Optic nerve assessment: a clinical endpoint of optic neuropathy

Objective, quantitative, and reproducible methods of optic nerve assessment need to be utilized during research that measures the capability of pharmacological agents to prevent or decrease the rate of progressive ganglion cell atrophy occurring with glaucoma. Confocal scanning laser ophthalmoscopy has recently been developed, and offers objective, quantitative, and three-dimensional evaluation of the optic nerve head and peripapillary retina. This article reviews the use, application, and parameters of one such instrument, the Heidelberg Retina Tomograph (HRT). Although HRT offers several methods to evaluate changes in optic nerve topography, these applications are still continually evolving. Therefore, confocal scanning laser ophthalmoscopy may be particularly useful for assessing the neuroprotective effect of new medications for glaucoma.