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Michael D. Boehm, MD; Chad Nedrud, MD; David S. Greenfield, MD; Philip P. Chen, MD

Arch Ophthalmol. 2003;121:189-194.

Objective  To examine retinal nerve fiber layer changes with scanning laser polarimetry (SLP) in the eyes of patients with glaucoma and optic disc hemorrhage.

Methods  Automated perimetry and SLP were performed in 17 eyes of 17 patients identified prospectively with optic disc hemorrhage. Criteria for visual field progression were based on decreased sensitivity seen at 3 adjacent points on the total deviation plot. Progression on SLP images was defined as a 15% or more decrease in the average thickness of the affected quadrant (superior or inferior), a 25% or more reduction in the affected quadrant ratio, an increase in the nerve fiber analyzer number of 10 or more (GDx Nerve Fiber Analyzer; Laser Diagnostic Technologies), or any change on Serial Analysis of the SLP images.

Main Outcome Measures  Visual field progression and SLP image progression.

Results  The mean follow-up was 31 months (minimum, 12 months). Of the 17 eyes, 10 (59%) had visual field progression. No significant change was seen on SLP images for either the total group or the group with visual field progression. Five eyes (29%) showed progression on SLP images, 3 of which also showed visual field progression. Ten eyes showed progression on SLP images that was not confirmed on subsequent imaging.

Conclusions  In eyes with visual field progression after optic disc hemorrhage, a significant change in the SLP image was not seen. Fluctuation of SLP results in patients with glaucoma necessitates confirmation of progression seen on SLP images.

From the Departments of Ophthalmology, University of Washington, Seattle (Drs Boehm, Nedrud, and Chen), and Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Fla (Dr Greenfield). None of the authors has any financial interest in any product mentioned within this article. Dr Greenfield is a member of the Clinical Advisory Board, Laser Diagnostic Technologies, San Diego, Calif.

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