Skip to main content
NCBI home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1998 Jun;82(6):684–690. doi: 10.1136/bjo.82.6.684

Retinal nerve fibre layer polarimetry: histological and clinical comparison

J Morgan 1, A Waldock 1, G Jeffery 1, A Cowey 1
PMCID: PMC1722644  PMID: 9797673

Abstract

AIMS—To compare histological thickness of the retinal nerve fibre layer in the primate with retardation measurements obtained in vivo using the Mark II Nerve Fiber Analyzer (NFA, Laser Diagnostic Technologies, San Diego, USA).
METHODS—Scanning laser polarimetry was performed on both eyes of a healthy anaesthetised adult primate (Macaca mulatta). The retinal nerve fibre layer thickness was measured in the eye with the best polarimetry image. A nerve fibre layer thickness map was scaled and aligned to a retardation map to permit correlation of retardation and thickness measurements.
RESULTS—Retinal nerve fibre layer thickness measurements could be satisfactorily aligned with corresponding retardation values at 216 locations. The overall correlation coefficient for nerve fibre layer thickness and retardation was r = 0.70 (n = 216, p <0.001). Regional comparison showed the best correlation (r = 0.76, n = 45, p <0.001) occurred inferior to the optic disc. Less positive but still highly significant correlations were seen superiorly and temporally (r = 0.52, n = 26, p = 0.007 and r = 0.49, n = 86, p = <0.001 respectively), with the lowest correlation occurring at the nasal aspect of the disc (r  = 0.06, n  = 67, p = 0.64).
CONCLUSIONS—In the primate eye, retinal nerve fibre layer thickness shows a positive correlation with retardation measurements obtained with the nerve fibre analyser. However, since the correlation coefficient varied around the optic disc, further evaluation of the device is advised before its routine clinical use.

 Keywords: nerve fibre layer; polarimetry; glaucoma; optic disc

Full Text

The Full Text of this article is available as a PDF (197.2 KB).

Figure 1  .

Figure 1  

Figure 1  

Open in a new tab

(A) Image of the optic disc of the right eye showing peripapillary birefringence. In the grey scale view, lighter pixels correspond to areas of higher retardation. (B) Extended focus image of the optic disc obtained at the time of the polarimetric scan. The bright spot just inferior to the centre of the optic disc is an imaging artefact.

Figure 2  .

Figure 2  

Open in a new tab

Photomicrographs showing the retinal nerve fibre layer as seen with Normarski optics. (A) At the edge of the macula, the retinal layers can clearly be seen. Scale bar 50 µm. (B) At the disc margin large vessels are seen within the nerve fibre layer. The nerve fibre layer retinal ganglion cell interface is shown (arrow). Scale bar 50 µm.

Figure 3  .

Figure 3  

Open in a new tab

Diagram showing representative retinal nerve fibre layer thickness measurements (µm) with respect to the disc margin (interrupted line). Major blood vessels are shaded in black and correspond to the field of view in Figure 1. Peripapillary retina is divided into superior (S), inferior (I), temporal (T), nasal (N) sectors by lines that intersect at 90 degrees at the centre of the optic disc. Scale bar 2 degrees (495 µm).

Figure 4  .

Figure 4  

Open in a new tab

Plots showing the change in retardation and histological retinal nerve fibre layer thickness along representative sections. The inset figure of the optic disc shows the location and orientation of the sections. Retardation is expressed as µm of nerve fibre layer (NFL) thickness (digital retardation value × 7.4).

Figure 5  .

Figure 5  

Open in a new tab

Plot of retardation value against measured nerve fibre layer (NFL) thickness for all thickness retardation pairs. n = 216. r = 0.70, p = <0.001. The equation describing the straight line fits is shown inset. The broken line shows the straight line fit through the origin.

Figure 6  .

Figure 6  

Open in a new tab

Plot of retardation and corresponding nerve fibre layer (NFL) thickness measures for points lying within a 1.5-2.0 disc diameter zone (from the disc centre) around the optic disc. The temporal aspect of the disc lies at 0 degrees and the superior aspect at 90 degrees. Bold line, solid markers: nerve fibre layer thickness. Fine line, open markers; retardation. Retardation and thickness scales have been normalised relative to their peak values to facilitate comparison.

Figure 7  .

Figure 7  

Open in a new tab

Plot of retinal nerve fibre layer (RNFL) around the optic disc for 10 normal (non-glaucomatous) patients. Bold line, mean RNFL. Fine lines show the 95% confidence intervals. (A) right eyes, (B) left eyes.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Airaksinen P. J., Drance S. M., Douglas G. R., Schulzer M., Wijsman K. Visual field and retinal nerve fiber layer comparisons in glaucoma. Arch Ophthalmol. 1985 Feb;103(2):205–207. doi: 10.1001/archopht.1985.01050020057019. [DOI] [PubMed] [Google Scholar]
  2. Balazsi A. G., Rootman J., Drance S. M., Schulzer M., Douglas G. R. The effect of age on the nerve fiber population of the human optic nerve. Am J Ophthalmol. 1984 Jun;97(6):760–766. doi: 10.1016/0002-9394(84)90509-9. [DOI] [PubMed] [Google Scholar]
  3. Caprioli J., Miller J. M. Measurement of relative nerve fiber layer surface height in glaucoma. Ophthalmology. 1989 May;96(5):633–641. doi: 10.1016/s0161-6420(89)32837-5. [DOI] [PubMed] [Google Scholar]
  4. Caprioli J., Ortiz-Colberg R., Miller J. M., Tressler C. Measurements of peripapillary nerve fiber layer contour in glaucoma. Am J Ophthalmol. 1989 Oct 15;108(4):404–413. doi: 10.1016/s0002-9394(14)73308-2. [DOI] [PubMed] [Google Scholar]
  5. Caprioli J. The contour of the juxtapapillary nerve fiber layer in glaucoma. Ophthalmology. 1990 Mar;97(3):358–366. doi: 10.1016/s0161-6420(90)32581-2. [DOI] [PubMed] [Google Scholar]
  6. Dolman C. L., McCormick A. Q., Drance S. M. Aging of the optic nerve. Arch Ophthalmol. 1980 Nov;98(11):2053–2058. doi: 10.1001/archopht.1980.01020040905024. [DOI] [PubMed] [Google Scholar]
  7. Jonas J. B., Nguyen N. X., Naumann G. O. The retinal nerve fiber layer in normal eyes. Ophthalmology. 1989 May;96(5):627–632. doi: 10.1016/s0161-6420(89)32838-7. [DOI] [PubMed] [Google Scholar]
  8. Niessen A. G., Van Den Berg T. J., Langerhorst C. T., Greve E. L. Retinal nerve fiber layer assessment by scanning laser polarimetry and standardized photography. Am J Ophthalmol. 1996 May;121(5):484–493. doi: 10.1016/s0002-9394(14)75422-4. [DOI] [PubMed] [Google Scholar]
  9. Niessen A. G., van den Berg T. J., Langerhorst C. T., Bossuyt P. M. Grading of retinal nerve fiber layer with a photographic reference set. Am J Ophthalmol. 1995 Nov;120(5):577–586. doi: 10.1016/s0002-9394(14)72204-4. [DOI] [PubMed] [Google Scholar]
  10. Ogden T. E. Nerve fiber layer of the primate retina: thickness and glial content. Vision Res. 1983;23(6):581–587. doi: 10.1016/0042-6989(83)90063-9. [DOI] [PubMed] [Google Scholar]
  11. Perry V. H., Cowey A. The ganglion cell and cone distributions in the monkey's retina: implications for central magnification factors. Vision Res. 1985;25(12):1795–1810. doi: 10.1016/0042-6989(85)90004-5. [DOI] [PubMed] [Google Scholar]
  12. Poinoosawmy D., Fontana L., Wu J. X., Fitzke F. W., Hitchings R. A. Variation of nerve fibre layer thickness measurements with age and ethnicity by scanning laser polarimetry. Br J Ophthalmol. 1997 May;81(5):350–354. doi: 10.1136/bjo.81.5.350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Quigley H. A., Addicks E. M. Quantitative studies of retinal nerve fiber layer defects. Arch Ophthalmol. 1982 May;100(5):807–814. doi: 10.1001/archopht.1982.01030030811018. [DOI] [PubMed] [Google Scholar]
  14. Quigley H. A., Dunkelberger G. R., Green W. R. Retinal ganglion cell atrophy correlated with automated perimetry in human eyes with glaucoma. Am J Ophthalmol. 1989 May 15;107(5):453–464. doi: 10.1016/0002-9394(89)90488-1. [DOI] [PubMed] [Google Scholar]
  15. Quigley H. A., Reacher M., Katz J., Strahlman E., Gilbert D., Scott R. Quantitative grading of nerve fiber layer photographs. Ophthalmology. 1993 Dec;100(12):1800–1807. doi: 10.1016/s0161-6420(93)31395-3. [DOI] [PubMed] [Google Scholar]
  16. Radius R. L. Thickness of the retinal nerve fiber layer in primate eyes. Arch Ophthalmol. 1980 Sep;98(9):1625–1629. doi: 10.1001/archopht.1980.01020040477018. [DOI] [PubMed] [Google Scholar]
  17. Sommer A., Katz J., Quigley H. A., Miller N. R., Robin A. L., Richter R. C., Witt K. A. Clinically detectable nerve fiber atrophy precedes the onset of glaucomatous field loss. Arch Ophthalmol. 1991 Jan;109(1):77–83. doi: 10.1001/archopht.1991.01080010079037. [DOI] [PubMed] [Google Scholar]
  18. Sommer A., Quigley H. A., Robin A. L., Miller N. R., Katz J., Arkell S. Evaluation of nerve fiber layer assessment. Arch Ophthalmol. 1984 Dec;102(12):1766–1771. doi: 10.1001/archopht.1984.01040031430017. [DOI] [PubMed] [Google Scholar]
  19. Tjon-Fo-Sang M. J., de Vries J., Lemij H. G. Measurement by nerve fiber analyzer of retinal nerve fiber layer thickness in normal subjects and patients with ocular hypertension. Am J Ophthalmol. 1996 Aug;122(2):220–227. doi: 10.1016/s0002-9394(14)72013-6. [DOI] [PubMed] [Google Scholar]
  20. Van Blokland G. J., Verhelst S. C. Corneal polarization in the living human eye explained with a biaxial model. J Opt Soc Am A. 1987 Jan;4(1):82–90. doi: 10.1364/josaa.4.000082. [DOI] [PubMed] [Google Scholar]
  21. Varma R., Skaf M., Barron E. Retinal nerve fiber layer thickness in normal human eyes. Ophthalmology. 1996 Dec;103(12):2114–2119. doi: 10.1016/s0161-6420(96)30381-3. [DOI] [PubMed] [Google Scholar]
  22. Weinreb R. N., Dreher A. W., Bille J. F. Quantitative assessment of the optic nerve head with the laser tomographic scanner. Int Ophthalmol. 1989 Jan;13(1-2):25–29. doi: 10.1007/BF02028633. [DOI] [PubMed] [Google Scholar]
  23. Weinreb R. N., Dreher A. W., Coleman A., Quigley H., Shaw B., Reiter K. Histopathologic validation of Fourier-ellipsometry measurements of retinal nerve fiber layer thickness. Arch Ophthalmol. 1990 Apr;108(4):557–560. doi: 10.1001/archopht.1990.01070060105058. [DOI] [PubMed] [Google Scholar]
  24. Weinreb R. N., Shakiba S., Zangwill L. Scanning laser polarimetry to measure the nerve fiber layer of normal and glaucomatous eyes. Am J Ophthalmol. 1995 May;119(5):627–636. doi: 10.1016/s0002-9394(14)70221-1. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES