Detection of Glaucoma Progression with Alternation Flicker

Abstract

Glaucoma is a progressive optic neuropathy characterized by functional visual loss and underlying optic nerve deterioration. Optic nerve imaging, achieved using photography and scanning ophthalmic laser diagnostic imaging techniques, is an important aspect of glaucoma diagnosis and management. Alternation flicker is a technique in which serial optic nerve photographs, typically taken one or more years apart, are aligned and alternated in order to allow the observer to easily detect change over time. Alternation flicker has been shown to improve several aspects of optic nerve evaluation and has been demonstrated to correlate with traditional glaucoma risk factors, with some limitations. In this review, we consider the literature with respect to flicker for the evaluation and monitoring of glaucomatous optic neuropathy.

Comparison of retinal image evaluation techniques in novice clinicians

“…Possible uses for enhanced retinal image evaluation through temporal evaluation techniques include red-free photos, autofluorescence, fluorescein angiography, as well as other multimodal imaging techniques. 17 A comprehensive review of the capabilities and limitations of the use of alternation flicker in the detection of glaucoma progression was published by Syed et al 18 Our findings agree with previous studies that temporal retinal image evaluation is a more sensitive method for detecting subtle retinal changes than spatial image evaluation. Both accuracy and time to decision in simulated retinal pathology assessment were improved in a temporal presentation compared to a spatial presentation, and the greatest improvements were demonstrated at the smallest pixel numbers.…”