title: Scanning laser tomography Z profile signal width as an objective index of macular retinal thickening.
abstract: OBJECTIVE
  (i) To evaluate the relation between retinal thickness and the Z profile signal width of a scanning laser tomographer in selected patients exhibiting clinically manifest and circumscribed macular retinal thickening; (ii) to compare the Z profile signal width values of a group of age similar normal subjects with those of the patients with macular retinal thickening; and (iii) to present the methodology underlying the Z profile signal width derivation.
  
  
  METHODS
  Three patients with the following conditions were selected: widespread diabetic macular oedema; localised diabetic macular oedema; and macular hole. The patients were selected because they exhibited clinically manifest and circumscribed macular retinal thickening. Patients underwent fundus photography and a clinical examination which included fundus biomicroscopy. Fourteen age similar normal subjects were also assessed. The Heidelberg retina tomograph (HRT) was utilised to acquire seven topographic images of each macula. Z profile signal width data were analysed using custom software. Signal width was measured at 50% of the maximum intensity.
  
  
  RESULTS
  For each patient with macular retinal thickening, Z profile signal width analysis (after normalisation to reduce the influence of variation in reflectance intensity between successive images) revealed a significant (p < 0.0001) localised increase of signal width which agreed with the HRT topographic analysis of retinal height, and also the clinical assessment of retinal thickness. The mean normalised Z profile signal width for the normal subjects (assessed over the whole image) ranged from 0.278 (SD 0.039) to 0.444 (0.063); these values compared with those obtained from patients in areas of macular retinal thickening of 0.761 (0.224) to 0.953 (0.194). Z profile signal width test-retest data for the patient with localised diabetic macular oedema were plus or minus 0.159 which compared with a mean signal width value of 0.761.
  
  
  CONCLUSIONS
  The evidence of this study, based upon three selected patients with macular retinal thickening and 14 normal subjects, would suggest that Z profile signal width analysis offers a non-invasive, objective, topographic, and reproducible index of macular retinal thickening. Studies employing larger sample sizes are required to determine the true clinical worth of the technique.
authors.affiliation: University Department of Ophthalmology, Manchester Royal Eye Hospital.
authors.forename: C
authors.initials: C
authors.lastname: Hudson
authors.forename: J G
authors.initials: JG
authors.lastname: Flanagan
authors.forename: G S
authors.initials: GS
authors.lastname: Turner
authors.forename: D
authors.initials: D
authors.lastname: McLeod
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003930:Diabetic Retinopathy / Q000473:pathology; D006801:Humans; D008266:Macula Lutea; D018613:Microscopy, Confocal; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012164:Retinal Diseases / Q000473:pathology*