Comparison of Blue and Green Confocal Scanning Laser Ophthalmoscope Imaging to Detect Retinal Nerve Fiber Layer Defects

Abstract

Purpose: We detected retinal nerve fiber layer (RNFL) defects using a confocal scanning laser ophthalmoscopy(CSLO) with both blue and green laser sources and evaluated image quality based on laser wavelength. Methods: This was a retrospective observational case study. Blue and green CSLO images of 181 eyes withsuspected glaucoma were evaluated and compared. Three independent observers identified the presenceof RNFL defects and determined which CSLO imaging source provided superior visibility of the defect. Afterassessing the defect imaging by laser source, demographics and image quality indices of optical coherencetomography between blue better and green better groups were analyzed. Results: Both blue and green CSLO showed high discriminating ability for RNFL defects. The discriminatingability of blue CSLO was significantly greater than that of green CSLO (p = 0.004). Among eyes with a detectableRNFL defect, 61.8% were better visualized with the blue laser compared to the green laser. Comparedwith the blue better group, the green better group was significantly older (p = 0.009), had a greater proportionof females (p = 0.005), had poorer best-corrected visual acuity (p = 0.001), more severe cataracts (p = 0.001),lower signal strength (p = 0.003), and poor image quality indices (p = 0.001). Conclusions: Both blue and green CSLO imaging was useful for detecting RNFL defects, but blue CSLO wassuperior to green CSLO in quality of RNFL defect imaging in most patients with clear media.