Novel software strategy for glaucoma diagnosis: asymmetry analysis of retinal thickness.

The benefits of high-speed, detailed retinal thickness measurement by spectral-domain optical coherence tomography in glaucoma diagnosis have not been fully realized. We have modified the software protocols for such measurement and applied it for diagnosis at different stages of glaucoma. Using the Spectralis SD-OCT (Heidelberg Engineering, Carlsbad, California), we have customized the retinal thickness protocol to acquire detailed retinal thickness measurements of the central 20° of the posterior pole. These custom maps are displayed in a compressed color scale that reveals small losses in retinal thickness. A novel asymmetry analysis protocol was created to highlight differences between the eyes and the 2 hemispheres within each eye. We present case examples illustrating the ability of this strategy to detect glaucomatous defects, showing the promise of the protocol in the diagnosis and management of glaucoma.