To evaluate nerve fiber layer photography as a method for glaucoma screening in a general medical clinic setting.
One hundred seventy-one persons who attended an academic hospital medical clinic were administered a questionnaire and underwent a complete eye examination, including automated perimetry and photography of the optic disc and nerve fiber layer.
Eighteen patients were diagnosed as having primary glaucoma; one, secondary glaucoma; and 21 were suspected of having glaucoma. Nerve fiber layer photographs were taken on 145 persons (85%) and were readable in 136 (80%) of the sample of 171 subjects. Nerve fiber layer atrophy was detected on masked evaluation in 64% of those with glaucoma, in 28% of those suspected of having glaucoma, and in 16% of persons who did not meet the criteria for glaucoma.
Nerve fiber layer photography can be carried out as a screening method and can identify a substantial proportion of those with glaucoma. It compares favorably with tonometry, cup-disc ratio estimation, or screening visual field examination for glaucoma detection.
Wang F, Quigley HA, Tielsch JM. Screening for Glaucoma in a Medical Clinic With Photographs of the Nerve Fiber Layer. Arch Ophthalmol. 1994;112(6):796–800. doi:10.1001/archopht.1994.01090180094042
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