Role of optic nerve imaging in glaucoma clinical practice and clinical trials.

PURPOSE To provide an update on the role of optic nerve and peripapillary retinal nerve fiber layer imaging in glaucoma clinical practice and clinical trials. DESIGN Perspective. METHODS Review of recent literature and authors' clinical and laboratory studies. RESULTS Imaging technologies such as confocal scanning laser ophthalmoscopy, scanning laser polarimetry, and optical coherence tomography provide objective and quantitative measurements that are highly reproducible and show very good agreement with clinical estimates of optic nerve head structure and visual function. Structural assessments provided by imaging complement optic disk photography in clinical care and have the potential to identify relevant structural efficacy endpoints in glaucoma randomized clinical trials. As with other technologies, imaging may produce false identification of glaucoma and its progression; thus, clinicians should not make management decisions based solely on the results of one single test or technology. CONCLUSIONS Although optic disk stereophotography represents the standard for documentation of glaucomatous structural damage in practice and research trials, advances in computerized imaging technology provide useful measures that assist the clinician in glaucoma diagnosis and monitoring and offer considerable opportunity for use as efficacy endpoints in clinical trials.

[1]  W. Green,et al.  Optic nerve damage in human glaucoma. III. Quantitative correlation of nerve fiber loss and visual field defect in glaucoma, ischemic neuropathy, papilledema, and toxic neuropathy. , 1982, Archives of ophthalmology.

[2]  F. Medeiros,et al.  The effect of atypical birefringence patterns on glaucoma detection using scanning laser polarimetry with variable corneal compensation. , 2007, Investigative ophthalmology & visual science.

[3]  G. Mcgwin,et al.  Discrimination between glaucomatous and nonglaucomatous eyes using quantitative imaging devices and subjective optic nerve head assessment. , 2006, Investigative ophthalmology & visual science.

[4]  W. Feuer,et al.  Quantitative assessment of atypical birefringence images using scanning laser polarimetry with variable corneal compensation. , 2005, American journal of ophthalmology.

[5]  L Frisén,et al.  Fundoscopy of nerve fiber layer defects in glaucoma. , 1973, Investigative ophthalmology.

[6]  A. Sommer,et al.  Clinically detectable nerve fiber atrophy precedes the onset of glaucomatous field loss. , 1991, Archives of ophthalmology.

[7]  M. Nicolela,et al.  Visual field and optic disc progression in patients with different types of optic disc damage: a longitudinal prospective study. , 2003, Ophthalmology.

[8]  Vertical cup/disc ratio in relation to optic disc size , 1999, The British journal of ophthalmology.

[9]  W. Feuer,et al.  Detection of psychophysical and structural injury in eyes with glaucomatous optic neuropathy and normal standard automated perimetry. , 2006, Archives of ophthalmology.

[10]  Joel S Schuman,et al.  Optic nerve head and retinal nerve fiber layer analysis: a report by the American Academy of Ophthalmology. , 2007, Ophthalmology.

[11]  Robert N Weinreb,et al.  Is scanning laser polarimetry ready for clinical practice? , 2007, American journal of ophthalmology.

[12]  R. Weinreb,et al.  Individualized compensation of anterior segment birefringence during scanning laser polarimetry. , 2002, Investigative ophthalmology & visual science.

[13]  Douglas R. Anderson,et al.  Detection and prognostic significance of optic disc hemorrhages during the Ocular Hypertension Treatment Study. , 2006, Ophthalmology.

[14]  Robert N Weinreb,et al.  The effect of disc size and severity of disease on the diagnostic accuracy of the Heidelberg Retina Tomograph Glaucoma Probability Score. , 2007, Investigative ophthalmology & visual science.

[15]  A Heijl,et al.  Early Manifest Glaucoma Trial: design and baseline data. , 1999, Ophthalmology.

[16]  Robin Ray,et al.  Evaluation of image artifact produced by optical coherence tomography of retinal pathology. , 2004, American journal of ophthalmology.

[17]  Chris A. Johnson,et al.  The Ocular Hypertension Treatment Study: baseline factors that predict the onset of primary open-angle glaucoma. , 2002, Archives of ophthalmology.

[18]  Douglas R. Anderson,et al.  Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures. Collaborative Normal-Tension Glaucoma Study Group. , 1998, American journal of ophthalmology.

[19]  M. Morales i Ballús,et al.  Baseline Optical Coherence Tomography Predicts the Development of Glaucomatous Change in Glaucoma Suspects , 2007 .

[20]  W. Drexler.  Ultrahigh-resolution optical coherence tomography. , 2004, Journal of biomedical optics.

[21]  F. Medeiros,et al.  Long-term intraocular pressure fluctuations and risk of conversion from ocular hypertension to glaucoma. , 2008, Ophthalmology.

[22]  S. Miglior,et al.  Predictive factors for open-angle glaucoma among patients with ocular hypertension in the European Glaucoma Prevention Study. , 2007, Ophthalmology.

[23]  A. Coleman,et al.  Comparison of optic nerve imaging methods to distinguish normal eyes from those with glaucoma. , 2002, Investigative ophthalmology & visual science.

[24]  L. Labree,et al.  Glaucoma care and conformance with preferred practice patterns. Examination of the private, community-based ophthalmologist. , 1996, Ophthalmology.

[25]  Robert N Weinreb,et al.  Correction for corneal polarization axis improves the discriminating power of scanning laser polarimetry. , 2002, American journal of ophthalmology.

[26]  J. Crowston,et al.  Validation of a predictive model to estimate the risk of conversion from ocular hypertension to glaucoma. , 2005, Archives of ophthalmology.

[27]  D. Friedman,et al.  Glaucoma management among individuals enrolled in a single comprehensive insurance plan. , 2005, Ophthalmology.

[28]  L. Zangwill,et al.  Retinal nerve fiber layer damage as assessed by optical coherence tomography in eyes with a visual field defect detected by frequency doubling technology perimetry but not by standard automated perimetry. , 2007, Ophthalmology.

[29]  B C Chauhan,et al.  Optic disc and visual field changes in a prospective longitudinal study of patients with glaucoma: comparison of scanning laser tomography with conventional perimetry and optic disc photography. , 2001, Archives of ophthalmology.

[30]  H. Quigley,et al.  Number of ganglion cells in glaucoma eyes compared with threshold visual field tests in the same persons. , 2000, Investigative ophthalmology & visual science.

[31]  Robert N Weinreb,et al.  The confocal scanning laser ophthalmoscopy ancillary study to the ocular hypertension treatment study: study design and baseline factors. , 2004, American journal of ophthalmology.

[32]  J. Crowston,et al.  Optic disk size and glaucoma. , 2007, Survey of ophthalmology.

[33]  R. Bourne,et al.  Agreement among 3 optical imaging methods for the assessment of optic disc topography. , 2005, Ophthalmology.

[34]  Jon C. Ervin,et al.  Clinician change detection viewing longitudinal stereophotographs compared to confocal scanning laser tomography in the LSU Experimental Glaucoma (LEG) Study. , 2002, Ophthalmology (Rochester, Minn.).

[35]  R. Knighton,et al.  Effect of corneal polarization axis on assessment of retinal nerve fiber layer thickness by scanning laser polarimetry. , 2000, American journal of ophthalmology.

[36]  Robert N Weinreb,et al.  Retinal nerve fiber layer thickness measurements with scanning laser polarimetry predict glaucomatous visual field loss. , 2004, American journal of ophthalmology.

[37]  Paul H Artes,et al.  Visual field progression in glaucoma: total versus pattern deviation analyses. , 2005, Investigative ophthalmology & visual science.

[38]  Kanika Kapur,et al.  Patterns of care for open-angle glaucoma in managed care. , 2003, Archives of ophthalmology.

[39]  G. Wollstein,et al.  Optical coherence tomography and histologic measurements of nerve fiber layer thickness in normal and glaucomatous monkey eyes. , 2007, Investigative ophthalmology & visual science.

[40]  E. E. Hartmann,et al.  The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. , 2002, Archives of ophthalmology.

[41]  Valter Torri,et al.  Results of the European Glaucoma Prevention Study. , 2005, Ophthalmology.

[42]  M. C. Leske,et al.  Measuring visual field progression in the Early Manifest Glaucoma Trial. , 2003, Acta ophthalmologica Scandinavica.

[43]  Valter Torri,et al.  European Glaucoma Prevention Study: Author reply , 2005 .

[44]  M. Araie,et al.  Morphometric evaluation of changes with time in optic disc structure and thickness of retinal nerve fibre layer in chronic ocular hypertensive monkeys. , 2004, Experimental eye research.

[45]  L. Labree,et al.  Factors associated with variability in retinal nerve fiber layer thickness measurements obtained by optical coherence tomography. , 2007, Ophthalmology.

[46]  J. Beiser,et al.  Baseline topographic optic disc measurements are associated with the development of primary open-angle glaucoma: the Confocal Scanning Laser Ophthalmoscopy Ancillary Study to the Ocular Hypertension Treatment Study. , 2005, Archives of ophthalmology.

[47]  G. Wollstein,et al.  Optical coherence tomography longitudinal evaluation of retinal nerve fiber layer thickness in glaucoma. , 2005, Archives of ophthalmology.