American Journal of Ophthalmology
Volume 133, Issue 2 , Pages 187-195, February 2002

Retinal nerve fiber layer analysis: relationship between optical coherence tomography and red-free photography☆

Presented in part at the 3rd International Glaucoma Symposium meeting, Prague, March 2001.

  • Mohamed A.E Soliman, MD

      Affiliations

    • Corresponding Author InformationReprint requests to Dr. Mohamed A.E. Soliman, MD, AMC, Glaucoma Unit, Room A2-150, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands; fax: 0031-20-5669053
    • Ophthalmology Department, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt (M.A.E.S., A-A.A.Y.); Glaucoma Unit, The Academic Medical Center, University Of Amsterdam, Amsterdam, The Netherlands (M.A.E.S., T.J.T.P.V.D.B., L.A.M.S.D.J., M.D.D.S.; The Netherlands Ophthalmic Research Institute, Amsterdam, The Netherlands (T.J.T.P.V.D.B.)
    • The authors have no proprietary interest in any of the equipment involved in the study.
    • ,
  • Thomas J.T.P Van Den Berg, PhD

      Affiliations

    • Ophthalmology Department, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt (M.A.E.S., A-A.A.Y.); Glaucoma Unit, The Academic Medical Center, University Of Amsterdam, Amsterdam, The Netherlands (M.A.E.S., T.J.T.P.V.D.B., L.A.M.S.D.J., M.D.D.S.; The Netherlands Ophthalmic Research Institute, Amsterdam, The Netherlands (T.J.T.P.V.D.B.)
    • The authors have no proprietary interest in any of the equipment involved in the study.
    • ,
  • Al-Araby A Ismaeil, MD

      Affiliations

    • Ophthalmology Department, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt (M.A.E.S., A-A.A.Y.); Glaucoma Unit, The Academic Medical Center, University Of Amsterdam, Amsterdam, The Netherlands (M.A.E.S., T.J.T.P.V.D.B., L.A.M.S.D.J., M.D.D.S.; The Netherlands Ophthalmic Research Institute, Amsterdam, The Netherlands (T.J.T.P.V.D.B.)
    • The authors have no proprietary interest in any of the equipment involved in the study.
    • ,
  • Leo A.M.S De Jong, MD

      Affiliations

    • Ophthalmology Department, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt (M.A.E.S., A-A.A.Y.); Glaucoma Unit, The Academic Medical Center, University Of Amsterdam, Amsterdam, The Netherlands (M.A.E.S., T.J.T.P.V.D.B., L.A.M.S.D.J., M.D.D.S.; The Netherlands Ophthalmic Research Institute, Amsterdam, The Netherlands (T.J.T.P.V.D.B.)
    • The authors have no proprietary interest in any of the equipment involved in the study.
    • ,
  • Marc D De Smet, MD, PhD

      Affiliations

    • Ophthalmology Department, Al-Hussein University Hospital, Al-Azhar University, Cairo, Egypt (M.A.E.S., A-A.A.Y.); Glaucoma Unit, The Academic Medical Center, University Of Amsterdam, Amsterdam, The Netherlands (M.A.E.S., T.J.T.P.V.D.B., L.A.M.S.D.J., M.D.D.S.; The Netherlands Ophthalmic Research Institute, Amsterdam, The Netherlands (T.J.T.P.V.D.B.)
    • The authors have no proprietary interest in any of the equipment involved in the study.

Accepted 11 October 2001.

Abstract 

PURPOSE: Comparison of retinal nerve fiber layer (RNFL) thickness measurements using optical coherence tomography (OCT) to the clinical standard red-free photography (evaluated semiquantitatively), in relation to functional visual field damage in primary open-angle glaucoma (POAG) patients, ocular hypertensives, and POAG suspects.

METHODS: Concurrent, cross-sectional study. In four age-matched groups (42 patients with early to moderate POAG, 34 ocular hypertensives, 22 POAG suspects, and 25 normal controls), RNFL was assessed with OCT, standardized red-free photographic scoring method and standard achromatic perimetry.

RESULTS: OCT RNFL thickness decreases with increased RNFL damage (detected with red-free photography). The global average OCT RNFL thickness correlated significantly with the photographic total RNFL score (r = .650, P = .0001). Both OCT and photographic scoring system were able to find significantly thinner RNFL in the glaucoma group as compared with normals (P = .0001 for both), ocular hypertensives (P = .0001 for both), and suspects (P = .0001 for both). However, neither OCT nor photography could significantly differentiate between ocular hypertensives, suspects, and normals. Both OCT and photography were significantly correlated with VF loss. For the percentage of VF points depressed <5%, the correlation was highest for OCT (r = −0.615 for OCT and r = −0.476 for photography). OCT had a higher diagnostic accuracy than photography (86% and 77%, respectively).

CONCLUSION: For RNFL thickness measurements, the presence of high correlations between OCT, photographic scores, and functional visual field loss suggest the validity of OCT measurements. The higher diagnostic accuracy of OCT RNFL measurements suggests its potential advantage for detection of early cases of glaucoma.

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☆ Supported in part by a grant from the Ministry of higher education, Cairo, Egypt, and the Netherlands Glaucoma Foundation, Rotterdam, the Netherlands.

PII: S0002-9394(01)01340-X

American Journal of Ophthalmology
Volume 133, Issue 2 , Pages 187-195, February 2002

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