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INTRODUCTION: Optical coherence tomography (OCT) is a potential tool for diagnosis and follow-up in diseases of the anterior visual pathway in that it provides a reproducible and reliable quantification of retinal nerve fiber layer (RNFL) thickness. A review of the literature was conducted to define the utility of OCT in neuro-ophthalmology. MATERIALS AND METHODS: The clinical applications of RNFL thickness measurement by OCT time domain were analyzed. The PubMed search engine enabled us to select the relevant publications, using the following keywords: "optic neuropathy", "retinal nerve fiber layer thickness", and "optical coherence tomography". Publications concerning glaucoma were excluded from this review. RESULTS: The course of RNFL thickness depends on the underlying disease: (I) progressive reduction toward atrophy (e.g., optic neuritis, chiasmal compression) or (II) initial increase in RNFL thickness followed by a reduction toward (IIa) normalization (papilledema) or (IIb) atrophy (anterior ischemic optic neuropathy, Leber hereditary optic neuropathy). DISCUSSION: Depending on the type of anterior visual pathway impairment, OCT provides RNFL data relevant for diagnosis, follow-up, and prognosis. As in macular disease, OCT has become an important clinical tool for routine disease assessment in neuro-ophthalmology.
Service d'ophtalmologie, hôpital Robert-Debré, CHU de Reims, avenue du Général-Koenig, 51092 Reims cedex, France.
Full article6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)