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Clinical Evaluation of Nerve Fiber Layer Atrophy as an Indicator of Glaucomatous Optic Nerve Damage

Clinical Evaluation of Nerve Fiber Layer Atrophy as an Indicator of Glaucomatous Optic Nerve Damage Abstract • To evaluate the usefulness of the retinal nerve fiber layer (NFL) appearance in the estimation of glaucomatous optic nerve damage, we examined 335 eyes of normal, glaucoma suspect, or glaucomatous patients. In eyes with field loss, 84% had NFL atrophy. In normal eyes, NFL atrophy was suspected in 3%. In glaucoma suspects, 13% of eyes had NFL defects. Defects in glaucoma suspect eyes were more often localized, compared with the diffuse atrophy found in eyes with visual field loss. The NFL abnormalities were seen in areas of the retina corresponding to the location of visual field defects with a high accuracy. The NFL examination is as sensitive in detecting eyes with field loss as the optic disc configuration and may help to identify which eyes are suffering optic nerve damage prior to field loss. References 1. Armaly MF: Ocular pressure and visual fields: A ten-year follow-up study . Arch Ophthalmol 81:25-40, 1969.Crossref 2. Graham PA: The definition of pre-glaucoma, a prospective study . Trans Ophthalmol Soc UK 88:153-165, 1968. 3. Perkins ES: The Bedford glaucoma survey: I. Long-term follow-up of borderline cases . Br J Ophthalmol 57:179-185, 1973.Crossref 4. Wilensky JT, Podos SM: Prognostic parameters in primary open angle glaucoma , in Anderson DR, Drance SM, Galin MA, et al (eds): Symposium on Glaucoma . St Louis, CV Mosby Co, 1975, pp 7-30. 5. Hart WM Jr, Yablonski M, Kass MA, et al: Multivariate analysis of the risk of glaucomatous visual field loss . Arch Ophthalmol 97:1455-1458, 1979.Crossref 6. Hoyt WF: Ophthalmoscopy of the retinal nerve fiber layer in neuroophthalmologic diagnosis . Aust J Ophthalmol 4:14-34, 1976.Crossref 7. Hoyt WF, Frisen L, Newman NM: Fundoscopy of the nerve fiber layer defects in glaucoma . Invest Ophthalmol 12:814-829, 1973. 8. Sommer A, Miller NR, Pollack I, et al: The nerve fiber layer in the diagnosis of glaucoma . Arch Ophthalmol 95:2149-2156, 1977.Crossref 9. Sommer A, Pollack I, Maumenee AE: Optic disc parameters and onset of glaucomatous field loss: I. Methods and progressive changes in disc morphology . Arch Ophthalmol 97:1444-1448, 1979.Crossref 10. Sommer A, Pollack I, Maumenee AE: Optic disc parameters and onset of glaucomatous field loss: II. Static screening criteria . Arch Ophthalmol 97:1449-1454, 1979.Crossref 11. Rock WJ, Drance SM, Morgan RW: A modification of the Armaly visual field screening technique for glaucoma . Can J Ophthalmol 6:283-292, 1971. 12. Miller NR, George T: Monochromatic (redfree) photography and ophthalmoscopy of the peripapillary retinal nerve fiber layer . Invest Ophthalmol Vis Sci 17:1121-1124, 1978. 13. Schwartz JT: Methodologic differences and measurement of cup-disc ratio: An epidemiologic assessment . Arch Ophthalmol 94:1101-1105, 1976.Crossref 14. Kirsch RE, Anderson DR: Identification of the glaucomatous disc . Trans Am Acad Ophthalmol Otolaryngol 77:143-156, 1973. 15. Susanna R, Drance SM, Douglas GR: Disc hemorrhages in patients with elevated intraocular pressure: Occurrence with and without field changes . Arch Ophthalmol 97:284-285, 1979.Crossref 16. Hitchings RA, Spaeth GL: The optic disc in glaucoma: I. Classification . Br J Ophthalmol 60:778-785, 1976.Crossref 17. Hoskins HD, Gelber EC: Optic disk topography and visual field defects in patients with increased intraocular pressure . Am J Ophthalmol 80:284-290, 1975. 18. Drance SM: Correlation between optic disc changes and visual field defects in chronic openangle glaucoma . Trans Am Acad Ophthalmol Otolaryngol 81:224-226, 1976. 19. Harbin TS, Podos SM, Kolker AE, et al: Visual field progression in open-angle glaucoma patients presenting with monocular field loss . Trans Am Acad Ophthalmol Otolaryngol 81:253-257, 1976. 20. Quigley HA, Green WR: The histology of human glaucoma cupping and optic nerve damage: Clinicopathologic correlation in 21 eyes. Ophthalmology, to be published. 21. Arden GB, Jacobson JJ: A simple grating test for contrast sensitivity: Preliminary results indicate value in screening for glaucoma . Invest Ophthalmol Vis Sci 17:23-32, 1978. 22. Atkin A, Bodis-Wollner I, Wolkenstein M, et al: Abnormalities of central contrast sensitivity in glaucoma . Am J Ophthalmol 88:205-211, 1979. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Clinical Evaluation of Nerve Fiber Layer Atrophy as an Indicator of Glaucomatous Optic Nerve Damage

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Publisher
American Medical Association
Copyright
Copyright © 1980 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1980.01020040416003
Publisher site
See Article on Publisher Site

Abstract

Abstract • To evaluate the usefulness of the retinal nerve fiber layer (NFL) appearance in the estimation of glaucomatous optic nerve damage, we examined 335 eyes of normal, glaucoma suspect, or glaucomatous patients. In eyes with field loss, 84% had NFL atrophy. In normal eyes, NFL atrophy was suspected in 3%. In glaucoma suspects, 13% of eyes had NFL defects. Defects in glaucoma suspect eyes were more often localized, compared with the diffuse atrophy found in eyes with visual field loss. The NFL abnormalities were seen in areas of the retina corresponding to the location of visual field defects with a high accuracy. The NFL examination is as sensitive in detecting eyes with field loss as the optic disc configuration and may help to identify which eyes are suffering optic nerve damage prior to field loss. References 1. Armaly MF: Ocular pressure and visual fields: A ten-year follow-up study . Arch Ophthalmol 81:25-40, 1969.Crossref 2. Graham PA: The definition of pre-glaucoma, a prospective study . Trans Ophthalmol Soc UK 88:153-165, 1968. 3. Perkins ES: The Bedford glaucoma survey: I. Long-term follow-up of borderline cases . Br J Ophthalmol 57:179-185, 1973.Crossref 4. Wilensky JT, Podos SM: Prognostic parameters in primary open angle glaucoma , in Anderson DR, Drance SM, Galin MA, et al (eds): Symposium on Glaucoma . St Louis, CV Mosby Co, 1975, pp 7-30. 5. Hart WM Jr, Yablonski M, Kass MA, et al: Multivariate analysis of the risk of glaucomatous visual field loss . Arch Ophthalmol 97:1455-1458, 1979.Crossref 6. Hoyt WF: Ophthalmoscopy of the retinal nerve fiber layer in neuroophthalmologic diagnosis . Aust J Ophthalmol 4:14-34, 1976.Crossref 7. Hoyt WF, Frisen L, Newman NM: Fundoscopy of the nerve fiber layer defects in glaucoma . Invest Ophthalmol 12:814-829, 1973. 8. Sommer A, Miller NR, Pollack I, et al: The nerve fiber layer in the diagnosis of glaucoma . Arch Ophthalmol 95:2149-2156, 1977.Crossref 9. Sommer A, Pollack I, Maumenee AE: Optic disc parameters and onset of glaucomatous field loss: I. Methods and progressive changes in disc morphology . Arch Ophthalmol 97:1444-1448, 1979.Crossref 10. Sommer A, Pollack I, Maumenee AE: Optic disc parameters and onset of glaucomatous field loss: II. Static screening criteria . Arch Ophthalmol 97:1449-1454, 1979.Crossref 11. Rock WJ, Drance SM, Morgan RW: A modification of the Armaly visual field screening technique for glaucoma . Can J Ophthalmol 6:283-292, 1971. 12. Miller NR, George T: Monochromatic (redfree) photography and ophthalmoscopy of the peripapillary retinal nerve fiber layer . Invest Ophthalmol Vis Sci 17:1121-1124, 1978. 13. Schwartz JT: Methodologic differences and measurement of cup-disc ratio: An epidemiologic assessment . Arch Ophthalmol 94:1101-1105, 1976.Crossref 14. Kirsch RE, Anderson DR: Identification of the glaucomatous disc . Trans Am Acad Ophthalmol Otolaryngol 77:143-156, 1973. 15. Susanna R, Drance SM, Douglas GR: Disc hemorrhages in patients with elevated intraocular pressure: Occurrence with and without field changes . Arch Ophthalmol 97:284-285, 1979.Crossref 16. Hitchings RA, Spaeth GL: The optic disc in glaucoma: I. Classification . Br J Ophthalmol 60:778-785, 1976.Crossref 17. Hoskins HD, Gelber EC: Optic disk topography and visual field defects in patients with increased intraocular pressure . Am J Ophthalmol 80:284-290, 1975. 18. Drance SM: Correlation between optic disc changes and visual field defects in chronic openangle glaucoma . Trans Am Acad Ophthalmol Otolaryngol 81:224-226, 1976. 19. Harbin TS, Podos SM, Kolker AE, et al: Visual field progression in open-angle glaucoma patients presenting with monocular field loss . Trans Am Acad Ophthalmol Otolaryngol 81:253-257, 1976. 20. Quigley HA, Green WR: The histology of human glaucoma cupping and optic nerve damage: Clinicopathologic correlation in 21 eyes. Ophthalmology, to be published. 21. Arden GB, Jacobson JJ: A simple grating test for contrast sensitivity: Preliminary results indicate value in screening for glaucoma . Invest Ophthalmol Vis Sci 17:23-32, 1978. 22. Atkin A, Bodis-Wollner I, Wolkenstein M, et al: Abnormalities of central contrast sensitivity in glaucoma . Am J Ophthalmol 88:205-211, 1979.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Sep 1, 1980

References