The flexible standard reference plane allows for automatic determination of intrapapillary variables once a disc border contour line is interactively defined. In contrast to a fixed offset reference plane (e.g. 320 microm below the mean retina height), the interindividual variability of optic disc topography (oblique insertion, glaucomatous surface flattening) is respected at the cost of the need for an accurate optic disc border outline.

B/Y visual field hemifield mean deviation values correlate well with ONH parameters examined with the HRT.

ABSTRACT.Purpose: The Heidelberg Retina Tomograph (HRT) is a confocal scanning laser tomograph that produces high resolution optical section images of the optic disc and central retina. Measurement accuracy and reproducibility is good. Several of the stereometric variables depend on the definition of a reference plane level. The purpose of the present study was to evaluate the four different reference levels in terms of their advantages and disadvantages in clinical work. Methods: Sixty-seven randomly chosen eyes belonging to 67 subjects were included in this study. Forty of the eyes were healthy and 27 had glaucoma. The HRT with software versions 1.09 and 1.11 was used to acquire and evaluate topographic measurements of the optic disc. Image analysis was performed at four different reference levels: 320 mm fixed offset reference level (REFd) (version 1.09), an individually determined reference level (REFi), a papillo-macular reference level (REFm) and a flexible reference level (REFf) (version 1.11). ANOVA was used to determine differences in the topographic parameters between the reference levels. Key words: confocal scanning laser tomograph ª Heidelberg Retina Tomograph (HRT) ª RNFL thickness ª rim area ª rim volume ª reference level ª optic disc ª glaucoma.

Cup shape measure and RNFL thickness, together with age- and lens coloration-corrected MD of the B/Y perimetry provided good discrimination between healthy individuals and patients with glaucoma.