Development of Computerized Densitometry for the Quantitative Analysis of Diffuse Retinal Nerve Fiber Layer Atrophy

Computerized densitometry was developed or the quantitative measurement of diffuse retinal nerve fiber layer (RNFL) atrophy and intra- and inter-operator reliability and clinical validity of this system were evaluated. Vertical diameter, center of the optic disc, and peripapillary circles which had radii of 1.5 and 2.5 times that of the optic disc were user-interactively determined in digitized RNFL photograph and density profile along each circle was measured and normalized. The areas under the normalized density profiles of the superior and the inferior segments in both circle were used or the study of RNFL. To determine the variability and correspondence in the measurements of density variations, 21 RNFL photographs of glaucoma patients which showed varying degrees of atrophy underwent computerized densitometry by two operators on two separate occasions. Coefficient of variation in the densitometric measurements was $1.2{\sim}5.4%$. Intra- and inter-operator reliabilities were excellent. The correlations between the densitometric values and mean deviations of Humphrey C30-2 visual field showed statistical significance. Computerized densitometry of RNFL photographs was useful in the objective and quantitative assessment of diffuse RNFL atrophy.