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Diurnal Variation of Confocal Scanning Laser Tomographic Measurements of the Optic Disc

Kamppeter B. A., Jonas J. B.,
Ruprecht-Karls-Universität Heidelberg, Fakultät für klinische Medizin Mannheim, Augenklinik (Mannheim)

Purpose: The confocal laser scanning tomography of the optic disc allows the three-dimensional documentation and measurement of the optic nerve head for the diagnosis and follow-up examination of patients with optic nerve diseases. For the follow-up examination, it is important to know parameters other than a progression of optic nerve damage as reason of a change in the optic disc tomographic measurements when the baseline examination is compared with a follow-up examination. Since the optic disc evaluations are performed at different times of the day, it was the purpose of the present study to examine the influence of diurnal variations on the optic disc tomographic measurements.
Method: The study included 20 eyes of 12 subjects who underwent confocal laser scanning tomography of the optic nerve head (Heidelberg Retina Tomograph) at 10 o´clock and at 16 o´clock during the same day. After each examination, intraocular pressure was measured by applanation tonometry. Results. Comparing both HRT examinations with each other, the mean differences in optic disc area were 0.002 ± 0.02 mm2 (p=0.65), in optic cup area 0.02 ± 0.17 mm² (p=0.55), in neuroretinal rim area 0.02 ± 0.02 mm² (p=0.67), and in optic cup volume 0.217 ± 0.124 mm² (p=0.20). The differences between the two HRT examinations were statistically independent of the daytime and the intraocular pressure (p=0.38).
Conclusions: Scanning laser tomographic measurements of the optic disc show diurnal variations which are not very pronounced. These diurnal variations in the tomographic optic disc measurements are not correlated with diurnal changes in intraocular pressure. For all tomographic optic disc parameters, the diurnal variability was less than 2.5%, and was thus within the normal reproducibility of the technique. The daytime at which the examinations are performed does not have to be taken into account if confocal laser scanning tomographic measurements of the optic nerve head are compared in the follow-up of patients.