Application of the ISNT rules on retinal nerve fibre layer thickness and neuroretinal rim area in healthy myopic eyes

Background/aimsAlthough measurements of the Bruch’s membrane opening minimum rim width (BMO-MRW) and retinal nerve fibre layer thickness (RNFLT) with optical coherence tomography (OCT) have been widely adopted in the diagnostic evaluation of glaucoma, there is no consensus on the diagnostic criteria to define BMO-MRW and RNFLT abnormalities. This study investigated the sensitivities and specificities of different diagnostic criteria based on the OCT classification reports for detection of glaucoma.Methods340 eyes of 137 patients with glaucoma and 87 healthy individuals, all with axial length ≤26mm, had global and sectoral BMO-MRW and RNFLT measured with Spectralis OCT (Heidelberg Engineering). Six diagnostic criteria were examined: global measurement below the fifth or the first percentile; ≥1 sector measurement below the fifth or the first percentile; superotemporal and/or inferotemporal measurement below the fifth or the first percentile. The sensitivities and specificities of BMO-MRW/RNFLT assessment for detection of glaucoma (eyes with visual field (VF) defects) were compared.ResultsAmong the six criteria examined, superotemporal and/or inferotemporal measurement below the fifth percentile showed the highest sensitivities and specificities for glaucoma detection. Abnormal superotemporal and/or inferotemporal RNFLT attained a higher sensitivity than abnormal superotemporal and/or inferotemporal BMO-MRW to detect mild glaucoma (mean VF MD: −3.32±1.59 dB) (97.9% and 88.4%, respectively, p=0.006), and glaucoma (mean VF MD: −9.36±8.31 dB) (98.4% and 93.6%, respectively, p=0.006), at the same specificity (96.1%).ConclusionsSuperotemporal and/or inferotemporal RNFLT/MRW below the fifth percentile yield the best diagnostic performance for glaucoma detection with RNFLT attains higher sensitivities than MRW at the same specificity in eyes without high myopia.

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Estimation of the retinal nerve fibre layer thickness in the papillomacular area of long standing stage IV macular holes

British Journal of Ophthalmology ◽

10.1136/bjo.83.5.573 ◽

1999 ◽

Vol 83 (5) ◽

pp. 573-576 ◽

Cited By ~ 5

Author(s):

A. Assi ◽

P. Watts ◽

J. McAllister

Keyword(s):

Layer Thickness ◽

Nerve Fibre ◽

Stage Iv ◽

Retinal Nerve Fibre Layer ◽

Fibre Layer ◽

Macular Holes ◽

Nerve Fibre Layer

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Is retinal nerve fibre layer thickness correlated with visual function in individuals having optic neuritis?

Clinical and Experimental Optometry ◽

10.1080/08164622.2021.1969213 ◽

2021 ◽

pp. 1-7

Author(s):

Abbas Ali Yekta ◽

Sara Sorouh ◽

Amir Asharlous ◽

Ali Mirzajani ◽

Ebrahim Jafarzadehpur ◽

...

Keyword(s):

Optic Neuritis ◽

Layer Thickness ◽

Nerve Fibre ◽

Visual Function ◽

Retinal Nerve Fibre Layer ◽

Fibre Layer ◽

Nerve Fibre Layer

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Influence of uveitis on Bruch’s membrane opening minimum rim width and retinal nerve fibre layer thickness measurements

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-313016 ◽

2018 ◽

Vol 103 (10) ◽

pp. 1413-1417 ◽

Cited By ~ 3

Author(s):

Matthias F Kriegel ◽

Arnd Heiligenhaus ◽

Carsten Heinz

Keyword(s):

Layer Thickness ◽

Nerve Fibre ◽

Retinal Nerve Fibre Layer ◽

Bruch's Membrane ◽

Bruch’S Membrane ◽

Fibre Layer ◽

Bruch’S Membrane Opening ◽

Nerve Fibre Layer ◽

Active Inflammation ◽

The Impact

Background/aimsTo assess the impact of papillary leakage and active inflammation on optical coherence tomography (OCT)-based retinal nerve fibre layer thickness (RNFLT) and Bruch’s membrane opening minimum rim width (BMO-MRW) measurements in uveitic eyes with and without secondary glaucoma.MethodsProspective, single-centre analysis of patients with uveitis. All patients included received a fluorescein angiography examination and an OCT scan measuring the BMO-MRW and the RNFLT in three concentric peripapillary ring scans.ResultsOverall, 95 eyes of 56 patients were enrolled. Papillary leakage and active inflammation were present in 39 (41%) and 57 (60%) eyes, respectively. Twenty-one eyes were classified as glaucomatous; 10 of those glaucomatous eyes showed papillary leakage. Both BMO-MRW and RNFLT measurements were significantly increased in eyes with papillary leakage (BMO-MRW: p=0.0001; RNFLT: first to third ring (p<0.0001)). Active inflammation led to a significantly thickened RNFLT (first ring: p=0.0026; second ring: p=0.0009; third ring: p=0.0002) while only a trend towards increased values could be observed in the BMO-MRW measurements (p=0.3063). Glaucomatous eyes with papillary leakage demonstrated significantly higher values on both BMO-MRW and RNFLT measurements than glaucomatous eyes without leakage (BMO-MRW: p=0.0159; RNFLT: first ring: p=0.0062; second ring: p=0.0037; third ring: p=0.0197). No significant difference could be observed between glaucomatous eyes with leakage and non-glaucomatous eyes without leakage (BMO-MRW: p=0.4132; RNFLT: first ring: p=0.5412; second ring: p=0.3208; third ring: p=0.1164).ConclusionsThe OCT scanning parameters BMO-MRW and RNFLT were significantly influenced by papillary leakage in uveitic eyes with and without glaucoma. RNFLT values were also significantly increased while active inflammation was present. In patients with uveitis, these OCT-based imaging tools should be interpreted with caution, especially in those with papillary leakage or active inflammation.

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