Clinically Detectable Nerve Fiber Atrophy Precedes the Onset of Glaucomatous Field Loss

Sommer, Alfred; Katz, Joanne; Quigley, Harry A.; Miller, Neil R.; Robin, Alan L.; Richter, Ronald C.; Witt, Kathe A.

doi:10.1001/archopht.1991.01080010079037

Cited by 1,017 publications

(574 citation statements)

References 20 publications

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“…[1][2][3] These data suggest that early detection of glaucoma may be only achieved with technology that provides qualitative or quantitative measurements of the axons (nerve fibers) or the bodies of the retinal ganglion cells (RGCs), the main target in glaucomatous optic neuropathy. Quantitative changes in the thickness of the peripapillary retinal nerve fiber layer (RNFL), the morphology of the optic nerve head (ONH), or both can be measured with several instruments such as confocal scanning laser ophthalmoscopy, scanning laser polarimetry, and optical coherence tomography (OCT).…”

Section: Introductionmentioning

confidence: 99%

Cup-to-disc ratio: agreement between slit-lamp indirect ophthalmoscopic estimation and stratus optical coherence tomography measurement

Arnalich‐Montiel¹,

Muñoz-Negrete²,

Rebolleda³

et al. 2006

Eye

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Cup-to-disc ratio: agreement between slit-lamp indirect ophthalmoscopic estimation and stratus optical coherence tomography measurement AbstractPurpose To determine agreement between slit-lamp indirect ophthalmoscopy and Stratus optical coherence tomography (OCT) when assessing cup-to-disc ratios (CDRs). Methods Twenty-five ocular hypertensive subjects and 56 patients with primary openangle glaucoma were included. Estimation of vertical (VCDR) and horizontal (HCDR) cupto-disc ratio with slit-lamp ophthalmoscopy was made by three glaucoma specialists along with OCT scanning of optic nerve head. Agreement between OCT and specialists was measured by intraclass correlation coefficients (ICC), Bland and Altman's scatterplots, and a regression coefficient of the average difference. Results The mean VCDR and HCDR was significantly higher (Po0.001) with OCT than that estimated by the specialists, with the difference ranging from 0.08 to 0.11, and from 0.13 to 0.18, respectively, depending on the specialist. Difference was higher (Po0.001) for cuppings below 0.3, and looses significance for larger VCDR cuppings (above 0.7). ICC for VCDR was 0.87 among specialists, and ranges from 0.82 to 0.75 when comparing OCT and specialists. ICC for HCDR was 0.83 among specialists and 0.74 between OCT and specialists. When data were plotted according to the Bland-Altman method, as the cupping increased, the agreement also increased. Conclusions There is very good agreement among the specialists when estimating CDRs by stereoscopic slit-lamp biomicroscopy. OCT shows higher values than the specialists; the greatest differences occurred when assessing small CDRs and the differences diminished as the cupping increased. These two methods of measurement are not interchangeable, and the difference must be considered, especially in discs with smaller CDRs.

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Section: Introductionmentioning

confidence: 99%

Cup-to-disc ratio: agreement between slit-lamp indirect ophthalmoscopic estimation and stratus optical coherence tomography measurement

Arnalich‐Montiel¹,

Muñoz-Negrete²,

Rebolleda³

et al. 2006

Eye

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“…During the clinical course of glaucomatous optic neuropathy, standard automated perimetry (SAP) detects a glaucoma-related visual field (VF) defect only after at least a 40% loss of retinal ganglion cells has already occurred. [2][3][4] Instruments measuring optic disc topography and RNFL thickness may assist clinicians in early diagnosis and follow-up of glaucomatous optic neuropathy. Many reports showed that with respect to SLP with fixed compensation (GDx-FCC), the use of variable compensation (GDx-VCC) improves significantly the structure-function relationship 5 and diagnostic ability in glaucomatous eyes.…”

Section: Introductionmentioning

confidence: 99%

Atypical pattern of retardation on GDx-VCC and its effect on retinal nerve fibre layer evaluation in glaucomatous eyes

Pozzo

Marchesan

Canziani

et al. 2005

Eye

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“…Thinning of the retinal nerve fiber layer (RNFL) has been shown to be a sensitive indicator of glaucomatous damage, preceding in many cases detectable changes of visual field and optic nerve head (Quigley et al 1980, Sommer et al 1991Tuulonen et al 1993). It has been shown that RNFL thickness measured using OCT correlates highly with visual field loss .…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography and localized defects of the retinal nerve fiber layer

Teesalu

Tuulonen

Airaksinen

2000

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To test the capability of the optical coherence tomography (OCT) to demonstrate and quantitate retinal nerve fiber layer (RNFL) defects. Methods: The authors examined 6 eyes of 6 chronic open angle glaucoma patients with the OCT. The patients had abnormal Humphrey 30-2 visual fields which corresponded to RNFL defects visible in monochromatic fundus images taken with a digital imaging system. The RNFL images were used for directing the OCT scans to areas where most information was believed to be obtainable. Several linear scans of different lengths across healthy and abnormal RNFL regions were made. Results: When the OCT images were compared to RNFL photographs, the defective areas showed reduced backscattering with the OCT, being distinctly different from the adjacent normal RNFL. Except for one case the RNFL thickness values were smaller in the areas of abnormal appearance compared to areas of normal appearance. Conclusion: This preliminary study suggests that the OCT examination results of the RNFL are in good agreement with the RNFL appearance in monochromatic fundus images.

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Clinically Detectable Nerve Fiber Atrophy Precedes the Onset of Glaucomatous Field Loss

Cited by 1,017 publications

References 20 publications

Cup-to-disc ratio: agreement between slit-lamp indirect ophthalmoscopic estimation and stratus optical coherence tomography measurement

Cup-to-disc ratio: agreement between slit-lamp indirect ophthalmoscopic estimation and stratus optical coherence tomography measurement

Atypical pattern of retardation on GDx-VCC and its effect on retinal nerve fibre layer evaluation in glaucomatous eyes

Optical coherence tomography and localized defects of the retinal nerve fiber layer

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