Scanning laser polarimetry with variable and enhanced corneal compensation in normal and glaucomatous eyes

PURPOSE: To investigate whether correction for atypical birefringence pattern (ABP) using scanning laser polarimetry with enhanced corneal compensation (SLP-ECC) reduces the severity of ABP compared with variable corneal compensation (SLP-VCC) and improves the correlation with visual function. DESIGN: Prospective observational study. METHODS: Normal and glaucomatous eyes enrolled from four clinical sites underwent complete examination, automated perimetry, SLP-ECC, and SLP-VCC. Eyes were characterized in three groups based upon the typical scan score (TSS): normal birefringence pattern (NBP) was defined as TSS : 80, mild ABP as TSS 61 to 79, and moderate-severe ABP as TSS <= 60. For each of four SLP parameters, the area under the ROC curve (AUROC) was calculated to compare the ability of SLP,ECC and SLP-VCC to discriminate between normal and glaucomatous eyes. RESULTS: Eighty-four normal volunteers and 45 glaucoma patients were enrolled. Mean TSS was significantly (P <.001) greater using SLP ECC (98.0 +/- 6.6) compared with SLP-VCC (83.4 +/- 22.5). The frequency of moderate,severe ABP images was significantly (P <.001, McNemar test) higher using SLP-VCC (18 of 129, 14%) compared with SLP-ECC (one of 129, 0.8%). Two SLP-ECC parameters (temporal superior nasal in, ferior temporal [TSNIT] average and inferior average) had significantly (P =.01, P <.001) higher correlation (r =.45, r =.50, respectively) with MD compared with SLP-VCC (r =.34, r =.37). Among eyes with moder, ate,severe ABP (n = 18), inferior average obtained using SLP,ECC had significantly (P =.03) greater AUROC (0.91 +/- 0.07) compared with SLP-VCC (0-78 +/- 0.11). CONCLUSIONS: SLP-ECC significantly reduces the frequency and severity of ABP compared with SLP-VCC and improves the correlation between RNFL measures and visual function.