title: Quantification of retinal nerve fiber defects in glaucoma: three-dimensional analysis by Heidelberg retina tomograph.
abstract: OBJECTIVE
  To describe a new method of quantifying retinal nerve fiber layer defects (NFLD) in glaucomatous eyes using the Heidelberg Retina Tomograph (HRT).
  
  
  METHODS
  Mean tomographic images including the optic disc and peripapillary area were constructed using HRT. An image field of 15 degrees x 15 degrees or 20 degrees x 20 degrees was used for the NFLD analysis. Data on the nerve fiber layer thickness was collected and further analyzed circumferentially across the NFLD at a position 500 microm away from the optic disc margin. We studied 31 patients with early to moderate open-angle glaucoma, ie, with visual field defects appearing earlier than stage 3 of the modified Aulhorn-Greve classification. We determined the width (W), maximum depth (D), and cross-sectional area of the NFLD (A), and we identified correlations between these parameters and the visual field indices from Humphrey Visual Field tests, mean deviation (MD) and corrected pattern standard deviation (CPSD).
  
  
  RESULTS
  NFLD parameters could be obtained from 20 of 31 eyes (65%). There was a statistically significant correlation between the D and A parameters, and between these parameters and the maximum depression threshold in the corresponding visual field. No significant correlation was found between the NFLD parameters, the global visual field indices (MD, CPSD) and the mean value of the total deviation (TD) in the corresponding hemifield visual field.
  
  
  CONCLUSIONS
  A cross-sectional NFLD image can be obtained using HRT. Among the three NFLD parameters, maximum depth (D), and area under the surface (A) correlated well with the visual field threshold.
authors.affiliation: Department of Ophthalmology, Gifu University School of Medicine, Gifu, Japan. kmgifu@aol.com
authors.forename: Kou
authors.initials: K
authors.lastname: Miyake
authors.forename: Hideya
authors.initials: H
authors.lastname: Uchida
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Sugiyama
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kitazawa
authors.forename: Hisashi
authors.initials: H
authors.lastname: Shinohara
mesh_terms: D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D008297:Male; D009412:Nerve Fibers / Q000473:pathology*; D009900:Optic Nerve / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D014054:Tomography / Q000379:methods; D014794:Visual Fields