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May 1995

Quantification of Nerve Fiber Layer Thickness in Normal and Glaucomatous Eyes Using Optical Coherence Tomography: A Pilot Study

Author Affiliations

From the New England Eye Center, Tufts University School of Medicine, Boston, Mass (Drs Schuman, Puliafito, Pedut-Kloizman, and Lin, Mr Wong, and Ms Hertzmark); the Department of Electrical Engineering and Computer Science, Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge (Mr Hee and Drs Izatt and Fujimoto); and Lincoln Laboratory, Massachusetts Institute of Technology, Lexington (Mr Swanson).; Drs Puliafito and Fujimoto are consultants to Humphrey Instruments, Inc, San Leandro, Calif.

Arch Ophthalmol. 1995;113(5):586-596. doi:10.1001/archopht.1995.01100050054031

Purpose:  Quantitative assessment of nerve fiber layer (NFL) thickness in normal and glaucomatous eyes, and correlation with conventional measurements of the optic nerve structure and function.

Methods:  We studied 59 eyes of 33 subjects by conventional ophthalmologic physical examination, Humphrey 24-2 visual fields, stereoscopic optic nerve head photography, and optical coherence tomography.

Results:  Nerve fiber layer thickness as measured by optical coherence tomography demonstrated a high degree of correlation with functional status of the optic nerve, as measured by visual field examination (P=.0001). Neither cupping of the optic nerve nor neuroretinal rim area were as strongly associated with visual field loss as was NFL thickness (P=.17 and P=.21,respectively). Cupping correlated with NFL thickness only when the cup was small (cup-to-diameter ratio, 0.1 to 0.3) or large (cup-to-diameter ratio, 0.8 to 1.0) (P=.006); there was no correlation between cupping and NFL thickness otherwise. Nerve fiber layer, especially in the inferior quadrant, was significantly thinner in glaucomatous eyes than in normal eyes (P=.04). Finally, we found a decrease in NFL thickness with aging, even when controlling for factors associated with the diagnosis of glaucoma (P=.03).

Conclusions:  Nerve fiber layer thickness can be measured using optical coherence tomography. These measurements provide good structural and functional correlation with known parameters.