Fundoscopy of Nerve Fiber Layer Defects in Glaucoma

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Abstract

Early attrition of nerve fiber bundles in glaucoma causes slit-like gaps to appear among the normally uniform, striated arcuate bundles of the retinal nerve fiber layer. The nerve fiber layer thins progressively, and its vessels become exposed as the defects coalesce, deepen, and widen with advancing disease. These changes in the peripapillary retina are exemplified photographically and compared with perimetric findings. We believe that these fundoscopic signs provide the earliest objective evidence of nerve fiber wasting in eyes with chronically elevated intraocular pressure.