Retinal nerve fiber layer thickness analysis in normal, ocular hypertensive, and primary open angle glaucoma: an optical coherence tomography study

Dipak Patel, Poonam Rana, Siddharth Dua, Roshni Patel


Background: To correlate the findings of optical coherence tomography (OCT) evaluation of retinal nerve fiber layer (RNFL) thickness in primary open angle glaucoma, ocular hypertensive and normal eyes.

Methods: A 34 consecutive normal, 26 consecutive ocular hypertensives and 40 consecutive glaucomatous eyes underwent a complete ophthalmic examination, including applanation tonometry, disc evaluation, gonioscopy and perimetry. Thickness of the RNFL around the optic disc was determined with 3.4 mm diameter-wide 3D 2000 TOPCON OCT. Average and segmental RNFL thickness values were compared among all groups.

Results: Of the 100 eyes enrolled, the mean RNFL thickness was significantly less in glaucomatous eyes (83.165±15.938) than in normal’s (102.42±15.2) and ocular hypertensive’s (100.45±7.38). RNFL, average thicknesses in all four quadrants in POAG patients were significantly decreased compared with the OHT and the control groups.

Conclusions: RNFL measurement with SD-OCT could provide important information for detection of early stages of glaucoma. (pre-perimetric glaucoma) as well as help in evaluating progression of glaucoma.


Ocular hypertension, Optical coherence tomography, Primary open angle glaucoma

Full Text:



Subbiah S, Sankarnarayanan S, Thomas PA, Jesudasan CN. Comparative evaluation of optical coherence tomography in glaucomatous, ocular hypertensive and normal eyes. Ind J Ophthalmol. 2007;55(4):283.

Nassif NA, Cense B, Park BH, Pierce MC, Yun SH, Bouma BE, et al. In vivo high-resolution video-rate spectral-domain optical coherence tomography of the human retina and optic nerve. Optics express. 2004;12(3):367-76.

Bussel II, Wollstein G, Schuman JS. OCT for glaucoma diagnosis, screening and detection of glaucoma progression. Brit J Ophthalmol. 2014;98(Suppl 2):ii15-9.

Rolle T, Dallorto L, Briamonte C, Penna RR. Retinal nerve fibre layer and macular thickness analysis with Fourier domain optical coherence tomography in subjects with a positive family history for primary open angle glaucoma. Brit J Ophthalmol. 2014;98(9):1240-4.

Quigley HA, Dunkelberger GR, Green WR. Retinal ganglion cell atrophy correlated with automated perimetry in human eyes with glaucoma. Am J Ophthalmol. 1989;107:453-64.

Kerrigan-Baumrind LA, Quigley HA, Pease ME, Kerrigan DF, Mitchell RS. Number of ganglion cells in glaucoma eyes compared with threshold visual field tests in the same persons. Invest Ophthalmol Vis Sci. 2000;41:741-8.

Schuman JS, Pedut-Kloizman T, Hertzmark E, Hee MR, Wilkins JR, et al. Reproducibility of nerve fiber layer thickness measurements using optical coherence tomography. Ophthalmology. 1996;103:1889-98.

Carpineto P, Ciancaglini M, Zuppardi E, Falconio G, Doronzo E, Mastropasqua L. Reliability of nerve fiber layer thickness measurements using optical coherence tomography in normal and glaucomatous eyes. Ophthalmology. 2003;110(1):190-5.

Blumenthal EZ, Williams JM, Weinreb RN, Girkin CA, Berry CC. Reproducibility of nerve fiber layer thickness measurements by use of optical coherence tomography. Ophthalmology. 2000;107:2278-82.

Jones AL, Sheen NJ, North RV, Morgan JE. The Humphrey optical coherence tomography scanner: quantitative analysis and reproducibility study of the normal human retinal nerve fibre layer. Br J Ophthalmol. 2001;85:673-7.

Paunescu LA, Schuman JS, Price LL, Stark PC, Beaton S. Reproducibility of nerve fiber thickness, macular thickness, and optic nerve head measurements using Stratus OCT. Invest Ophthalmol Vis Sci. 2004;45:1716-24.

Budenz DL, Chang RT, Huang X, Knighton RW, Tielsch JM. Reproducibility of retinal nerve fiber thickness measurements using the stratus OCT in normal and glaucomatous eyes. Invest Ophthalmol Vis Sci. 2005;46:2440-3.

Budenz DL, Fredette MJ, Feuer WJ, Anderson DR. Reproducibility of peripapillary retinal nerve fiber thickness measurements with Stratus OCT in glaucomatous eyes. Ophthalmology. 2008;115:661-6.

Yalvac IS, Kulacoglu DN, Satana B, Eksioglu U, Duman S. Correlation between optical coherence tomography results and the scoring tool for assessing risk (STAR) score in patients with ocular hypertension. Eur JOphthalmol. 2010;20:1018-25.

Mwanza JC, Chang RT, Budenz DL, Durbin MK, Gendy MG. Reproducibility of peripapillary retinal nerve fiber layer thickness and optic nerve head parameters measured with cirrus HD-OCT in glaucomatous eyes. Invest Ophthalmol Vis Sci. 2010;51:5724-30.

Manassakorn A, Aupapong S. Retinal nerve fiber layer defect patterns in primary angle-closure and open-angle glaucoma: a comparison using optical coherence tomography. Jpn J Ophthalmol. 2011;55:28-34.