Thickness and birefringence of healthy retinal nerve fiber layer tissue measured with polarization-sensitive optical coherence tomography.

PURPOSE Thinning of the retinal nerve fiber layer and changes in retinal nerve fiber layer (RNFL) birefringence may both precede clinically detectable glaucomatous vision loss. Early detection of RNFL changes may enable treatment to prevent permanent loss of vision. Polarization-sensitive optical coherence tomography (PS-OCT) can provide objective information on RNFL thickness and birefringence. METHODS PS-OCT scans around the optic nerve head (ONH) of two healthy young volunteers were made using 10 concentric circles of increasing radius. Both the mean RNFL thickness and mean retinal nerve fiber birefringence for each of 48 sectors on a circle were determined with data analysis. RESULTS Both the RNFL thickness and birefringence varied as a function of sector around the ONH. The RNFL became thinner with increasing distance from the ONH. In contrast, the birefringence did not vary significantly as a function of radius. CONCLUSIONS Birefringence of healthy RNFL is constant as a function of scan radius but varies as a function of position around the ONH, with higher thickness values occurring superior and inferior to the ONH. Measured double-pass phase retardation per unit depth around the ONH ranged between 0.10 and 0.35 deg/microm, equivalent to birefringences of 1.2 x 10(-4) and 4.1 x 10(-4) respectively, measured at a wavelength of 840 nm. Consequently, when a spatially constant birefringence around the ONH is assumed, the conversion of scanning laser polarimetry (SLP) phase-retardation measurements to RNFL thickness may yield incorrect values. The data do not invalidate the clinical value of a phase-retardation measurement, but affect the conversion of phase retardation to RNFL thickness.