Glaucoma imaging devices have limitations but can aid in detection, tracking

VERACRUZ, Mexico — Retinal image analyzers can help identify glaucoma suspects early, but four out of five physicians polled during a presentation here do not have one in their office, said Henry D. Jampel, MD, at the Mexican Congress of Ophthalmology.

Dr. Jampel said that because the patterns of glaucomatous damage are known, clinicians can logically study the optic disc, the retinal nerve fiber layer and the macula using digital imaging devices. The goals of imaging are similar to the goals of perimetry, he said: to detect initial glaucoma injury and then follow the progression of damage.

Dr. Jampel said all image analyzers have limitations. However, he said, “structural analysis of the optic nerve using a computerized imaging system has great promise because it is objective; it is quantitative as long as you take the numbers with a grain of salt; it provides a documentation of appearance, which is so important; and it may detect changes earlier than functional tests.”

“For the four-fifths of you in the room who don’t have an image analyzer, if you have the resources to obtain one, do so,” Dr. Jampel said.

He pointed out that it is still not clear which structures are the most important to study and track; these are considerations when looking at the available imaging analyzers and the structures they detect.