April 2014
Volume 55, Issue 13
ARVO Annual Meeting Abstract  |   April 2014
The Macula/RNFL ratio, a new index for assessment of glaucoma severity
Author Affiliations & Notes
    Fundacion para el Estudio del Glaucoma, Universidad Favaloro, Buenos Aires, Argentina
  • Fabian S Lerner
    Fundacion para el Estudio del Glaucoma, Universidad Favaloro, Buenos Aires, Argentina
  • Footnotes
    Commercial Relationships LUIS PABLO FORNERO, None; Fabian S Lerner, Alcon (C), Alcon (R), Allergan (R), Bausch and Lomb (C), MSD (C), MSD (R), Sanofi Fovea (C), Sidus (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 4749. doi:
  • Views
  • Share
  • Tools
    • Alerts
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      LUIS PABLO Pablo FORNERO, Fabian S Lerner; The Macula/RNFL ratio, a new index for assessment of glaucoma severity. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4749.

      Download citation file:

      © ARVO (1962-2015); The Authors (2016-present)

  • Supplements

To describe a new index to assess glaucoma’s stage using Spectral Domain OCT, based on a macular thickness to retinal nerve fiber layer (RNFL) thickness ratio.


Two hundred and nine consecutive eyes (209 patients) were assessed. Eyes with myopic refraction > 6.0 diopters, retinal diseases, uveitis or non-glaucomatous optic neuropathy were excluded. Patients younger than 21 y/o were also excluded. Patients received a complete ophthalmic evaluation. Glaucoma was defined using the structural definition of the International Society for Geographical and Epidemiological Ophthalmology (ISGEO): a vertical C/D ratio of 0.7 or more, asymmetry in the cupping of the optic nerves of 0.2 or more, and/or thinning of the neuroretinal rim in any place of 0.1 or less with corresponding perimetric damage. Glaucomatous damage was classified according to disc evaluation as moderate or advanced by clinical evaluation of the optic disc. Control subjects did not have glaucoma or ocular hypertension. The protocol used for images acquisition was (ONH) and RNFL analysis, optic disc cube 200x200 and macular thickness cube 512x128, using the Cirrus OCT.(Carl Zeiss Ophthalmic Systems, Inc. Dublin). Mean values for macular segments, as well as mean Retinal Nerve Fiber Layer (RNFL) thicknesses were obtained. A ratio Macular segment/RNFL thickness was calculated for each of the 4 macular segments in the 3 groups. Statistical analysis was performed using InStat Graph pad software (La Jolla, CA).


Seventy three eyes (73) were included. Mean age of the patients was 61.4 years old. The ratio Macular segment/RNFL thickness (Mean +SD) was: 4.64, 4.96, 5.11, and 4.63 in the advanced (4.84+0.6); 3.97, 4, 4.16, and 3.91 (4+0.4) in the moderate; and 3, 3.2, 3.3 and 3.17 (3.21+ 0.2) in the control groups; respectively for temporal, superior, nasal and inferior. Advanced glaucomas had an index ranging from 4.5 to 5, moderate from 3.5 to 4.4 and controls from 3.0 to 3.5. Differences between groups were statistically significant (p<.001)


This Index was able to differentiate eyes with different stages of glaucomatous damage or controls in this population. It should be validated in other populations to assess its usefulness in the management of the disease.

Keywords: 465 clinical (human) or epidemiologic studies: systems/equipment/techniques • 550 imaging/image analysis: clinical • 627 optic disc  

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.