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Abstract #46382 Published in IGR 13-3
Hypodense Regions ("Holes") in the Retinal Nerve Fiber Layer in Frequency-Domain OCT Scans of Glaucoma Patients and Suspects
Xin D; Talamini CL; Raza AS; De Moraes CG; Greenstein VC; Liebmann JM; Ritch R; Hood DCInvestigative Ophthalmology and Visual Science 2011; 52: 7180-7186
See also comment(s) by David Huang •
PURPOSE: To better understand hypodense regions ("holes") that appear in the retinal nerve fiber layer (RNFL) of frequency-domain optic coherence tomography (fdOCT) scans of patients with glaucoma and glaucoma suspects. METHODS: Peripapillary circle (1.7 mm radius) and cube optic disc fdOCT scans were obtained on 208 eyes from 110 patients (57.4±13.2 yrs) with glaucomatous optic neuropathy (GON) and 45 eyes of 45 controls (48.0±12.6 yrs) with normal fundus exams. Holes in the RNFL were identified independently by 2 observers on the circle scans. RESULTS: Holes were found in 33 (16%) eyes of 28 (25%) patients; they were not found in any of the control eyes. 24 eyes had more than one hole. While some holes were relatively large, others were small. In general, the holes were located adjacent to blood vessels; only 3 eyes had isolated holes that were not adjacent to a vessel. The holes tended to be in the regions that are thickest in healthy controls and associated with arcuate defects in patients. Holes were not seen in the center of the temporal disk region. They were more common in the superior (25 eyes) than in the inferior (15 eyes) disc. Of the 30 eyes with holes with reliable visual fields 7 were glaucoma suspect eyes with normal visual fields. CONCLUSIONS: The holes in the RNFL seen in patients with GON are probably due to a local loss of RNFL fibers and can occur in eyes of glaucoma suspects with normal visual fields.
Classification:
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
2.13 Retina and retinal nerve fibre layer (Part of: 2 Anatomical structures in glaucoma)
