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Robert N. Weinreb, MD; Christopher Bowd, PhD; Linda M. Zangwill, PhD

Arch Ophthalmol. 2003;121:218-224.

Objective  To compare the ability of scanning laser polarimetry (SLP) to discriminate between healthy and glaucomatous eyes with manufacturer-assumed fixed and subject-specific variable corneal polarization magnitude (CPM) and corneal polarization axis (CPA) values.

Methods  An SLP was modified to enable the measurement of CPM and CPA values so that compensation for corneal birefringence could be corrected on a subject-specific variable basis. We examined 40 healthy eyes and 54 glaucomatous eyes with repeatable visual field damage (average ± SD mean deviation, -6.5 ± 4.9 dB) were examined by SLP using the manufacturer-assumed fixed corneal compensation (FCC-SLP) values and subject-specific variable corneal compensation (VCC-SLP) values. Areas under the receiver operating characteristic (ROC) curve for discriminating between healthy and glaucomatous eyes using FCC-SLP and VCC-SLP parameters were compared.

Results  The areas under the ROC curve increased with VCC-SLP compared with FCC-SLP, particularly for all thickness parameters. The parameters with which the area under the ROC curve improved significantly from FCC-SLP to VCC-SLP included average thickness (ROC curve area, 0.62 vs 0.75), superior integral (0.66 vs 0.79), ellipse average (0.65 vs 0.80), inferior average (0.66 vs 0.80), and superior average (0.68 vs 0.83).

Conclusion  Variable corneal compensation to correct for subject-specific CPM and CPA can improve the ability of SLP to discriminate between healthy and glaucomatous eyes.

From the Hamilton Glaucoma Center and the Department of Ophthalmology, University of California, San Diego. Dr Weinreb is a consultant who has received research support from Laser Diagnostic Technologies, San Diego.

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