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The Shape of Glaucoma: Quantitative Neural Imaging Techniques - Couverture rigide

Lemij, H. G.

 
9789062991754: The Shape of Glaucoma: Quantitative Neural Imaging Techniques

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Clinicians managing glaucoma have long felt the desire to have objective, reliable, user-friendly, and preferably fast and inexpensive technologies at their disposal that assist them in making the diagnosis of glaucoma and monitoring its change over time. For screening programs, such technologies might also be of great benefit. Over the years, many promising imaging technologies that might serve these purposes have become commercially available. Some of these technologies have died an early death, others are probably on the verge of extinction, while the remainder are struggling to find a niche in the broad ophthalmic diagnostic armamentarium. Clinicians are faced with the decision of whether or not to purchase such technology, funds permitting, and if so, which technology to choose. The choice is not easy, for various reasons. For one thing, each .technology has its inherent limitations, which may not be readily put forward by the inventors/manufacturers. In addition, the various technologies are in different stages of their development. As a result, potentially more promising technologies could, in principle, `lose out' to-more developed (but less appropriate) ones. In addition, it is usually difficult to compare reports in the literature on the various technologies, because different scientific testing methods were used; there is no standard for technology evaluation. Also, few research workers are probably totally impartial to the technology they are testing. Investigators may have an emotional interest, or even a financial one. What is more, few research groups have access to all technologies to allow objective comparison. Even provided these groups were equally committed to each technology, they would still have to deal with the different stages of development of each of them. Unless a dramatic advantage were present for a new technology, each time a new device came onto the market, or an existing one was upgraded, long-term follow-up studies adopting all technologies would have to be started all over again, in order to allow a fair comparison between them. These are just a few of the many problems associated with comparing technologies. To explore and compare the various glaucoma diagnostic technologies, a closed imaging meeting was held on February 10th-12th, 1999, at The Rotterdam Eye Hospital in The Netherlands. We invited 30 researchers dedicated to five imaging technologies: red-free fundus photography, scanning laser tomography, scanning laser polarimetry, optical coherence tomography, and retinal thickness mapping. Unfortunately, some invitees did not attend, and, as a result, red-free fundus photography and the Heidelberg Retina Tomograph (HRT) were under-represented. The meeting was enjoyable and fruitful. About a third of the time was spent on prepared presentations, and the remainder on discussions, during which most speakers were put to the test of their peers' scrutiny. The discussions were audiotaped. The reader will find the proceedings of this meeting in this book, as submitted chapters with the discussions added, abridged to avoid any redundancies. Some discussions appear to have been omitted. In these cases, the authors chose to completely revise their chapters, following the comments of their peers. We have taken great care to maintain the tenet of the discussions. We greatly acknowledge the sponsors of the meeting, namely (in alphabetical order), Allergan, Heidelberg Engineering, Humphrey Systems, Laser Diagnostic Technologies, Pharmacia and Upjohn, and Talia Technology. We believe that this book will provide an invaluable insight into the various imaging technologies, their assets, limitations and potential use.

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