Purpose:
To describe a new feature of glaucoma in Spectral Domain Optical Coherence Tomography.
Methods:
Retrospective case series out of a large follow up study on progression in glaucoma. All participants (118 glaucoma patients and 77 healthy participants) were measured with the Spectralis OCT (Heidelberg Engineering GmbH, Dossenheim, Germany). In the same session, all participants were measured with several other imaging techniques as well, including scanning laser polarimetry and scanning laser tomography. In addition, standard automated perimetry was performed in everybody.
Results:
Six out of 118 glaucoma patients (186 eyes) showed a localised, heterogeneously structured thickening of the RNFL in SD-OCT. None of the healthy eyes showed this phenomenon, nor did any of the other imaging techniques display it. The thickening was transient in some cases. An example of this (temporary) localised thickening of the RNFL is shown in Figures 1A&B. The disappearance of the thickening was not associated with any changes in the visual field or in other the imaging devices.
Conclusions:
Localised, heterogeneous thickening of the RNFL has, to our knowledge, never been described before in glaucoma. In our cases, it is only identifiable with SD-OCT. The pathogenesis and consequences of this condition are yet unclear.
Keywords: imaging/image analysis: clinical • nerve fiber layer