 76 years (the mean age of 50.5±12.5 years); men and women roughly equal in number. The eyes were divided into 8 groups depending on the disc area, which ranged from 0.89 to 3.5 mm2. With HRT, 11 global and sector optic disc parameters were examined, 4 of which (disc area, rim area, cup/disc ratio, mean RNFL thickness) are presented in this paper. The study revealed a great variability of disc area values as well as individual morphometric features of the examined optic discs. We have also established high statistical significance of the difference between the above-listed optic disc parameters, both global and sectoral, in groups with different disc areas with the exception of the mean RNFL thickness. For early glaucoma detection with HRT, it is advisable to consider the individual area-dependent anatomical and topographic features of the optic disc.

Optical Coherence Tomography Parameters in Morbidly Obese Patients Who Underwent Laparoscopic Sleeve Gastrectomy.

Purpose. To investigate changes in optical coherence tomography parameters in morbidly obese patients who had undergone laparoscopic sleeve gastrectomy (LSG). Methods. A total of 41 eyes of 41 morbidly obese patients (BMI ≥ 40) who had undergone LSG were included in study. The topographic optic disc parameters, central macular thickness (CMT), total macular volume (TMV), and retinal ganglion cell layer (RGCL) were measured by spectral-domain optical coherence tomography (SD-OCT). Subfoveal choroidal thickness (SFCT) was measured by enhanced deep imaging-optical coherence tomography (EDI-OCT). Results. The mean CMT was 237.4 ± 24.5 μm, 239.3 ± 24.1 μm, and 240.4 ± 24.5 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p < 0.01). The mean TMV was 9.88 ± 0.52 mm3, 9.96 ± 0.56 mm3, and 9.99 ± 0.56 mm3 preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p < 0.01). The mean RGCL was 81.2 ± 6.5 μm, 82.7 ± 6.6 μm, and 82.9 ± 6.5 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p < 0.01). The mean SFCT was 309.8 ± 71.8 μm, 331.0 ± 81.4 μm, and 352.7 ± 81.4 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p < 0.01). No statistically significant differences were found between the preoperative values and 3- and 6-month postoperative values in rim area (p = 0.34), disc area (p = 0.64), vertical cup/disc ratio (p = 0.39), cup volume (p = 0.08), or retinal nerve fiber layer (p = 0.90). Conclusions. Morbidly obese patients who undergo LSG experience a statistically significant increase in CMT, TMV, SFCT, and RGCL at 3 months and 6 months after surgery.

Decreased retinal nerve fiber layer thickness in patients with congenital isolated growth hormone deficiency.

To evaluate the optic disc topography parameters of children with congenital isolated growth hormone deficiency (GHD) using the Heidelberg retina tomograph (HRT) in a controlled study. This prospective study included 32 eyes of 32 patients with congenital isolated GHD and 36 eyes of 36 healthy subjects. The topographic optic disc parameters (mean cup volume, rim volume, cup area, disc area, rim area, mean cup-to-disc ratio and cup depth, retinal nerve fiber layer thickness [RNFL]) were imaged in all subjects with HRT-III (software 3.01 a-M). Pearson correlation analysis was used to investigate the correlation between right and left eyes regarding the optic disc parameters. Differences between the 2 groups were evaluated by independent t test, Mann-Whitney U test, and chi-square test. The mean RNFL thickness in children with congenital isolated GHD was found to be statistically significantly thinner than in healthy subjects (p&lt;0.05). However, no statistically significant differences were found between the mean cup volume, rim volume, cup area, disc area, rim area, mean cup-to-disc ratio and cup depth, and mean sectorial RNFL thickness (p&gt;0.05). The results suggest that congenital GHD may lead to thinner RNFL thickness when compared with healthy subjects. This indicates that GH has an important role in the development of the neural retina.

Optic disc topographic analysis in diabetic patients

The aim of our study was to evaluate the optic disc (OD) topographic parameters by using Heidelberg Retina Tomograph II (HRT II) in patients with type 2 diabetes mellitus (DM). The study group consisted of 78 patients with type 2 DM (patient group) and age-sex matched 50 healthy subjects (control group). All patients and controls underwent a detailed ophthalmological examination, automated perimetry, central corneal thickness (CCT) measurement and OD topography by using HRT II. Glycosylated haemoglobin (HbA1c) levels of the diabetic patients were also noted. Age, gender, intraocular pressure and CCT measurements were similar in patients with diabetes and control group. Mean retinal nerve fiber layer thickness (MRNFLT) and retinal nerve fiber layer cross-sectional area (RNFLcsA) parameters were found significantly lower in diabetic patients compared to those of the controls (p = 0.030, p = 0.038). In the patient group, MRNFLT value was found significantly lower in patients with DM duration ≥120 months (p = 0.020) and HbA1c level ≥7 % (p = 0.029). Rim volume, MRNFLT and RNFLcsA values were significantly lower in proliferative diabetic retinopathy group (p = 0.004, p = 0.003, p = 0.001 respectively) and laser treated patients (p = 0.003, p = 0.002, p = 0.004 respectively). In conclusion, poor metabolic control of diabetes, severe DR and received laser therapies cause RNFL damage. Heidelberg Retina Tomograph may help us to detect and follow-up the changes in optic disc and RNFL in diabetic patients.

Effects of optic disc topography and retinal nerve fiber layer thickness measurement by spectral-domain OCT on diagnosis of glaucoma

Background Glaucoma is an optic neuropathy caused by structural damage of the optic nerve,and its early diagnosis is critical for arresting the irreversible damage of visual function. Optical coherence tomography (OCT) allows an early diagnosis of glaucoma by the measurements of the optic disc and retinal nerve fiber parameters. Objective This study was carried out to evaluate the effects of optic disc tomography and the measurement of the retinal nerve fiber layer (RNFL) thickness by spectral-domain OCT on the diagnosis of glaucomatous eye. Methods It was a noninterventional, cross-sectional study. The optic disc topographic parameters and total and regional RNFL thickness were measured by RTVue OCT in 62 normal eyes and 67 glaucomatous eyes. The area under the receiver operating characteristic curve( ROC ) was used to assess the ability to differentiate glaucoma eyes from normal eyes of each testing parameter. This trial complied with the Helsinki Declaration and was approved by the Clinical Trial Ethic Committee of Beijing Tongren Hospital. All of the participants signed the written informed consent before any medical examination. Results In the comparison of demography ,the ages of patients, the mean deficiency( MD ) and pattern standard difference( PSD ) of perimetry were obviously larger in the glaucoma group, primary open angle glaucoma ( POAG ) group and primary closure-angle glaucoma(PACG) group than those of normal controls( P＜0. 01 ). No significant differences were found in the disc area between a total glaucoma group, POAG group or PACG group and normal group ( P =0. 101,0. 741 and 0. 652, respectively) ;however, the average RNFL thickness between normal eyes and glaucomatous eyes were significantly different( 109. 758 μm versus 79. 539 μm, P＜0. 01 ). Among the eight regions around the optic disc, the thickest RNFL located at the inferotemporal( 150. 109 μm) and superotemporal( 146. 105 μm) regions in normal eyes,and at the superotemporal( 104. 354 μm) and inferotemporal( 102. 436 μm) regions in glaucomatous eyes. Both in normal and glaucomatous eyes,the thinnest RNFL located at the nasal(NU+NL) and temporal(TU + TL) regions. For optic disc topographic parameters,the highest ROC were observed in rim volume( ROC--0. 850,0. 841 and 0. 862 in total glaucoma,POAG and PACG, respectively) and vertical cup/disc ratio( ROC =0. 840,0. 849 and 0. 830 in total glaucoma,POAG and PACG,respectively), and the sensitivities for specificity cutoff set at 80％ were 73.1％ and 76. 1％ in total glaucoma,73.0％ and 81.1％ in POAG and 73.3％ and 70.0％ in PACG, respectively. For RNFL thickness ,the highest ROC was observed in average RNFL( ROC =0. 925,0. 910 and 0. 942 in total glaucoma, POAG and PACG,respectively) ,and the sensitivities for specificity cutoff set at 80％ were 89. 6％ ,89.2％ and 90. 0％ in total glaucoma,POAG and PACG, respectively. Among the eight regions around the optic disc, RNFL thickness of region IT achieved the highest ROC, RNFL thickness of region TU and TL had the lowest ROC. Conclusions RTVue OCT appears to be of fair discriminating ability in distinguishing normal from glaucomatous eyes. RTVue OCT shows promise for the diagnosis of glaucoma. Key words: Optical coherence tomography; Glaucoma; Optic disc; Retinal nerve fiber layer

Influence of Refractive Error on Optic Disc Topographic Parameters: The Singapore Malay Eye Study

To examine the relationship between refractive error and optic disc topographic parameters and retinal nerve fiber layer (RNFL) thickness. Population-based cross-sectional study. All 3,280 (78.7% response rate) persons of Asian Malay ethnicity 40 to 80 years of age underwent a standardized interview, ocular examinations, and optic disc imaging with the Heidelberg Retina Tomography II (HRT; Heidelberg Engineering). Associations between spherical equivalent (SE) and HRT parameters were evaluated by partial correlation analysis. There were 2,457 (74.9%) right eyes with good-quality HRT images for analyses. When compared with emmetropic eyes, highly myopic eyes (SE < -6.0 diopters) had greater disc area, rim area, rim volume, whereas hyperopic eyes (SE > 0.5 diopters) had significantly smaller disc area, rim area, and cross-sectional RNFL area (all P < .005). In partial correlation after adjustment for age, sex, body mass index, intraocular pressure, and optic disc area, increase of SE (toward hyperopia) was related significantly with greater cup area (partial correlation coefficient, r = 0.058; P = .004) and cup-to-disc area ratio (r = 0.058; P = .004) and with smaller optic disc area (r = -0.058; P = .004), rim area (r = 0.058; P = .004), and rim volume (r = -0.091; P < .001). This population-based study shows that refractive error is significantly (but weakly) associated with HRT parameters of disc area, cup area, rim area, cup-to-disc area ratio, and rim volume. The clinical significance of these associations need to be determined in further studies.

A Comparison of Optic Disc Topographic Parameters in Primary Open-Angle Glaucoma Cases with or without Family History of Glaucomai

A Comparison of Optic Disc Topographic Parameters in Primary Open-Angle Glaucoma Cases with or without Family History of Glaucomai

Comparison of Optic Disc Topography in Non-Glaucomatous Eyes of Children with Juvenile Diabetes Mellitus and Normal Children

To compare the optic disc topography parameters of children with juvenile diabetes mellitus and normal children using the Heidelberg Retinal Tomograph (HRT III) (Heidelberg Engineering, Heidelberg, Germany). The topographic optic disc parameters (cup volume, cup area, rim volume, rim area, disc area, mean cup-to-disc ratio, and mean cup depth) of 28 non-glaucomatous eyes of 28 children with type 1 diabetes mellitus and 28 eyes of 28 age-matched healthy children were compared using the nonparametric Mann-Whitney U test. No statistically significant differences were found between cup volume (P = .782), cup area (P = .878), rim volume (P = .853), disc area (P = .452), mean cup-to-disc ratio (P = .852), and mean cup depth (P = .711) of eyes of cases with diabetes mellitus and normal subjects. This result suggests that non-glaucomatous eyes of children with type 1 diabetes mellitus and healthy subjects have similar topographic optic disc characteristics.

Significance of optic disc topography and retinal nerve fiber layer thickness measurement by spectral-domain OCT in diagnosis of glaucoma

To study the significance of optic disc tomography and retinal nerve fiber layer (RNFL) thickness measurement by spectral-domain optical coherence tomography (OCT) in the diagnosis of glaucoma. It was a noninterventional, observational study. The optic disc topographic parameters and total and regional RNFL thickness were measured by RTVue OCT in 60 normal eyes and 97 glaucomatous eyes. One-way analysis of variance was used to compare the parameters above mentioned between normal and glaucomatous groups. The area under the receiver operating characteristic curve (AUC) and the sensitivity at 80% specificity were used to assess the ability of each testing parameter in the differentiation between normal and glaucoma eyes. There were statistically significant differences in all RTVue OCT measurement parameters (F = 1.024, P = 0.596;F = 36.519, 54.464, 27.659, 36.176, 20.562, 63.833, 30.031, 54.652, 98.146, 78.705, 99.839, 43.728, 75.720, 45.709, 39.380, 33.590, 66.887, 78.335, 45.485;P = 0.000) except disc area. The average RNFL thickness in normal, early, moderate and advanced glaucomatous eyes was 109.950, 93.313, 80.374 and 65.570 µm, respectively. Among the eight regions around the optic disc, the thickest RNFL was located at the inferotemporal (150.066 µm) and superotemporal (146.285 µm) regions in normal eyes, and the superotemporal (108.569, 103.420 and 88.708 µm in early, moderate and advanced glaucomatous eyes, respectively) and inferotemporal (108.201, 102.830 and 86.369 µm in early, moderate and advanced glaucomatous eyes, respectively) regions in glaucomatous eyes. Both in normal and glaucomatous eyes, the thinnest RNFL was located at the nasal and temporal regions, respectively. For optic disc topographic parameters, the highest AUC was vertical cup/disc ratio (AUC = 0.762, 0.946 and 0.988 in early, moderate and advanced glaucomatous eyes, respectively), and the sensitivity at 80% specificity was 62.2%, 76.5% and 99.2% in early, moderate and advanced glaucomatous eyes, respectively. For RNFL thickness, the highest AUC was superotemporal region RNFL thickness (AUC = 0.915) and the sensitivity at 80% specificity was 89.5% in early glaucomatous eyes. The highest AUC was inferior average RNFL thickness (AUC = 0.967) and the sensitivity at 80% specificity was 94.1% in moderate glaucomatous eyes. The highest AUC was average RNFL thickness (AUC = 0.985) and the sensitivity at 80% specificity was 99.2% in advanced glaucomatous eyes. Among the eight regions around the optic disc, RNFL thickness of region ST (AUC = 0.915, 0.926 and 0.966 in early, moderate and advanced glaucomatous eyes, respectively) achieved the highest AUC. RNFL thicknesses of the nasal and temporal regions showed the lowest AUCs. RTVue OCT shows fair discriminating ability in distinguishing normal from glaucomatous eyes. RTVue OCT is a useful equipment for the diagnosis of glaucoma.

Predicting the Onset of Glaucoma: The Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the Ocular Hypertension Treatment Study

To evaluate the predictive ability of baseline confocal scanning laser ophthalmoscopy (CSLO) Glaucoma Probability Score (GPS) for the development of primary open-angle glaucoma (POAG) and to compare it with the Moorfields regression analysis (MRA) classification, other topographic optic disc parameters, and stereophotograph-based cup-to-disc ratio. Longitudinal, randomized clinical trial. We included 857 eyes of 438 participants in the CSLO Ancillary Study to the Ocular Hypertension Treatment Study (OHTS) with good quality baseline CSLO images. The ability of baseline GPS, MRA, and optic disc parameters to predict the development of POAG was evaluated in univariate and multivariable proportional hazard ratio analyses. Likelihood ratios and positive and negative predictive values were compared. The POAG end point as determined by repeatable changes in the visual field or optic disc. Sixty-four eyes of 50 CSLO Ancillary Study participants developed POAG. Median time to reach a POAG end point was 72.3 months. The 93 eyes of 388 participants not reaching endpoint were followed for a median of 124.9 months. Baseline GPS identified many more eyes as outside normal limits than the MRA. In multivariable analyses, all regional and global baseline GPS indices were significantly associated with the development of POAG; hazard ratios (95% confidence interval) ranged from 2.92 to 3.74 for an outside normal limits result. The MRA indices were also significantly associated with the development of POAG in multivariable analyses. In addition, the predictive ability of baseline GPS, MRA and stereometric parameters were similar to the predictive ability of models using photograph-based horizontal cup-to-disc ratio. These results suggest that baseline GPS, MRA, and stereoparameters alone or when combined with baseline clinical and demographic factors can be used to predict the development of POAG end points in OHTS participants and are as effective as stereophotographs for estimating the risk of developing POAG in ocular hypertensive subjects.

The Relationship Between Parameters Measured by Optical Coherence Tomography and Visual Field Indices

Purpose: To evaluate the diagnostic ability of optic disc topographic parameters and the retinal nerve fiber layer (RNFL) thickness parameter measured by optical coherence tomography (OCT) and to determine the association of these structural parameters with visual field indices. Methods: Fifty-six glaucomatous eyes and 65 healthy control eyes were enrolled in this retrospective cross-sectional study. Each subject had a 24-2 full threshold test on a Humphrey visual field analyzer and an optical coherence tomographic evaluation. The parameters from the fast RNFL thickness algorithm and the fast optic disc algorithm were analyzed by an ROC curve, and we sought to determine the association of these parameters with visual field indices by linear and logarithmic regression. Results: The area under the receiver operating characteristic curve (AUROC) value of the fast optic disc algorithm parameters ranged from 0.78 to 0.79 and that of the fast RNFL thickness algorithm parameters ranged from 0.74 to 0.81. The associations between the parameters from the fast optic disc algorithm and from the fast RNFL thickness algorithm with visual field indices were statistically significant (P

Correlación entre los índices globales de la perimetría automatizada convencional y los parámetros topográficos papilares (Heidelberg Retina Tomograph II)

To correlate the optic nerve head topographic parameters measured by the Heidelberg Retina Tomograph II (HRT) with the perimetric indices of standard automated perimetry (SAP). This study included 101 normal subjects, 247 ocular hypertensive eyes (increased intraocular pressure with normal SAP) and 102 glaucomatous subjects (IOP above 21 mm Hg and abnormal standard automated perimetry). Only one eye was randomly chosen from each subject for the study. The visual field was evaluated by means of Humphrey Field Analyzer (24-2 full threshold strategy). The HRT II (Heidelberg Engineering) was used to acquire and measure the optic disc topographic parameters. Pearson correlations between topographic data and perimetric indices were performed for the total sample and each group of patients. The distribution of values obtained in the samples was normal. A significant correlation was found between several optic disc parameters and the global indices of SAP. Rim area, rim volume, cup/disc area ratio, rim/disc area ratio, cup shape measurement, RNFL cross-sectional area, and discriminant functions FSM and RB, showed the strongest correlation with the visual field indices in the total and glaucoma groups (RIM AREA: total group: r=0.32; p=4.14x10(-11)/glaucoma group: r=0.28; p=0.004. RIM VOLUME: total group: r=0.26; p=1.55x10(-7)/glaucoma group: r=0.26; p=0.006). The ocular hypertensive group showed few significant correlations. The correlations found between standard automated perimetry and HRT defined topographic parameters allow a better understanding of glaucomatous damage and make decision-making easier.

Comparison of Optic Disc Topography Between Migrainous and Normal Subjects

The purpose of this study was to compare the optic disc topography parameters in migrainous and normal subjects, by using Heidelberg retinal tomograph (HRT). The topographic optic disc parameters of 29 nonglaucomatous eyes of 29 cases with migraine and 29 eyes of 29 normal subjects were compared with nonparametric Mann Whitney U test. The mean cup area (0.743 mm2) and cup to disc ratio (0.345) of migrainous subjects were greater than the mean cup area (0.591 mm2) and cup to disc ratio (0.288) of normal subjects (p = .009, p = .005). This result suggests that migrainous subjects have larger cup areas and higher cup to disc ratio ratios than normal subjects.

Optic disc topographic measurements after pupil dilation

Purpose To determine the effect of pupil dilation on topographic optic disc parameters measured with confocal scanning laser ophthalmoscopy. Design Prospective, comparative, observational case series. Participants Thirty-eight subjects (25 glaucoma patients, 5 glaucoma suspects, and 8 normal subjects) representing a range of lens opacities participated in this study. Methods Topographic optic disc parameter measurements were obtained before and after pupil dilation with a confocal scanning laser ophthalmoscope (Heidelberg Retina Tomograph). Cataract severity was measured with the LOCS III grading system. Image quality was assessed using the standard deviation of the mean topography image and an image quality score. Multiple regression techniques were used to evaluate the effect of image quality, cataract density, and pupil size on the change in topographic parameters after dilation. Main outcome measures Topographic optic disc parameter measurements. Results With dilation, mean change in most topographic optic disc parameters was not significantly different from zero. Changes in topographic optic nerve parameters tended to be relatively small when undilated images were of good quality and larger in images of relatively poor quality. The strongest predictor of the absolute value of change in topographic optic disc parameters was the standard deviation of the undilated mean topography image. Conclusions When confocal scanning laser ophthalmoscope images are of good quality, topographic optic disc parameter measurements obtained with a dilated pupil are similar to those obtained with an undilated pupil. However, caution should be exercised when interpreting information from poor quality confocal scanning laser ophthalmoscopic images.

Longitudinal changes in optic disc topography of adult patients after trabeculectomy

Objective To study longitudinal changes in optic disc topography after trabeculectomy in adult patients. Design Prospective case series. Participants Twenty-five eyes of 25 patients undergoing trabeculectomy were enrolled. Intervention Images of the optic disc were obtained preoperatively and approximately 2 weeks, 4 months, and 8 months after surgery by use of a confocal scanning laser ophthalmoscope (Heidelberg Retina Tomograph). Main outcome measures The topographic optic disc parameters (cup volume, cup area, rim volume, rim area, cup-disc area ratio, mean cup depth, maximum depth, cup shape, and height variation contour) were measured automatically for each image with the Heidelberg Retina Tomograph Software (version 1.11). Results Approximately 2 weeks after surgery, the mean preoperative intraocular pressure (IOP) of 19.3 mmHg (SD, 6.4 mmHg) decreased to 6.0 mmHg (SD, 3.6 mmHg), cup volume and mean cup depth decreased, height variation contour increased, and the cup shape parameter became more negative. Approximately 4 months after surgery, mean IOP was 9.7 mmHg (SD, 4.2 mmHg), and the only statistically significant change from preoperative values of optic disc parameters was in the cup shape measure. Approximately 8 months after surgery, there was no statistically significant change in any of the optic disc parameters compared with preoperative values, although IOP was 10.4 mmHg (SD, 5.9 mmHg). Conclusions Changes in the optic disc that may be present 2 weeks after a trabeculectomy do not appear to persist 4 and 8 months later in eyes with advanced glaucomatous optic nerve damage, except for cup shape, which was different from preoperative values at 4 months but not at 8 months.