Quantitative assessment of atypical birefringence images using scanning laser polarimetry with variable corneal compensation

被引:97
作者
Bagga, H
Greenfield, DS
Feuer, WJ
机构
[1] Univ Miami, Sch Med, Bascom Palmer Eye Inst, Dept Ophthalmol, Miami, FL USA
[2] Univ Miami, Sch Med, Bascom Palmer Eye Inst, Dept Ophthalmol, Palm Beach Gardens, FL 33418 USA
关键词
D O I
10.1016/j.ajo.2004.10.019
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
center dot PURPOSE: To define the clinical characteristics of atypical birefringence images and to describe a quantitative method for their identification. center dot DESIGN: Prospective, comparative, clinical observational study. center dot METHODS: Normal and glaucomatous eyes underwent complete examination, standard automated perimetry, scanning laser polarimetry with variable corneal compensation (GDx,VCC), and optical coherence tomography (OCT) of the macula, peripapillary retinal nerve fiber layer (RNFL), and optic disk. Eyes were classified into two groups: normal birefringence pattern (NBP) and atypical birefringence pattern (ABP). Clinical, functional, and structural characteristics were assessed separately. A multiple logistic regression model was used to predict eyes with ABP on the basis of a quantitative scan score generated by a support vector machine (SVM) with GDx-VCC. center dot RESULTS: Sixty-five eyes of 65 patients were enrolled. ABP images were observed in 5 of 20 (25%) normal eyes and 23 of 45 (51%) glaucomatous eyes. Compared with eyes with NBP, glaucomatous eyes with ABP demonstrated significantly lower SVM scores (P <.0001, <.0001, 0.008, 0.03, and 0.03, respectively) and greater temporal, mean, inferior, and nasal RNFL thickness using GDx-VCC; and a weaker correlation with OCT generated RNFL thickness (R-2 =.75 vs .27). ABP images were significantly correlated with older age (R-2 = .16, P =.001). The SVM score was the only significant (P <.0001) predictor of ABP images and provided high discriminating power between eyes with NBP and ABP (area under the receiver operator characteristic curve 0.98). center dot CONCLUSIONS: ABP images exist in a subset of normal and glaucomatous eyes, are associated with older patient age, and produce an artifactual increase in RNFL thickness using GDx-VCC. The SVM score is highly predictive of ABP images. (c) 2005 by Elsevier Inc. All rights reserved.
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收藏
页码:437 / 446
页数:10
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