4.3 Article

Adaptive optics scanning laser ophthalmoscopy may support early diagnosis of glaucoma

Journal

INDIAN JOURNAL OF OPHTHALMOLOGY
Volume 70, Issue 8, Pages 2877-2882

Publisher

WOLTERS KLUWER MEDKNOW PUBLICATIONS
DOI: 10.4103/ijo.IJO_1044_21

Keywords

Adaptive optics scanning laser ophthalmoscopy (AOSLO) in glaucoma; early detection of glaucoma; reflectivity of retinal nerve fiber layer

Categories

Funding

  1. Hyderabad Eye Research Foundation
  2. L. V. Prasad Eye Institute, Hyderabad, India

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This study compared the image characteristics of RNFL between glaucoma patients and healthy controls using AOSLO, revealing differences between early glaucoma and controls. However, imaging success rate was lower in moderate and severe glaucoma groups, with indiscernible RNFL bundles and similar reflectivity compared to the early glaucoma group.
Purpose: To compare image characteristics of retinal nerve fiber layer (RNFL) between glaucoma patients and healthy controls using adaptive optics scanning laser ophthalmoscopy (AOSLO). Methods: This was a cross-sectional pilot study with two groups: a glaucoma group with patients with moderate or severe glaucoma as per the Hodapp-Parrish-Anderson classification system and a control group with healthy individuals. The optic nerve damage in moderate glaucoma was predominantly located in only one hemisphere; the other hemisphere was un- or minimally affected on optical coherence tomography and automated perimetry and is referred to as early glaucoma. The structure of RNFL bundles and gain (%) in RNFL images with mean pixel values between 15 and 35 were analyzed. Imaging was performed one degree away from the optic disc margin at two and four cardinal dock positions in the glaucoma and control groups, respectively. The field of view was 1.3 degrees at 2.3 mu resolution. We studied one eye per participant. Results: There were 11 glaucoma patients and 7 healthy controls. Imaging was successful at 88% of the locations in controls and early glaucoma; the reflectivity differed significantly (0.51 and 0.56, respectively, P < 0.001) but not the structure of RNFL bundles (Cohen's Kappa 0.11) between them. In patients with moderate and severe glaucoma, imaging was successful only at 46% of the locations; RNFL bundles were not discernible, and RNFL reflectivity did not differ from those with early glaucoma (P < 0.11). Conclusion: The recorded gain (%) of RNFL images obtained using AOSLO could be an objective indicator of early glaucoma.

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