The Importance of Perimetry, Pachimetry and Ocular Coherent Tomography in The Early Treatment of Glaucoma

Abstract Introduction. Pachymetry and ocular coherence tomography is a relatively new method for an accurate diagnosis of glaucoma. Since the newer diagnostic procedures are painless and easily available, they give a great opportunity for establishing a correct diagnosis. Pachymetry is one of the newer methods for measuring the central corneal thickness (CCT). Transparent normal cornea is normally 545 micrometers thick. As one of the newer diagnostic machines OCT is a non-contact, non-invasive imaging technology for optic nerve and macular region. It works on the principle of low coherent interferometry measuring the time delay of the light rays and intensity of light rejected from the tissue structures. Because of the ability to see a detailed view of all layers of the retina recording, it is called “in vivo histology” or “optical biopsy”. Methods. In the period of 6 months, at the Department for ocular coherence tomography we made 430 trials with different referral diagnoses; 45 were with referral diagnosis of glaucoma. The measured intraocular pressure was over 24 mmHg, these patients were referred for further treatment in the Department for glaucoma and ocular coherence tomography. Results. In 28 (58%) of the referred patients glaucomatous changes were found. In the group of patients with confirmed diagnosis, visual field defect was confirmed in 12 and it was not confirmed in 16 patients. In 4 patients positive relationship with central corneal thickness was found (528 nm, with a standard deviation of 29.93) and in 19 patients the diagnosis was confirmed by a positive finding in the thinning of the retinal nerve layer fiber. Regarding the difference between the two groups, those with ocular hypertension and those with glaucoma, the average thickness was 91.6 in the group with glaucoma, 106.5 in the upper segment and 112 in the lower segment. Conclusions. The results showed that it was necessary to start treatment of glaucoma in 58% of the patients, Therefore, the usefulness of these diagnostic procedures in the early detection and treatment of glaucoma is obvious.