1. Delving into glaucoma

    eyeworld.org Ophthalmology
    Delving into glaucoma
    How imaging devices and long-used assessments help with glaucoma detection, progression Newer methods to detect glaucoma strike a balance with the tried-and-true but less high-tech methods, a number of ophthalmologists said. Although state-of-the-art imaging methods to detect glaucoma earlier are now commonplace, glaucoma specialists said they don’t want to lose the value of perimetry, gonioscopy, tonometry, visual fields, and other detection tests. For now, high-tech versus low-tech detection methods are used hand in hand. “The most common tests within glaucoma are perimetry and scanning computerized ophthalmic diagnostic imaging,” said Kevin J. Corcoran, C.O.E., C.P.C., F ...
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    1. I am becoming a big fan of spectral-domain OCT, especially Spectralis [Heidelberg Engineering, Vista, Calif.]...To this point with time-domain OCT, I have not been convinced that you can use this technology to follow patients over time. Now, with the faster image acquisition and better axial resolution we see with SD OCT, there is better quantitative peripapillary retinal nerve fiber layer measurement for glaucoma management. The improved accuracy of the OCT segmentation allows for better long-term evaluation of patients.
    2. At a comparable level of specificity, Spectralis OCT RNFL measurement attained a higher sensitivity than HRT optic disc measurement.
    3. Stratus OCT RNFL parameters were able to discriminate eyes with progressing disease by visual fields or optic disc photographs with eyes that remained stable according to these methods, and performed significantly better than [optic nerve head] and macular thickness parameters in detecting change over time.

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