Analysis of retinal nerve fiber layer birefringence in patients with glaucoma and diabetic retinopathy by polarization sensitive OCT

The retinal nerve fiber layer (RNFL) is a fibrous tissue that shows form birefringence. This optical tissue property is related to the microstructure of the nerve fiber axons that carry electrical signals from the retina to the brain. Ocular diseases that are known to cause neurologic changes, like glaucoma or diabetic retinopathy (DR), might alter the birefringence of the RNFL, which could be used for diagnostic purposes. In this pilot study, we used a state-of-the-art polarization sensitive optical coherence tomography (PS-OCT) system with an integrated retinal tracker to analyze the RNFL birefringence in patients with glaucoma, DR, and in age-matched healthy controls. We recorded 3D PS-OCT raster scans of the optic nerve head area and high-quality averaged circumpapillary PS-OCT scans, from which RNFL thickness, retardation and birefringence were derived. The precision of birefringence measurements was 0.005°/µm. As compared to healthy controls, glaucoma patients showed a slightly reduced birefringence (0.129 vs. 0.135°/µm), although not statistically significant. The DR patients, however, showed a stronger reduction of RNFL birefringence (0.103 vs. 0.135°/µm) which was highly significant. This result might open new avenues into early diagnosis of DR and related neurologic changes.

[1]  Maximilian G. O. Gräfe,et al.  Optic axis uniformity as a metric to improve the contrast of birefringent structures and analyze the retinal nerve fiber layer in polarization-sensitive optical coherence tomography. , 2019, Optics letters.

[2]  Jost B Jonas,et al.  Incidence and progression of diabetic retinopathy: a systematic review. , 2019, The lancet. Diabetes & endocrinology.

[3]  Joobin Khadamy,et al.  An Update on Optical Coherence Tomography Angiography in Diabetic Retinopathy , 2018, Journal of ophthalmic & vision research.

[4]  Jae Hyung Lee,et al.  Relationship between Systemic Vascular Characteristics and Retinal Nerve Fiber Layer Loss in Patients with Type 2 Diabetes , 2018, Scientific Reports.

[5]  B. Vakoc,et al.  Diagnostic Capability of Peripapillary Three-dimensional Retinal Nerve Fiber Layer Volume for Glaucoma Using Optical Coherence Tomography Volume Scans. , 2017, American journal of ophthalmology.

[6]  Yogesan Kanagasingam,et al.  Evaluation of Cholinergic Deficiency in Preclinical Alzheimer's Disease Using Pupillometry , 2017, Journal of ophthalmology.

[7]  Jennifer K. Sun,et al.  Diabetic retinopathy: current understanding, mechanisms, and treatment strategies. , 2017, JCI insight.

[8]  Cristina Hernández,et al.  Update on Diagnosis and Treatment of Diabetic Retinopathy: A Consensus Guideline of the Working Group of Ocular Health (Spanish Society of Diabetes and Spanish Vitreous and Retina Society) , 2017, Journal of ophthalmology.

[9]  Bernhard Baumann,et al.  Polarization Sensitive Optical Coherence Tomography: A Review of Technology and Applications , 2017 .

[10]  C. Hitzenberger,et al.  Polarization sensitive optical coherence tomography - a review [Invited]. , 2017, Biomedical optics express.

[11]  W. Feuer,et al.  Cytoskeletal Alteration and Change of Retinal Nerve Fiber Layer Birefringence in Hypertensive Retina , 2017, Current eye research.

[12]  J. Leksell,et al.  Visual functioning and health-related quality of life in diabetic patients about to undergo anti-vascular endothelial growth factor treatment for sight-threatening macular edema. , 2015, Journal of diabetes and its complications.

[13]  Lin Wang,et al.  Relating Retinal Ganglion Cell Function and Retinal Nerve Fiber Layer (RNFL) Retardance to Progressive Loss of RNFL Thickness and Optic Nerve Axons in Experimental Glaucoma. , 2015, Investigative ophthalmology & visual science.

[14]  Michael Pircher,et al.  Retinal nerve fiber bundle tracing and analysis in human eye by polarization sensitive OCT. , 2015, Biomedical optics express.

[15]  Peter K Kaiser,et al.  Optical coherence tomography imaging of macular oedema , 2014, British Journal of Ophthalmology.

[16]  F. Medeiros,et al.  The pathophysiology and treatment of glaucoma: a review. , 2014, JAMA.

[17]  Gadi Wollstein,et al.  OCT for glaucoma diagnosis, screening and detection of glaucoma progression , 2013, British Journal of Ophthalmology.

[18]  Barry Cense,et al.  Henle fiber layer phase retardation measured with polarization-sensitive optical coherence tomography. , 2013, Biomedical optics express.

[19]  Lin Wang,et al.  Onset and progression of peripapillary retinal nerve fiber layer (RNFL) retardance changes occur earlier than RNFL thickness changes in experimental glaucoma. , 2013, Investigative ophthalmology & visual science.

[20]  Robert N Weinreb,et al.  Rates of retinal nerve fiber layer thinning in glaucoma suspect eyes. , 2013, Ophthalmology.

[21]  J. Duker,et al.  Optical coherence tomography – current and future applications , 2013, Current opinion in ophthalmology.

[22]  Michael Pircher,et al.  Measuring retinal nerve fiber layer birefringence, retardation, and thickness using wide-field, high-speed polarization sensitive spectral domain OCT. , 2013, Investigative ophthalmology & visual science.

[23]  U. Schmidt-Erfurth,et al.  Polarization sensitive optical coherence tomography in the human eye , 2011, Progress in Retinal and Eye Research.

[24]  V. Greenstein,et al.  Hypodense regions (holes) in the retinal nerve fiber layer in frequency-domain OCT scans of glaucoma patients and suspects. , 2011, Investigative ophthalmology & visual science.

[25]  Hiroshi Ishikawa,et al.  Clinical use of OCT in assessing glaucoma progression. , 2011, Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye.

[26]  Leonard K. Seibold,et al.  Comparison of retinal nerve fiber layer thickness in normal eyes using time-domain and spectral-domain optical coherence tomography. , 2010, American journal of ophthalmology.

[27]  F. Horn,et al.  Retinal Nerve Fiber Layer Thickness in Normals Measured by Spectral Domain OCT , 2010, Journal of glaucoma.

[28]  Joseph A. Izatt,et al.  Automatic segmentation of seven retinal layers in SDOCT images congruent with expert manual segmentation , 2010, Optics express.

[29]  C. Hitzenberger,et al.  Polarization maintaining fiber based ultra-high resolution spectral domain polarization sensitive optical coherence tomography. , 2009, Optics express.

[30]  F. Medeiros,et al.  Detection of glaucoma progression with stratus OCT retinal nerve fiber layer, optic nerve head, and macular thickness measurements. , 2009, Investigative ophthalmology & visual science.

[31]  M. Sonka,et al.  Selective loss of inner retinal layer thickness in type 1 diabetic patients with minimal diabetic retinopathy. , 2009, Investigative ophthalmology & visual science.

[32]  Michael Pircher,et al.  Analysis of the origin of atypical scanning laser polarimetry patterns by polarization-sensitive optical coherence tomography. , 2008, Investigative ophthalmology & visual science.

[33]  U. Schmidt-Erfurth,et al.  Retinal pigment epithelium segmentation by polarization sensitive optical coherence tomography. , 2008, Optics express.

[34]  V. Greenstein,et al.  An Analysis of Normal Variations in Retinal Nerve Fiber Layer Thickness Profiles Measured With Optical Coherence Tomography , 2008, Journal of glaucoma.

[35]  C K Hitzenberger,et al.  Retinal nerve fiber layer birefringence evaluated with polarization sensitive spectral domain OCT and scanning laser polarimetry: A comparison , 2008, Journal of biophotonics.

[36]  C. Hitzenberger,et al.  Corneal birefringence compensation for polarization sensitive optical coherence tomography of the human retina. , 2007, Journal of biomedical optics.

[37]  F. Medeiros,et al.  Retinal nerve fiber layer thickness and visual sensitivity using scanning laser polarimetry with variable and enhanced corneal compensation. , 2007, Ophthalmology.

[38]  Douglas R. Anderson,et al.  Determinants of normal retinal nerve fiber layer thickness measured by Stratus OCT. , 2007, Ophthalmology.

[39]  H. Quigley,et al.  The number of people with glaucoma worldwide in 2010 and 2020 , 2006, British Journal of Ophthalmology.

[40]  M. Sugimoto,et al.  Detection of Early Diabetic Change with Optical Coherence Tomography in Type 2 Diabetes Mellitus Patients without Retinopathy , 2005, Ophthalmologica.

[41]  G. Savini,et al.  Correlation between retinal nerve fibre layer thickness and optic nerve head size: an optical coherence tomography study , 2005, British Journal of Ophthalmology.

[42]  R. Knighton,et al.  Variation of peripapillary retinal nerve fiber layer birefringence in normal human subjects. , 2004, Investigative ophthalmology & visual science.

[43]  Barry Cense,et al.  Thickness and birefringence of healthy retinal nerve fiber layer tissue measured with polarization-sensitive optical coherence tomography. , 2004, Investigative ophthalmology & visual science.

[44]  Charles Wallace,et al.  Detection of glaucomatous retinal nerve fiber layer damage by scanning laser polarimetry with variable corneal compensation , 2003, SPIE BiOS.

[45]  S. Ozdek,et al.  Assessment of nerve fiber layer in diabetic patients with scanning laser polarimetry , 2002, Eye.

[46]  Mark C. Pierce,et al.  In vivo depth-resolved birefringence measurements of the human retinal nerve fiber layer using polarization-sensitive optical coherence tomography , 2002, SPIE BiOS.

[47]  V. P. Costa,et al.  Retinal nerve fibre layer loss in patients with type 1 diabetes mellitus without retinopathy , 2002, The British journal of ophthalmology.

[48]  L. Zangwill,et al.  Detection of glaucoma with scanning laser polarimetry. , 1998, Archives of ophthalmology.

[49]  E A Swanson,et al.  Quantification of nerve fiber layer thickness in normal and glaucomatous eyes using optical coherence tomography. , 1995, Archives of ophthalmology.

[50]  Kenichi Saito,et al.  Analysis of optimum conditions of depolarization imaging by polarization-sensitive optical coherence tomography in the human retina , 2015, Journal of biomedical optics.

[51]  Kenichi Saito,et al.  Motion artifact and speckle noise reduction in polarization sensitive optical coherence tomography by retinal tracking. , 2013, Biomedical optics express.

[52]  Shu Liu,et al.  Evaluation of retinal nerve fiber layer progression in glaucoma: a study on optical coherence tomography guided progression analysis. , 2010, Investigative ophthalmology & visual science.

[53]  Toyohiko Yatagai,et al.  Phase retardation measurement of retinal nerve fiber layer by polarization-sensitive spectral-domain optical coherence tomography and scanning laser polarimetry. , 2008, Journal of biomedical optics.

[54]  Barry Cense,et al.  In vivo birefringence and thickness measurements of the human retinal nerve fiber layer using polarization-sensitive optical coherence tomography. , 2004, Journal of biomedical optics.