An improved method of densitometry of red-free retinal nerve fibre layer photographs

The red-free negatives of 53 right eyes (30 normal eyes and 23 glaucomatous eyes) and 51 left eyes (32 normal eyes and 19 glaucomatous eyes) were analysed using two different image densitometry techniques. The first technique measured the density from rectangular sample areas, while the second measured density from sector-shaped sample areas which more closely follow the course of the nerve fibres in the retina. Indices which measured the deviation of the data from a clinically determined normal 'gold standard' were calculated, and were used to determine the optimum sensitivity and specificity in separating normal from glaucomatous eyes. There is a significant difference between the data from the normal and glaucomatous groups of eyes, when measured from the sector sample areas. The relative efficacy of this technique is also shown by the improved values of sensitivity (from 42%-70% to 70%-91%), although specificity remained fairly constant (from 66%-83% to 62%-88%).