Objective: To assess the reproducibility of retinal nerve fiber layer measurements in pseudophakic normal and glaucomatous eyes using scanning laser polarimetry (GDx, Laser Diagnostic Technologies, Inc., San Diego, CA).
Patients and methods: Normal and glaucomatous patients with polymethylmethacrylate posterior chamber intraocular lenses that satisfied entry criteria underwent imaging by two experienced operators. Eyes with posterior capsule opacification or vision less than 20/30 were excluded. Baseline images (mean pixel SD less than 8 mm) were obtained on 3 separate days within a 7-week period. Reproducibility, defined as the pooled within eye variance of these 3 measurements and the coefficient of variation for 12 retardation parameters generated by GDx software were calculated.
Results: Eighteen eyes (11 glaucoma, 7 normal) of 15 patients (7 female, 8 male) were enrolled (mean age 78 +/- 6 years). Among glaucomatous eyes, the average mean deviation and corrected pattern standard deviation using achromatic automated perimetry (Zeiss-Humphrey, Dublin, CA) was -3.8 +/- 1.5 dB (range, -1.89 to -5.04 dB) and 4.9 +/- 3.3 dB (range 0 to 11.05 dB), respectively. Coefficient of variation was 10% or less for all retardation parameters except ellipse modulation (20.2%) and neural network number (12.4%). Glaucomatous and normal eyes had similar variability for 8 of 12 (66.7%) retardation parameters. Inferior ratio, ellipse modulation, and superior ratio were significantly less variable in glaucomatous eyes (P = 0.007, 0.02, and 0.04 respectively) than normal eyes. Superior integral was more variable in glaucomatous eyes (P = 0.03).
Conclusion: Retardation measurements may be obtained in pseudophakic eyes with acceptable reproducibility. Normal eyes and eyes with mild glaucomatous damage have similar variability for most retardation parameters.