Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 1569
  • Home
  • Print this page
  • Email this page

   Table of Contents      
ORIGINAL ARTICLE
Year : 2004  |  Volume : 52  |  Issue : 4  |  Page : 303-9

Quantification of the retinal nerve fibre layer thickness in normal Indian eyes with optical coherence tomography.


Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All Institute of Medical Sciences, New Delhi, India

Date of Submission15-Jan-2004
Date of Acceptance29-Jun-2004

Correspondence Address:
P Sony
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All Institute of Medical Sciences, New Delhi
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


PMID: 15693322

Rights and PermissionsRights and Permissions
  Abstract 

PURPOSE: To quantitatively assess the normative values for peripapillary retinal nerve fibre layer (RNFL) thickness with Optical Coherence Tomography (OCT 3) in Indian subjects. METHODS: The peripapillary retinal nerve fibre layer of 146 normal subjects was imaged on OCT 3 in this cross-sectional study. Thickness of the RNFL around the disc was determined with three 3.4 mm diameter circle OCT scan. The RNFL thickness was measured in four quadrants; superior, nasal, inferior and temporal. The data was analysed using SAS commercial statistical software. Influence of age and gender was evaluated on various measured parameters using unpaired t test, one-way analysis variance (ANOVA) and Pearson's correlation coefficient. RESULTS: One hundred and forty six eyes of 146 patients, 84 males and 62 females were studied. The average RNFL thickness in the sample population under study was 104.27 +/- 8.51 (95% CI 87.25-121). The RNFL was thickest in the inferior quadrant, followed by the superior quadrant, and progressively less in nasal and temporal quadrant. The difference between inferior and superior quadrants was not statistically significant. Age had a significant negative correlation with average RNFL thickness (r = -0.321, P = 0.000) and with average superior (r = -0.233, P = 0.005) and average inferior RNFL thickness (r = -0.234, P = 0.004). There was no effect of gender on various RNFL thickness parameters. CONCLUSIONS: RNFL thickness is significantly correlated with age, but not with gender. This normative database of RNFL thickness with OCT in Indian eyes is similar to previously reported values in normal Asian eyes.

Keywords: Retinal nerve fibre layer, Optical Coherence Tomography, Indian eyes


How to cite this article:
Sony P, Sihota R, Tewari HK, Venkatesh P, Singh R. Quantification of the retinal nerve fibre layer thickness in normal Indian eyes with optical coherence tomography. Indian J Ophthalmol 2004;52:303

How to cite this URL:
Sony P, Sihota R, Tewari HK, Venkatesh P, Singh R. Quantification of the retinal nerve fibre layer thickness in normal Indian eyes with optical coherence tomography. Indian J Ophthalmol [serial online] 2004 [cited 2020 Mar 30];52:303. Available from: http://www.ijo.in/text.asp?2004/52/4/303/14565



Click here to view


Click here to view


Click here to view


Click here to view


Click here to view


Click here to view


Click here to view


Click here to view
Retinal nerve fibre layer (RNFL) examination is important in diagnosing and monitoring the progress of glaucoma. [1],[2],[3]Damage to RFNL mostly precedes visual field loss.[1] Hence, objective methods of measuring RNFL thickness may aid physicians in making an accurate and early diagnosis. Recent advances in various imaging technologies have made assessment of RFNL possible. [4],[5],[6],[7],[8]These methods utilise the optical property of RFNL for obtaining the quantitative RFNL thickness measurements. [4],[5],[6],[7],[8]These techniques are rapid, have good reproducibility and objectivity. [9],[10],[11]

Optical Coherence Tomography (OCT) is a non-contact, non-invasive diagnostic technique that provides detailed structural information of the posterior segment.[12] It shows a cross-sectional living histology of retina with high resolution (of approximately 10 µ) than most of the conventional imaging systems. [12],[13],[14],[15],[16],[17]It also has a high reproducibility. [14],[15],[16],[17]Optical coherence tomo-graphy allows direct measurement of RNFL thickness by in vivo visualisation of retina and RNFL. A high reflectance layer located just under the inner surface of the retina that corresponds to the RFNL is measured using a computer-fed algorithm to generate the RFNL measurement.[4] Optical coherence tomography generated morphologic findings in experimental animals have been shown to correspond very well with histological findings.[12],[14],[18]

Retinal nerve fibre layer has been shown to have considerable inter-individual variation.[3],[19],[20] This variation can be age or race related. [19],[20],[21],[22]Retinal nerve fibre layer measurement varies with the technique used.[6],[7],[23] The measurement may also differ with the population used as a database. It would therefore be preferable to use the values derived from a normative population as close as possible to the population for which the instrument is used. To the best of our knowledge there are no reported data for RFNL thickness in Indian eyes (Medline Search).


  Material and Methods Top


One hundred and forty six healthy volunteers constituting patients or attendants of patients who were not blood relatives were included in this cross sectional study. Informed consent was obtained. All subjects underwent anterior segment slitlamp examination, Goldmann applanation tonometry, gonioscopy and fundus examination with plus 90D lens. Automated refraction (Retinomax 2 Autorefractor, Nikon Corp., Japan), axial length measurement (EchoScan US 3300, Nidek Corp., Japan) and automated visual field examination (Humphrey visual field analyser, HFA, Model 745, Humphrey Instruments; full threshold program 30-2) was performed.

Inclusion criteria

Refractive error of <±4 Diopters, a normal optic nerve head, normal posterior segment, intraocular pressure - 21mmHg, mean deviation (MD) and corrected pattern standard deviation (CPSD) on HFA within 95% confidence interval, and normal glaucoma hemi-field test.

Exclusion criteria

Family history of glaucoma, history of prior photocoagulation, history of prior ocular disease, history of intraocular surgery, previous ocular trauma, vertical asymmetry of cup: disc (C:D) ratio (>0.2) between the two eyes, high C: D ratio (>0.6), disc haemorrhages, disc pallor, and localized RNFL defects. Visual fields : Pattern deviation plot showing a cluster of 3 or more non-edge points that have sensitivities occurring in fewer than 5% of the normal population (P< 5%), with one of these points with a sensitivity occurring in less than 1% of the normal population (P< 1%), CPSD with P< 5%; and glaucoma hemifield test outside normal limits; and consistently unreliable visual fields (defined as false negative> 33%, false positive> 20%, fixation losses> 20%).

Normal contra-lateral eyes of the patients with incipient cataract or unilateral macular hole, fulfilling the above criteria were also included in the study.

Optical coherence tomography

OCT measurements were performed using OCT (OCT 3 STRATUS, Zeiss Humphrey, Dublin CA), with software version 3. The basic principle and technical characteristics of the OCT have been described previously.[14]

Each eye was dilated with tropicamide 1% before recording the images, and scans were performed with a minimum pupillary diameter of 5 mm. The internal fixation target was used owing to its higher reproducibility. The fast retinal nerve fibre layer thickness protocol was used [Figure - 1]. This protocol provides better reproducibility than the single scan.[7],[9],[10],[13] It consists of three circular scans each of 3.46 mm in diameter centered on the optic disc. This diameter has been shown to be optimal and reproducible for RNFL thickness analysis.[7],[9],[10],[13] One of the authors (PS) acquired all the images. Mean RNFL thickness was calculated using the inbuilt RNFL thickness average analysis protocol. Retinal thickness was measured using the location of the vitreo-retinal interface and the retinal pigment epithelium defining the inner and outer boundaries of retina respectively. These are seen as sharp edges with high reflectivity. The boundaries of RNFL were defined by first determining the thickness of the neuro-sensory retina. The location of posterior boundary of RNFL was determined by evaluating each A-scan for a threshold value at 15dB greater than the filtered maximum reflectivity of the adjacent retina.

Various parameters were employed for evaluation of RNFL thickness. The important ones included RNFL average thickness over the entire cylindrical section and average RNFL thickness in each quadrant (superior, nasal, temporal and inferior). Eyes that fulfilled both exclusion and inclusion criteria were selected for analysis, if both eyes fulfilled the criteria only the eye with better image quality and higher Signal to Noise Ratio (SNR) was used for analysis.

Statistical analysis

The analysis was performed using SAS commercial statistical software package (SAS institute, Inc, Cary, NC). Unpaired ′t′ test was used to evaluate gender difference. One-way ANOVA was used to compare the different parameters amongst different age groups with post hoc test whenever applicable. Associations between age, axial length, refractive error and OCT parameters were evaluated by Pearson′s coefficient of correlation. A ′P′ value - 0.05 was considered statistically significant.


  Results Top


One hundred and forty six eyes of 146 patients were included in the study. The mean age was 44.55±16.14 years (range 20-70). There were 84 males and 62 females. The various RNFL thickness parameters measured during the study are presented in [Table - 1]. The average RNFL thickness in our sample population was 104.27±8.51µ (range 79.03-140.53 µ). The superior quadrant had an average thickness of 131.09±14.31µ (range 85-171µ), inferior quadrant 132.34±14.70µ (range 90-180µ), temporal quadrant 67.10±12.77µ (range 35-145µ) and nasal quadrant 85.93±17.85µ (range 44-150µ). The difference between inferior and superior quadrants was not statistically significant (p=0.48). The average RNFL thickness had a normal distribution in the sample population [Figure 2].

The average RNFL thickness, average superior, nasal, inferior and temporal RNFL thickness showed a trend towards decrease with the advancing age. The age had significant negative correlation (Pearson′s correlation coefficient) with average RNFL thickness (r=-0.321, P=0.000) and with average superior (r=-0.233, P=0.005) and average inferior RNFL thickness (r=-0.234, P=0.004). There was no significant correlation between age and average nasal or temporal RNFL thickness. The one-way analysis of variance (ANOVA) was used to compare the various parameters, amongst the various age groups (A=< 30 Years, B=31-50 Years, C=>51 years). The results are given in [Table - 2]. The differences in average RNFL thickness, average inferior and average superior RNFL thickness and maximum inferior quadrant thickness (IMAX) were significant. These parameters (Average RNFL, Inferior average, Superior average, IMAX) showed no significant difference amongst the group A and group B, but the difference was significant when group A and group C were compared. Most of the other parameters showed no significant differences amongst the three age groups.

Refractive error and axial length did not show significant correlation with any of the measured RNFL parameters. The various parameters obtained were compared between males and females but were not statistically different [Table - 3].


  Discussion Top


Retinal nerve fibre layer damage invariably occurs in glaucoma. [1],[2],[3]Various investigational modalities like, retinal nerve fibre layer analyser (NFA), scanning laser ophthalmoscope (GDx, and GDx with variable corneal compensation), and OCT are used to measure the RNFL changes. [4],[5],[6],[7],[8],[9],[10],[11],[12]OCT is a non-invasive, non-contact modality that can be used for measurement of peripapillary RNFL thickness.[12] It is found to correlate with RNFL as measured with scanning laser ophthalmoscope (SLO) and the Heidelberg retinal tomography (HRT).[7],[24],[25] OCT measured RNFL thickness is not affected by the corneal and lenticular birefringence, as is the case with confocal scanning laser polarimetry.[26],[27] No additional reference plane is required to calculate the RNFL thickness because OCT provides an absolute cross-sectional measurement of retina, from which RNFL thickness is calculated.[12] Additionally, the measurement is unaffected by the refractive status and axial length of the eye.[10],[28]

A high level of correlation between OCT generated RNFL thickness and visual function has been reported in previous studies.[6],[24],[29] The RNFL may show a racial variation and the various values may be specific to the population under study.[3], [19],[20],[21],[22]The detection of RNFL loss also varies in accordance with the imaging technology used, and the normative RNFL data of the concerned population.[6],[7],[23] RNFL thickness parameters are already studied in the western population. [29],[30],[31],[32],[33],[34],[35],[36]To the best of our knowledge, this is the first report of RNFL thickness measurements with OCT in normal Indian eyes.

The mean RNFL thickness in our sample population was 104.27 ± 8.5 microns, and it is comparable to the RNFL thickness reported in the Chinese population.[35],[37] A summary of some of the previous reports on normal RNFL thickness parameters is presented in [Table - 4].[6], [29],[30],[31],[32],[33],[34],[35],[36],[37]It shows a higher value of RNFL thickness in most of the studies in Caucasians (except those 1 reported by Bowd[34] and Mistelberger[6] when compared to Chinese eyes. Such a discrepancy has not been addressed earlier but might be related to the ethnicity of study group, or to the OCT model, and the analysis protocol used.

Previous studies have similarly shown that RFNL thickness decreases with advancing age.[23],[31],[32],[36] We also observed this in our study. The decrease in average inferior RNFL thickness with advancement of age was more as compared to decrease in average superior RNFL thickness; this is also seen as increase in the S Max/ I Max ratio with age [Table - 2]. However, the one-way analysis of variance amongst the three age groups failed to show statistically significant difference in other variables. Further study with a larger sample size with more number of individuals in each age group may highlight any possible difference.

On quadrant-wise analysis of the RNFL thickness, we observed that the RNFL was thickest in the inferior (132.34±14.70µ) and superior (131.09±14.13µ) quadrants. The thickness was lesser in nasal (85.93±17.89µ) and temporal (67.1±12.77µ) quadrants. This corresponds to the double hump pattern of RNFL as is previously described.[38],[39] The difference between inferior and superior quadrants was not statistically significant suggesting that the ISNT rule does not the apply to Indian eyes. Kanamori et al in their study of 160 normal eyes showed slightly higher values than ours.[30] They found that superior thickness (145.5± 19.6µ), was maximum followed by inferior RNFL thickness (143.1±19.5µ), temporal (98.7±20.8µ) and lastly in nasal quadrant (92.6±20.4µ). Their observation also did not follow the previously described ISNT rule. Bowd et al (30 eyes) found lower values as compared to our study.[3],[4] They noted a highest inferior (107.6µ) followed by superior (105.7µ) quadrant RNFL thickness; the temporal (66.2µ) quadrant had a higher thickness as compared to the nasal quadrant (61.8µ). These variations in the quadrantic RNFL thickness can again be attributed to racial variation in the population studied.

We found I max/S max ratio close to one (1.05 ± 0.172), denoting a symmetrical RNFL superiorly and inferiorly. This again shows that ISNT rule is not followed. The ratios, S max/ T avg. (2.48±0.94) and I max / T avg. (2.48±0.45) were almost similar, though no comparative values of these ratios are available in literature on OCT generated RNFL thickness.

There was no effect of gender on the RNFL parameters measured in our study. A similar finding has been reported previously.[23],[31] Schuman et al showed nerve fibre layer of men were usually thinner than the females, but not statistically significant.[29]

In conclusion, our study provides a normative database for the retinal nerve fibre layer thickness in normal Indian eyes by optical coherence tomography. This can serve as a useful guideline in diagnosis, management and research in glaucoma.



 
  References Top

1.
Sommer A, Miller NR Pollack J, Maumenee AE, George T. The nerve fibre layer in the diagnosis of glaucoma. Arch Ophthalmol 1977;95:2149-56.  Back to cited text no. 1
    
2.
Quigley HA, Miller NR, George T. Clinical evaluation of nerve fibre layer as an indicator of glaucomatous optic nerve damage. Arch Ophtahmol 1980;98:1504-71.  Back to cited text no. 2
[PUBMED]    
3.
Repka M, Quigley HA. The effect of age on normal human optic nerve fibre number and diameter. Ophthamology 1989;96:26-32.  Back to cited text no. 3
    
4.
Zangwill LM, Bowd C Berry CC, William J, Bluementhal EZ, Sanchez-Galena CA et al. Discriminating between normal and glaucomatous eyes using the Heidelberg Retinal tomography, GDx nerve fibre analyzer and optical coherence tomography. Arch Ophthalmol 2001;119:985-93.  Back to cited text no. 4
    
5.
Soliman MA, Van Den Berg TJ, Ismaiel AA. Dejong LA, De Smet MD. Retinal nerve fibre layer analysis; relationship between optical coherence tomography and red free photography. Am J Ophthalmol 2002;133:187-95.  Back to cited text no. 5
    
6.
Mistlberger A, Liebmann JM, Greenfield DS, Pons ME, Hoh ST, Ishikawa H, et al. Heidelberg retina tomography and optical coherence tomography in normal, ocular hypertensive, and glaucomatous eyes. Ophthamology 1999;106:2027-32.  Back to cited text no. 6
[PUBMED]    
7.
Hoh ST, Greenfield DS, Mistlberger A, Liebmenn JM, Ishikawa H, Ritch R. Optical coherence tomography and scanning laser polarimetry in normal, ocular hypertensive, and glaucomatous eyes. Am J Ophthalmol 2000;129:120-33.  Back to cited text no. 7
    
8.
Niessen AG, Van Den Berg TJ, Langerhorst CT, Greve EL. Retinal nerve fiber layer assessment by scanning laser polarimetry and standardized photography. Am J Ophthalmol 1996;121:484-93.  Back to cited text no. 8
[PUBMED]    
9.
Blumenthal EZ, Williams JM, Weinreb RN, Girkin CA, Berry CC, Zangwill LM, et al. Reproducibility of nerve fibre layer measurements by use of Optical coherence tomography. Ophthalmology 2000;107:2278-82.  Back to cited text no. 9
    
10.
Schuman JS, Pedut-Kloizmen T, Hertzmark E, Hee MR, Wilkins JR, Coker JG et al. Reproducibility of nerve fibre layer thickness measurements using optical coherence tomography. Ophthalmology 1996;103:1889-98.  Back to cited text no. 10
    
11.
Mikelberg FS, Wijsman K, Schulzer M. Reproducibility of topographic parameters obtained with the Heidelberg retinal tomography. J Glaucoma 1993;2:101-3.  Back to cited text no. 11
    
12.
Huang D, Swanson EA, Lin CP, Schuman JS, Stinson WG, Chang W, Hee MR, Flotte T, Gregory K, Puliafito CA. Optical coherence tomography. Science 1991;254:1178-81.  Back to cited text no. 12
    
13.
Baumann M, Gentile RC, Lebmenn JM, Ritch R. Reproducibility of retinal thickness measurements in normal eyes using optical coherence tomography. Ophthalmic Surg Lasers Imaging 1998;29:280-85.  Back to cited text no. 13
    
14.
Hee MR, Izatt JA, Swanson EA, Huang D, Schuman JS, Lin CP, Puliafito CA, Fujimoto JG. Optical coherence tomography of the human retina. Arch Ophthalmol 1995;113:325-32.  Back to cited text no. 14
[PUBMED]    
15.
Villain MA, Green field DS. Peripapillary nerve fibre layer thickness measurement reproducibility using optical coherence tomography. Ophthalmic Surg Lasers Imaging 2003;34:33-37.  Back to cited text no. 15
    
16.
Mastropasqua L, Carpineto P, Ciacaglini M Falconio G, Harris A. Reproducibility of nerve fibre layer thickness measurements using optical; coherence tomography in silicone oil filled eyes. Ophthalmologica 2001;215:91-96.  Back to cited text no. 16
    
17.
Jones AL, Sheen NJL, North RV, Morgan JE. The Humphrey optical coherence tomography scanner; quantitative analysis and reproducibility study of the normal human retinal nerve fibre layer. Br J Ophthalmol 2001;85:673-77.  Back to cited text no. 17
    
18.
Toth CA, Bringruber R, Boppart SA, Hee MR, Fujimoto JG, DiCarlo CD, et al. Argon laser retinal lesions evaluation in vivo by optical coherence tomography. Am J Ophthalmol 1997;123:188-98.  Back to cited text no. 18
    
19.
Quigley HA, Brown AE, Morrison JD, Drance SM. The size and shape of the optic disc in normal human eyes. Arch Ophthalmol 1990;108:51-57.  Back to cited text no. 19
[PUBMED]    
20.
Poinoosawmy D, Fontana L, Wu JX, Fitzke FW, Hitchings RA . Variation of nerve fibre layer thickness measurements with age and ethnicity by scanning laser polarimetry. Br J Ophthalmol 1997;81:350-54.  Back to cited text no. 20
[PUBMED]  [FULLTEXT]  
21.
Chi QM, Tomita G, Inazumi K. Evaluation of the effect of aging on the retinal nerve fibre layer thickness using scanning laser polarimetry. J Glaucoma 1995;4:406-13.  Back to cited text no. 21
    
22.
Tsai C, Zangwill L, Gonzalez C, et al. Ethnic differences in optic nerve head topography. J Glaucoma 1995;4248-257.  Back to cited text no. 22
    
23.
Patker HM, Schuman JS, Hertzmerk E. Optical coherence tomography of the retinal nerve fibre layer, with comparison to Heidelberg retinal tomography optic nerve head measurements, in normal and glaucomatous human eyes. In Lemji Hg, Schuman JS, editors. The shape of Glaucoma. Quantitative Neural Imaging Techniques . The Hague: Kugler Publications, 2000; pp149-184.  Back to cited text no. 23
    
24.
Bowd CA, Zangwill Lm, Berry CC, Bluementhal EZ, Vasula C, Sanchez Galena C, et al. Detecting early glaucoma by assessment of retinal nerve fibre layer thickness and visual function. Invest Ophthalmol Vis Sci 2001;42:1993-2003.  Back to cited text no. 24
    
25.
Greaney MJ, Hoffman DC, Garway-Heath DF, Nakla M, Coleman AL, Caprioli J. Comparison of optic nerve imaging methods to distinguish normal eyes from those with glaucoma. Invest Vis Sci Ophthalmol 2002;43:140-45.  Back to cited text no. 25
    
26.
Knighton RW, Huang XR. Linear birefringence of the central human cornea. Invest Ophthalmol Vis Sci 2002;43:82-86.  Back to cited text no. 26
[PUBMED]  [FULLTEXT]  
27.
Green field DS, Huang XR, Knighton RW. Effect of corneal polarization axis on assessment of retinal nerve fibre layer thickness by scanning laser polarimetry. Am J Ophthalmol 2000;129:715-22.  Back to cited text no. 27
    
28.
Bowd C, Zangwill LM, Blumenthal EZ, Vasile C, Boehm AG, Gokhale PA, et al. Imaging of the optic disc and retinal nerve fiber layer: the effects of age, optic disc area, refractive error, and gender. J Opt Soc Am A Opt Image Sci Vis 2002;19:197-207.   Back to cited text no. 28
[PUBMED]    
29.
Schuman JS, Hee MR, Puliafito CA, Wong C, Pedut-Kloizman T, Lin CP, et al. Quantification of nerve fibre layer thickness in normal and glaucomatous eyes using optical coherence tomography. Arch Ophthalmol 1995;113:586-96.  Back to cited text no. 29
[PUBMED]    
30.
Kanamori A, Nakamura M, Escano MFT, Seya R, Maeda H, Negi A. Evaluation of the glaucomatous damage on the retinal nerve fibre layer thickness measured by optical coherence tomography. Am J Ophthalmol 2003;135:513-20.  Back to cited text no. 30
    
31.
Guedes V, Schuman JS, Hertzmerk E, Wollstein G, Correnti A, Mancini R, et al. Optical coherence tomography measurement of macular and nerve fiber layer thickness in normal and glaucomatous eyes. Ophthalmology 2003;110:177-89.  Back to cited text no. 31
    
32.
Carpineto P, Ciancaglini M, Zuppardi E, Falconio G, Doronzo E, Mastropasqua L. Reliability of retinal nerve fibre layer thickness measurements using optical coherence tomography in normal and glaucomatous eyes. Ophthalmology 2003;110:190-95.  Back to cited text no. 32
[PUBMED]    
33.
Bagga H, Greenfield DS, Feuer W, Knighton WR. Scanning laser polarimetry with variable corneal compensation and optical coherence tomography in normal and glaucomatous eyes. Am J Ophthalmol 2003;135:512-29.  Back to cited text no. 33
    
34.
Bowd C, Weinreb RN, Williams JM, Zangwill LM. Retinal nerve fibre layer thickness in ocular hypertensive, normal and glaucomatous eyes with optical coherence tomography. Arch Ophthalmol 2000;118:22-26.  Back to cited text no. 34
    
35.
Luo R, Ge J, Liu X, Wang M, Ling Y, Zheng X. A quantitative measurement of retinal nerve fiber layer thickness by opticalcoherence tomography in normal Chinese people. Yan Ke Xue Bao 1998;14:207-9.   Back to cited text no. 35
[PUBMED]    
36.
Varma R, Bazzaz S, Lai M. Optical tomography-measured retinal nerve fiber layer thickness in normal latinos. Invest Ophthalmol Vis Sci 2003;44:3369-73.   Back to cited text no. 36
[PUBMED]  [FULLTEXT]  
37.
Liu X, Ling Y, Zhou W, Zheng X, Liang D. Qualitative and quantitative measurement of retinal nerve fiber layer in primary open angle glaucoma by optical coherence tomography. Honghua Yan Ke Za Zhi 2000;36:420-28.   Back to cited text no. 37
    
38.
Caprioli J. The contour of the juxta-papillary nerve fibre layer in glaucoma. Ophthalmology 1990;97:358-65.  Back to cited text no. 38
[PUBMED]    
39.
Varma R, Skaf M, Barron E. Retinal nerve fibre layer thickness in normal human eyes. Ophthalmology 1998;103:2114-19.  Back to cited text no. 39
    


    Figures

  [Figure - 1]
 
 
    Tables

  [Table - 1], [Table - 2], [Table - 3], [Table - 4]


This article has been cited by
1 Predictors of normal optic nerve head, retinal nerve fiber layer, and macular parameters measured by spectral domain optical coherence tomography
Rao, H.L., Kumar, A.U., Babu, J.G., Kumar, A., Senthil, S., Garudadri, C.S.
Investigative Ophthalmology and Visual Science. 2011; 52(2): 1103-1110
[Pubmed]
2 Interocular symmetry in peripapillary retinal nerve fiber layer thickness measured with the cirrus HD-OCT in healthy eyes
Mwanza, J.-C., Durbin, M.K., Budenz, D.L.
American Journal of Ophthalmology. 2011; 151(3): 514-521
[Pubmed]
3 Optical coherence tofmography (OCT) in optic neuritis and multiple sclerosis
Lamirel, C., Newman, N.J., Biousse, V.
Revue Neurologique. 2010; 166(12): 978-986
[Pubmed]
4 Impact of ethnicity on the correlation of retinal parameters with axial length
Tariq, Y.M., Samarawickrama, C., Pai, A., Burlutsky, G., Mitchell, P.
Investigative Ophthalmology and Visual Science. 2010; 51(10): 4977-4982
[Pubmed]
5 Optical coherence tomography measurement of retinal nerve fibre layer, optic nerve head and macula in normal subjects
KiliÁ, A., Altinta, ÷., YŁksel, N., Altintaş, L., «elik, M., «aǧlar, Y.
Neuro-Ophthalmology. 2010; 34(1): 36-44
[Pubmed]
6 Peripapillary retinal nerve fiber layer thickness in normal Japanese eyes measured with optical coherence tomography
Kanno, M., Nagasawa, M., Suzuki, M., Yamashita, H.
Kanno, M., Nagasawa, M., Suzuki, M., Yamashita, H.. 2010; 54(1): 36-42
[Pubmed]
7 Retinal nerve fiber layer thickness analysis in suspected malingerers with optic disc temporal pallor
Civelekler, M., Halili, I., Gundogan, F.C., Sobaci, G.
Indian Journal of Ophthalmology. 2009; 57(5): 365-370
[Pubmed]
8 Retinal Nerve Fiber Layer Thickness in Amblyopic Eyes
Retinal Nerve Fiber Layer Thickness in Amblyopic Eyes
American Journal of Ophthalmology. 2009; 148(1): 143-147
[Pubmed]
9 Retinal nerve fibre layer thickness analysis in X-linked retinoschisis using Fourier-domain OCT
Genead, M.A., Pasadhika, S., Fishman, G.A.
Eye. 2009; 23(5): 1020-1027
[Pubmed]
10 Retinal Nerve Fiber Structure versus Visual Field Function in Patients with Ischemic Optic Neuropathy. A Test of a Linear Model
Hood, D.C., Anderson, S., Rouleau, J., Wenick, A.S., Grover, L.K., Behrens, M.M., Odel, J.G., (...), Kardon, R.H.
Ophthalmology. 2008; 115(5): 904-910
[Pubmed]
11 Retinal nerve fiber layer thickness in normal, ocular hypertensive, and glaucomatous Indian eyes: An optical coherence tomography study
Gyatsho, J., Kaushik, S., Gupta, A., Pandav, S.S., Ram, J.
Journal of Glaucoma. 2008; 17(2): 122-127
[Pubmed]
12 Modeling the effects of aging on retinal ganglion cell density and nerve fiber layer thickness
Harwerth, R.S., Wheat, J.L.
Graefeśs Archive for Clinical and Experimental Ophthalmology. 2008; 246(2): 305-314
[Pubmed]
13 Age-related losses of retinal ganglion cells and axons
Harwerth, R.S., Wheat, J.L., Rangaswamy, N.V.
Investigative Ophthalmology and Visual Science. 2008; 49(10): 4437-4443
[Pubmed]
14 Retinal nerve fiber layer thickness in normal, ocular hypertensive, and glaucomatous Indian eyes: An optical coherence tomography study
Gyatsho, J., Kaushik, S., Gupta, A., Pandav, S.S., Ram, J.
Journal of Glaucoma. 2008; 17(2): 122-127
[Pubmed]
15 Normative database of retinal nerve fiber layer and macular retinal thickness in a Thai population
Manassakorn, A., Chaidaroon, W., Ausayakhun, S., Aupapong, S., Wattananikorn, S.
Japanese Journal of Ophthalmology. 2008; 52(6): 450-456
[Pubmed]
16 Retinal nerve fiber layer defects in RP patients
Walia, S., Fishman, G.A., Edward, D.P., Lindeman, M.
Investigative Ophthalmology and Visual Science. 2007; 48(10): 4748-4752
[Pubmed]
17 The relationship between nerve fiber layer and perimetry measurements
Harwerth, R.S., Vilupuru, A.S., Rangaswamy, N.V., Smith III, E.L.
Investigative Ophthalmology and Visual Science. 2007; 48(2): 763-773
[Pubmed]
18 The relationship between retinal ganglion cell function and retinal nerve fiber thickness in early glaucoma
Ventura, L.M., Sorokac, N., De Los Santos, R., Feuer, W.J., Porciatti, V.
Investigative Ophthalmology and Visual Science. 2006; 47(9): 3904-3911
[Pubmed]
19 Peripapillary Retinal Nerve Fiber Layer Thickness in a Population of 6-Year-Old Children. Findings by Optical Coherence Tomography
Huynh, S.C., Wang, X.Y., Rochtchina, E., Mitchell, P.
Ophthalmology. 2006; 113(9): 1583-1592
[Pubmed]
20 Influence of pupil size and cataract on retinal nerve fiber layer thickness measurements by stratus OCT
Savini, G., Zanini, M., Barboni, P.
Journal of Glaucoma. 2006; 15(4): 336-340
[Pubmed]
21 Quantitative analysis of multi-spectral fundus images
Styles, I.B., Calcagni, A., Claridge, E., Orihuela-Espina, F., Gibson, J.M.
Medical Image Analysis. 2006; 10(4): 578-597
[Pubmed]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
Abstract
Material and Methods
Results
Discussion
References
Article Figures
Article Tables

 Article Access Statistics
    Viewed9169    
    Printed338    
    Emailed23    
    PDF Downloaded0    
    Comments [Add]    
    Cited by others 21    

Recommend this journal