Scanning laser polarimetry to measure the nerve fiber layer of normal and glaucomatous eyes.

Abstract

To determine whether retardation (change in polarization) measurements of healthy subjects and glaucoma patients obtained by using a confocal scanning laser polarimeter correspond to known properties of the nerve fiber layer. A polarimeter, an optical device used to measure the change in linear polarization of light (retardation), was interfaced with a scanning laser ophthalmoscope to obtain retardation data at 65,536 locations (256 x 256 pixels) in a study of normal subjects and patients with primary open-angle glaucoma. To validate the instrument, we compared our measurements with known properties of the human retinal nerve fiber layer in 105 normal subjects. Additionally, we compared retardation measurements in eyes of 64 normal subjects and 64 age-matched glaucoma patients treated in a referral practice. In normal eyes, mean (+/- S.D.) peripapillary retardation was highest in the superior and inferior arcuate regions and lowest in the temporal and nasal regions, 12.0 +/- 1.9, 13.1 +/- 2.0, 7.0 +/- 1.8, and 7.0 +/- 1.6 degrees, respectively. Retardation decreased toward the periphery and was lower over blood vessels. In normal eyes, retardation decreased with increasing age in the superior and inferior regions. Mean retardation was statistically significantly higher among normal eyes than glaucoma eyes in the inferior and superior regions but not in the temporal or nasal areas. Scanning laser polarimetry provides quantitative measurements that correspond to known properties of the retinal nerve fiber layer in normal and glaucomatous eyes.