New developments in scanning laser polarimetry for glaucoma.
OBJECTIVE
Scanning laser polarimetry is a technique that is used to evaluate the thickness of the retinal nerve fiber layer. It has been shown to have a high accuracy for diagnosing glaucoma. In a subset of eyes, atypical retardation patterns may be present that do not match the expected retinal nerve fiber layer appearance. This review summarizes recent advances made to reduce the frequency and severity of these patterns. In addition, recent progress in the development of algorithms for detecting progression is discussed.


RESULTS
A new measurement algorithm--enhanced corneal compensation--has been developed to improve the instrument's signal-to-noise ratio. Enhanced corneal compensation has been shown to improve the accuracy of scanning laser polarimetry for diagnosing glaucoma. In addition, enhanced corneal compensation improves the relationship between standard automated perimetry and scanning laser polarimetry measurements. Furthermore, research is being done on detecting progression in glaucoma. Recently, a method for simulating progression has been proposed, thereby diminishing the need for long-term studies to validate numerous measurement algorithms.


CONCLUSIONS
With enhanced corneal compensation, the diagnostic accuracy of scanning laser polarimetry has been further improved for glaucoma. Newly developed algorithms for detecting any progressive retinal nerve fiber layer thinning await clinical validation.
Lemij
Hans G
HG
Glaucoma Service, Rotterdam Eye Hospital, Rotterdam, The Netherlands. lemij@wxs.nl
Reus
Nicolaas J
NJ
D001718:Birefringence; D003315:Cornea / Q000502:physiology; D003941:Diagnostic Techniques, Ophthalmological; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D007834:Lasers; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D012165:Retinal Ganglion Cells / Q000473:pathology*