May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Retinal Nerve Fiber Layer (RNFL) Defects in Glaucoma Suspects
Author Affiliations & Notes
  • M. Fingeret
    Department of Veterans Affairs, New York Harbor Health Care System, Brooklyn, NY
    State University of New York College of Optometry, New York, NY
  • S. Zafar
    Dept. of Ophthalmology,
    The New York Eye and Ear Infirmary, New York, NY
  • M. Bosco
    Department of Veterans Affairs, New York Harbor Health Care System, Brooklyn, NY
  • R.D. Fechtner
    Institute of Ophthalmology and Visual Science, New Jersey Medical School, UMDNJ, Newark, NJ
  • E. Buroff
    Institute of Ophthalmology and Visual Science, New Jersey Medical School, UMDNJ, Newark, NJ
  • R. Ritch
    The New York Eye and Ear Infirmary, New York, NY
    New York Medical College, Valhalla, NY
  • J.M. Liebmann
    Dept. of Ophthalmology, New York University, New York, NY
    Dept. of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, New York, NY
  • Footnotes
    Commercial Relationships  M. Fingeret, Laser Diagnostic Technologies F, R; S. Zafar, None; M. Bosco, None; R.D. Fechtner, Laser Diagnostic Technologies F; E. Buroff, None; R. Ritch, None; J.M. Liebmann, Laser Diagnostic Technologies F.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 5519. doi:
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    • Get Citation

      M. Fingeret, S. Zafar, M. Bosco, R.D. Fechtner, E. Buroff, R. Ritch, J.M. Liebmann; Retinal Nerve Fiber Layer (RNFL) Defects in Glaucoma Suspects . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5519.

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

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Abstract

Abstract: : Purpose: To assess the RNFL in glaucoma suspect eyes. Methods: Individuals classified as glaucoma suspects based upon cup–to–disc (C/D) asymmetry ≥0.2, or enlarged, but symmetrical C/D ratio (≥ 0.6) were enrolled in this prospective multi–center study. All eyes had normal IOP and normal achromatic automated perimetry (AAP). RNFL assessment was performed using polarimetry (GDx–VCCTM, Laser Diagnostic Technologies, Inc., San Diego, CA). GDx–VCC data were considered abnormal when a TSNIT (RNFL map) parameter was at the p<2% significance level, if the deviation map showed at least 3 contiguous points at the p<0.5% significance level, or for a neural network score (NFI) ≥ 30. The GDx–VCC normative database was used to determine abnormality. Results: Thirty eyes (15 subjects; 8 males, 7 females) with C/D ratio asymmetry and 43 eyes (24 subjects; 14 male, 10 female) with enlarged C/D ratios were enrolled. In the latter group, 20/43 eyes (46.5%) demonstrated a GDx–VCC RNFL defect, whereas only two eyes (6%) with C/D asymmetry demonstrated a GDx abnormality (one eye had an abnormal TSNIT standard deviation while one eye demonstrated an abnormality on the deviation map). Conclusions:Clinical assessment of cup–to–disc asymmetry on its own is not a useful criterion for classifying glaucoma suspects. Eyes with enlarged cup–to–disc ratios and normal achromatic perimetry require careful assessment of the RNFL to avoid missing early glaucomatous injury.

Keywords: imaging/image analysis: clinical • nerve fiber layer • optic disc 
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