Detection of progressive macular thickness loss using optical coherence tomography in glaucoma suspect and glaucomatous eyes

Aims

To examine the rate of macular thickness loss using time-domain optical coherence tomography (OCT) in functionally progressing versus non-progressing eyes, determined by standard automated perimetry (SAP).

Methods

Glaucoma suspects (GS) and glaucomatous (G) eyes underwent SAP and OCT imaging every 6 months. Functional progression was determined using pointwise linear regression, defined as 2 contiguous locations losing ≥1.0 dB/year at P<1.0% in the same hemifield. The annual rate of macular thickness loss was calculated from inner and outer regions of the macular map.

Results

72 eyes (43 GS and 29G) with ≥30 months of follow-up were enroled. Fourteen eyes demonstrated SAP progression. The annual rate of macular thickness loss (μm/year) in progressing eyes was faster (all P<0.05) than non-progressing eyes in temporal outer (−1.90±2.97 vs 0.33±2.77), nasal inner (−1.70±2.66 vs 0.14±2.76), superior inner (−2.15±4.57 vs 0.51±2.99), temporal inner quadrants (−2.58±5.05 vs −0.38±2.34), and the average of inner macular quadrants (−1.84±2.90 vs 0.03±2.10). The rate of loss in the nasal inner (P=0.02) and temporal outer (P=0.02) macular regions was associated with optic disc haemorrhage.

Conclusions

Eyes with SAP progression have significantly greater rates of macular thickness loss consistent with glaucomatous retinal ganglion cell atrophy, as compared with non-progressing eyes.     

Analysis of macular volume in normal and glaucomatous eyes using optical coherence tomography

PURPOSE: To evaluate macular volume in normal and glaucomatous eyes using optical coherence tomography (OCT). DESIGN: Case control study. METHOD: The authors assessed 272 eyes of 164 subjects as part of an institutional study at New England Eye Center in Boston, Massachusetts; 202 eyes were in the study group and 70 eyes in the control group. Eyes were categorized as normal (70 eyes of 43 subjects), glaucoma suspect (70 eyes of 44 subjects), early glaucoma (70 eyes of 47 subjects), or advanced glaucoma (62 eyes of 43 subjects). Subjects underwent analysis with the commercially available OCT1 unit. Optical coherence tomography macular neurosensory retinal thickness maps were used to calculate macular volume for comparison to Humphrey visual field testing, intraocular pressure measurement, and stereo biomicroscopy of the optic nerve head and nerve fiber layer. RESULTS: Using repeated measures regression, macular volume in normal (2.37 +/- 0.11 mm(3)) glaucoma suspect (2.33 +/- 0.16 mm(3)), and early glaucoma eyes (2.27 +/- 0.13 mm(3)) was significantly greater than in eyes with advanced glaucoma (2.12 +/- 0.23 mm(3), P =.0001, P =.0001, and P =.0008, respectively). Macular volume in normal eyes was significantly greater than in early glaucoma eyes (P =.01). CONCLUSIONS: Optical coherence tomography retinal macular volume correlates with known structural defects of glaucoma, providing a potential objective and quantitative parameter for evaluation. Our data show a significant difference in macular volume between normal, glaucoma suspect, and early glaucoma eyes, compared with advanced glaucomatous eyes as well as between normal and early glaucomatous eyes. This correlates with a trend of decreasing macular volume in eyes with more advanced disease.     

相干光断层扫描测量正常人和青光眼患者黄斑厚度

目的 探讨相干光断层成像(optical coherence tomography,OCT)测量黄斑厚度对青光眼的诊断价值.设计 前瞻性对照研究.研究对象 62例(101眼)正常人和41例(64眼)青光眼患者.方法 应用Stratus OCT测量正常人和青光眼患者的黄斑厚度,观察正常人和青光眼患者的黄斑厚度地形图的图像特征;将正常人和青光眼患者黄斑厚度进行比较;用受试者工作特征曲线下面积(area under the receive operator characteristic curve,AROC)的分析方法找出青光眼早期诊断的最佳指标.主要指标 黄斑厚度地形图特征及各分区黄斑厚度、AROC.结果 正常人黄斑厚度地形图呈"马蹄形",青光眼患者的黄斑区视网膜呈局限性或弥漫性变薄.青光眼患者黄斑各分区视网膜厚度均比正常人减少,差异有统计学意义(P＜0.05),而早期青光眼患者仅黄斑外环各分区较正常人减少,差异有统计学意义(P＜0.05).无论是正常人和青光眼患者之间还是正常人和早期青光眼患者之间,黄斑下方外环区的AROC均最大(分别为0.876、0.728).结论 OCT测量正常人黄斑厚度地形图呈"马蹄形",青光眼患者黄斑厚度呈局限性或弥漫性变薄,黄斑下方外环区改变是较佳的早期诊断指标.(眼科,2008,17:25-28)     

频域干涉光断层扫描观察正常人眼脉络膜厚度的研究

目的 应用频域干涉光断层扫描仪(spectral-domain optical coherence tomography,SDOCT)观测正常人眼脉络膜厚度,并观察其与年龄、性别的关系.方法 临床观察研究.对2010年6～12月在沈阳军区总医院眼科,无视网膜或脉络膜疾病的109人(109只眼)应用Cirrus HD-OCT行黄斑部扫描,测量黄斑中心凹下及由中心凹向鼻侧及颞侧每隔500μm直至2500μm的脉络膜厚度.并评估脉络膜厚度与年龄、眼别及性别的关系.结果 黄斑中心凹下脉络膜平均厚度为(298.13 ±44.56)μm,明显厚于其鼻、颞两侧部位(P＜0.01).由中心凹向鼻、颞两侧脉络膜厚度逐渐变薄,且距中心凹同等距离颞侧脉络膜厚度明显大于鼻侧脉络膜厚度(P＜0.01).中心凹下平均脉络膜厚度与性别、眼别无关,与年龄呈负相关(r =-0.48,P＜0.01).结论 脉络膜厚度与所处位置有关,与年龄呈负相关.     

Comparison of glaucomatous parameters in normal, ocular hypertensive and glaucomatous eyes using optical coherence tomography 3000

This study was performed to evaluate optic disc appearance, retinal nerve fiber layer (RNFL) thickness, and macular thickness in normal, ocular hypertensive (OHT) and glaucomatous eyes using optical coherence tomography (OCT) 3000. One hundred fifty-eight eyes of 167 consecutive subjects were enrolled: 60 normal, 53 OHT, and 54 glaucomatous. OCT topographic parameters of cup diameter, cup area, rim area, and cup/disc area ratio were significantly less in OHT eyes than in normal eyes and were significantly less in glaucomatous eyes than in normal and OHT eyes. RNFL was significantly thinner in OHT eyes than in normal eyes in the inferior quadrant, and in glaucomatous eyes than in OHT and normal eyes in the mean and for all four quadrants. Macular thickness was significantly thinner in glaucomatous eyes than in OHT and normal eyes throughout all subdivisions. Optic disc parameters, and RNFL and macular thickness measurements made with OCT may be useful in the clinical assessment of glaucoma.     

Evaluation of retinal nerve fiber layer thickness in the area of apparently normal hemifield in glaucomatous eyes with optical coherence tomography

PURPOSE: The authors investigated the correlation between visual field defects detected by automated perimetry and the thickness of the retinal nerve fiber layer measured with optical coherence tomography, and examined whether there is a decrease in retinal nerve fiber layer thickness in the apparently normal hemifield of glaucomatous eyes. PATIENTS AND METHODS: Forty-one patients with glaucoma and 41 normal control subjects were included in this study. Statistical correlations between the sum of the total deviation of 37 stimuli of each hemifield and the ratio of decrease in retinal nerve fiber layer thickness were evaluated. The statistical difference between the retinal nerve fiber layer thickness of the apparently normal hemifield in glaucomatous eyes and that of the corresponding hemifield in normal subjects was also evaluated. RESULTS: There was a statistically significant correlation in the sum of the total deviation and retinal nerve fiber layer thickness decrease ratio (superior hemifield, P = 0.001; inferior hemifield, P = 0.003). There was no significant decrease in retinal nerve fiber layer thickness in the area that corresponded to the normal visual field in the hemifield defect with respect to the horizontal meridian in glaucomatous eyes (superior side, P = 0.148; inferior side, P = 0.341). CONCLUSIONS: Optical coherence tomography was capable of demonstrating and measuring retinal nerve fiber layer abnormalities. No changes in the retinal nerve fiber layer thickness of the apparently normal hemifield were observed in glaucomatous eyes.     

Discrimination between normal and glaucomatous eyes using Stratus optical coherence tomography in Taiwan Chinese subjects

Background We differentiated between normal and glaucomatous eyes in the Taiwan Chinese population based solely on the quantitative assessment of summary data reports from Stratus optical coherence tomography (OCT) by comparing their area under the receiver operating characteristic (ROC) curve.Methods One randomly selected eye from each of the 62 patients with early glaucomatous damage (mean deviation –2.8 ± 1.8 dB) and from each of the 62 age- and sex-matched normal individuals were included in the study. Measurements of glaucoma variables (retinal nerve fiber layer thickness and optic nerve head analysis results) were obtained by Stratus OCT. Twenty-one OCT parameters were included in a linear discriminant analysis (LDA) using forward selection and backward elimination to determine the best combination of parameters for discriminating between glaucomatous and healthy eyes based on ROC curve area.Results The average RNFL thickness was the best individual parameter for differentiating between normal eyes and glaucomatous eyes (ROC curve area 0.793). The maximum area under the ROC curve of six input parameters (average RNFL thickness; 10, 11, and 12 oclock segment thicknesses; cup area; and vertical integrated rim area) generated by the forward selection method was 0.881. Whereas the maximum area under the ROC curve of 15 input parameters (average RNFL thickness; 1, 3, 4, 6, 8–10, 12 oclock segment thicknesses; vertical integrated rim area; horizontal integrated rim area; disc area; cup to disc area ratio; cup to disc horizontal ratio; and cup to disc vertical ratio) generated by backward elimination method was 0.929.Conclusions The performance of individual parameters obtained from Stratus OCT is fairly reliable for differentiating the early glaucomatous eyes from normal eyes. However, the discriminant power increases when LDA with forward selection and backward elimination methods is applied.     

Assessment of serous macular detachment in eyes with diabetic macular edema by use of spectral-domain optical coherence tomography

Background

The introduction of optical coherence tomography (OCT) has brought new potentialities for an objective evaluation of macular diseases. The purpose of the present study was to assess the serous macular detachment (SMD) in eyes with diabetic macular edema (DME) by use of spectral-domain OCT.

Methods

In this prospective study were included 79 eyes of 46 patients with diabetic retinopathy and DME. All patients underwent examination of best-corrected visual acuity (BCVA), non-contact slit-lamp fundus biomicroscopy, fluorescein angiography and OCT. Spectral-domain OCT (OCT/SLO Combination Imaging System, OPKO/OT Inc., Toronto, Ontario, Canada) was used to evaluate retinal morphology and the presence of macular traction (vitreomacular and/or from epiretinal membranes) on B-scans, C-scans and C-scan OCT/SLO fundus image overlays. With OCT were measured retinal thickness, volume, diameter of intraretinal cystoid spaces, diameter and height of SMD. The correlation of retinal thickness and volume with BCVA in all eyes with DME and the relation of SMD to retinal thickness, volume, BCVA, macular traction and ischemia were assessed.

Results

The SMD was diagnosed only by means of OCT in nine eyes (11.4%) of five patients. In eight of nine eyes it was combined with intermediate (300–600 µm) or severe (>600 µm) cystoid spaces, and in one eye with simple macular edema. Retinal thickness and volume correlated with BCVA (r?=?0.464, P?<?0.0001 and r?=?0.480, P?<?0.0001). The SMD height did not correlate with retinal thickness, volume or BCVA. Six eyes with SMD had macular ischemia, and five eyes had severe ischemia in retinal periphery. Macular traction was: absent in three eyes, questionable (without distortion of retinal contour from partial posterior vitreous detachment and/or epiretinal membrane) in three eyes, and definite (with distortion of retinal contour) in three eyes.

Conclusions

Spectral-domain OCT provided valuable information on retinal morphology and was particularly useful in diagnosing sub-clinical SMD in eyes with DME. It disclosed the presence and strength of macular traction either by partially detached posterior hyaloid or by epiretinal membranes. C-scans and C-scan OCT/SLO fundus image overlays added complementary information for the extent and location of the pathological features. Larger studies which follow subjects longitudinally are needed to explain the pathogenesis and determine the prognosis of SMD.     

Analysis of retinal nerve fiber layer thickness measured by optical coherence tomography in glaucomatous eyes with hemifield defect

PURPOSE: To analyze the retinal nerve fiber layer thickness(NFLT) as measured by optical coherence tomography(OCT) in glaucomatous eyes with hemifield defect and to evaluate the most effective parameter for the diagnosis of glaucoma with OCT. METHODS: One hundred eighty four(184) normal eyes(128 subjects) and 108 open-angle glaucomatous eyes(87 subjects) with superior or inferior hemifield defects verified by Humphrey field analyzer(HFA) were measured for NFLT with OCT. The correlations between NFLT and mean deviation on HFA were calculated. In combination with normal eye data, receiver operating characteristic curve(ROC curve) and AUC(area under the curve) of each NFLT in the affected hemifield were evaluated for the diagnosis of glaucoma. RESULTS: NFLT in both affected and unaffected hemifields was significantly correlated with mean deviation in HFA. An average of four 30 degrees segments close to the temporal side in the affected hemifield (parameter A120) had the highest correlation(r = 0.571) and the highest AUC(0.948) among all parameters. CONCLUSIONS: NFLT in the unaffected visual field decreases with the progression of glaucomatous damage. We suggest that the parameter A120 is the best indication in a diagnosis of glaucoma when measuring NFLT by OCT.     

Reliability of nerve fiber layer thickness measurements using optical coherence tomography in normal and glaucomatous eyes

OBJECTIVE: To evaluate the reliability of nerve fiber layer (NFL) thickness measurements by optical coherence tomography (OCT) in normal and glaucomatous eyes. DESIGN: Prospective, comparative, observational case series and instrument validation study. PARTICIPANTS: Twenty-four glaucomatous patients were compared with 24 gender- and age-matched normal subjects. METHODS: Each individual underwent OCT measurements of NFL thickness. Five repetitions of a series of scans on five separate occasions within a 0.5-month period were performed. Each eye was scanned at three different nerve head programs (1.5 radius [R], R = 1.73 mm, 2.0 R). For each option (1.5 R, R = 1.73 mm, and 2.0R) and region (superior, inferior, temporal, nasal, and overall mean), variance components and intraclass correlation coefficients were determined using repeated measures regression. In these models, NFL thickness, as measured by OCT, was assumed to have three variance components: intersubject, intervisit (within-subject between-dates), and intravisit (within-subject within-date). The intraclass correlation coefficient (intersubject variance/total variance) was used as a measure of reliability. MAIN OUTCOME MEASURES: Measurements of NFL thickness using OCT were performed. RESULTS: Reliability values, as measured by intraclass correlation coefficients, resulted as follows: 1.5 R, 0.54/0.52 (normal/glaucoma); R = 1.73 mm, 0.50/0.50; 2.0 R, 0.49/0.50. CONCLUSIONS: Our results indicate that the recent commercially available OCT provides reliable NFL thickness measurements in both healthy and glaucomatous eyes with each circle radius tested. The greatest amount of variability can be attributed to intersubject differences.     

Effect of pupil dilation on macular choroidal thickness measured with spectral domain optical coherence tomography in normal and glaucomatous eyes

To compare choroidal thickness before and after pupil dilation. Macular subfoveal, nasal, temporal and average choroidal thicknesses were measured in one eye of 17 healthy individuals and 40 glaucoma patients using enhanced depth imaging optical coherence tomography before and after pupil dilation. Comparisons were made between pre- and post-dilation measurements, and between normal and glaucomatous eyes. No statistically significant differences were found between pre- and post-dilation choroidal thickness measurements both in normal (p = 0.361 for subfoveal, 0.760 for nasal, 0.941 for temporal, 0.881 for average) and glaucomatous eyes (p = 0.687 for subfoveal, 0.340 for nasal, 0.913 for temporal, and 0.642 for average). After adjusting for age, the comparison between normal and glaucomatous eyes showed no significant differences in measurements both before (p = 0.701–0.907) and after pupil dilation (p = 0.757–0.988). Similar results were obtained for measurements unadjusted for age. Measurements obtained under the two conditions correlated well in normal (r = 0.92–0.97, p < 0.001) and in glaucomatous eyes (r = 0.84–0.98, p < 0.001). Bland–Altman analyses showed good agreements between them in both groups of eyes, with mean difference ranges of 0.43–2.86 and 0.39–3.08 μm between pre- and post-dilation measurements in normal and glaucomatous eyes, respectively. Subfoveal and average choroidal thickness decreased significantly by 2 μm/year. Each millimeter increase in axial length decreased subfoveal choroidal thickness by 16.5 μm and average thickness by 14.1 μm. Macular choroidal thicknesses measured before and after pupil dilation are comparable and may be used interchangeably without significant discrepancies both in normal and glaucomatous eyes.     

Comparison of central macular thickness between two spectral-domain optical coherence tomography in elderly non-mydriatic eyes

AIM: To compare central macular thickness (CMT) measurements obtained by two spectral-domain optical coherence tomography (SD-OCT) exams, and to evaluate measurement reproducibility and agreement between these two exams, and to investigate the relationship between CMT and possible influencing factors such as age, sex, eye (OD/OS), and operators in elderly non-mydriatic eyes. METHODS: Seventy-two normal subjects were included. Every subject underwent CMT measurement twice using one of two SD-OCT (OSE-2000, Moptim, Shenzhen, China & 3-D OCT-1000, Topcon, Tokyo, Japan) instruments respectively where we randomly chose one eye in each patient for the test; these exams were performed by two operators over an hour period with a brief rest between sessions. Comparison of the OSE-2000 and 3-D OCT-1000 CMT measurements was based on paired-t test. The mean difference between the CMT measurements was calculated. General linear model analyzed the relationships among eye (OD/OS), operator, sex, and CMT values using age as co-variant. All tests were considered statistically significant at P<0.05. The main outcome measures included CMT. RESULTS: When evaluated with general linear model analysis, CMT measurements were found to have high reproducibility across the two instruments between the two operators for the OSE-2000 single line scan and 3-D OCT-1000 macular scans (P=0.731; P=0.443). There was statistically significant difference in CMT values between the two instruments (P<0.001) and the mean difference was -46.83μm at 95% confidence limits (-49.15,-44.51). Age was positively correlated with CMT (beta coefficient = 0.516, P=0.001; beta coefficient = 0.453, P=0.009) and sex was correlated with CMT from the OSE-2000 (P=0.021) but not with the 3-D OCT-1000 (P=0.056). According to the actual thickness measurements, the CMT of the male was thicker than the female’s but there was no statistical difference. There was interaction between sex and eye in OSE-2000 and not in 3-D OCT-1000 (P=0.02; P=0.374). No significant correlation was found between CMT and the influencing factor of eye in both of the instruments (P=0.884; P=0.492).CONCLUSION: Reproducibility of CMT measurement using the two SD-OCTs is excellent in normal eyes according to the operator factor analysis. OSE-2000 has a different posterior retinal boundary of CMT measurement, which results in the CMT value differences, compared with the 3-D OCT-1000. Age is positively correlated with CMT measurement while sex is correlated with CMT in the OSE-2000 but not in the 3-D OCT-1000 and eye (OD/OS) had no correlation with CMT values. Mydriatic drops may not be necessary for CMT measurement using high scan rate SD-OCT in normal eyes in dark room.     

Comparison of central macular thickness between two spectral-domain optical coherence tomography in elderly non-mydriatic eyes

AIM: To compare central macular thickness (CMT) measurements obtained by two spectral-domain optical coherence tomography (SD-OCT) exams, and to evaluate measurement reproducibility and agreement between these two exams, and to investigate the relationship between CMT and possible influencing factors such as age, sex, eye (OD/OS), and operators in elderly non-mydriatic eyes. METHODS: Seventy-two normal subjects were included. Every subject underwent CMT measurement twice using one of two SD-OCT (OSE-2000, Moptim, Shenzhen, China & 3-D OCT-1000, Topcon, Tokyo, Japan) instruments respectively where we randomly chose one eye in each patient for the test; these exams were performed by two operators over an hour period with a brief rest between sessions. Comparison of the OSE-2000 and 3-D OCT-1000 CMT measurements was based on paired-t test. The mean difference between the CMT measurements was calculated. General linear model analyzed the relationships among eye (OD/OS), operator, sex, and CMT values using age as co-variant. All tests were considered statistically significant at P<0.05. The main outcome measures included CMT. RESULTS: When evaluated with general linear model analysis, CMT measurements were found to have high reproducibility across the two instruments between the two operators for the OSE-2000 single line scan and 3-D OCT-1000 macular scans (P=0.731; P=0.443). There was statistically significant difference in CMT values between the two instruments (P<0.001) and the mean difference was -46.83μm at 95% confidence limits (-49.15,-44.51). Age was positively correlated with CMT (beta coefficient = 0.516, P=0.001; beta coefficient = 0.453, P=0.009) and sex was correlated with CMT from the OSE-2000 (P=0.021) but not with the 3-D OCT-1000 (P=0.056). According to the actual thickness measurements, the CMT of the male was thicker than the female’s but there was no statistical difference. There was interaction between sex and eye in OSE-2000 and not in 3-D OCT-1000 (P=0.02; P=0.374). No significant correlation was found between CMT and the influencing factor of eye in both of the instruments (P=0.884; P=0.492). CONCLUSION: Reproducibility of CMT measurement using the two SD-OCTs is excellent in normal eyes according to the operator factor analysis. OSE-2000 has a different posterior retinal boundary of CMT measurement, which results in the CMT value differences, compared with the 3-D OCT-1000. Age is positively correlated with CMT measurement while sex is correlated with CMT in the OSE-2000 but not in the 3-D OCT-1000 and eye (OD/OS) had no correlation with CMT values. Mydriatic drops may not be necessary for CMT measurement using high scan rate SD-OCT in normal eyes in dark room.     

GDx-VCC performance in discriminating normal from glaucomatous eyes with early visual field loss

Background To evaluate the ability of scanning laser polarimetry with variable corneal compensation (GDx-VCC) in separating healthy from glaucomatous patients with early visual field (VF) loss.Methods Sixty-two healthy and 48 glaucomatous age-matched patients with early glaucoma [mean deviation (MD): −1.74dB ±1.69] underwent complete ophthalmological evaluation, automated achromatic perimetry (AAP) and retinal nerve fiber layer (RNFL) measurement with GDx-VCC. One randomly selected eye from each subject was considered. Glaucomatous VF defects had either Glaucoma Hemifield Test (GHT) outside normal limits or pattern standard deviation (PSD) outside 95% confidence limits. Mean (±SD) MD, PSD and GDx-VCC parameters in the two groups were compared by t-test. For each GDx-VCC parameter, area under receiver operating characteristics (AUROC) curve and sensitivity at predetermined specificity ≥80% and ≥95% were calculated. Moreover, the parameter with largest AUROC was evaluated by likelihood ratios (LRs).Results Mean values for MD, PSD and ten of 14 GDx-VCC parameters were significantly different between the two groups (P<0.001). The three parameters with largest AUROCs were the nerve fiber indicator (NFI) (0.870), superior average (0.817) and normalized superior area (0.816) (P=0.08 for differences between AUROCs). NFI displayed sensitivity values of 80.2% and 60.4% for specificity ≥80% and ≥95%, respectively. At NFI cutoff value of 30, positive LR was 34.9 (95% CI: 4.9–247.6) and negative LR was 0.45 (95% CI: 0.32–0.61). Interval LRs showed large effect on post-test probability for NFI values ≤18 or ≥31.Conclusions In our sample of eyes with early VF loss, GDx-VCC showed moderate-to-good discriminating ability. Among the best performing parameters, NFI had the largest AUROC, but several glaucomatous eyes (21, 43.8%) had NFI <30. This suggests that algorithm for NFI calculation requires some refinement when eyes with early VF loss are evaluated.     

Comparative evaluation of optical coherence tomography in glaucomatous, ocular hypertensive and normal eyes

BACKGROUND: To correlate the findings of optical coherence tomography (OCT) evaluation of retinal nerve fiber layer (RNFL) thickness with visual field changes in glaucomatous, ocular hypertensive and normal eyes. MATERIALS AND METHODS: Thirty consecutive normal, 30 consecutive ocular hypertensive and 30 consecutive glaucomatous eyes underwent a complete ophthalmic examination, including applanation tonometry, disc evaluation, (30-2) Humphrey field analyzer white on white (W/W) perimetry and short- wavelength automated perimetry. Thickness of the RNFL around the optic disc was determined with 3.4 mm diameter-wide OCT scans. Average and segmental RNFL thickness values were compared among all groups. A correlation was sought between global indices of perimetry and RNFL thickness. RESULTS: Of the 90 eyes enrolled (mean age of patients 52.32+/-10.11 years), the mean RNFL thickness was significantly less in ocular hypertensive (82.87+/-17.21 mm; P =0.008 and glaucomatous eyes (52.95+/-31.10 microm; P < 0.001), than in normals (94.26+/-12.36 microm). The RNFL was significantly thinner inferiorly in glaucomatous eyes (64.41+/-43.68 microm; P<0.001). than in normals (120.15+/-14.32 microm) and ocular hypertensives (107.87+/-25.79 microm; P<0.001). Ocular hypertensives had thinner RNFL in the nasal, inferior and temporal quadrants (P<0.001) when compared to normals. Global indices in ocular hypertensives on SWAP showed Mean Deviation (MD) of 5.32+/-4.49, Pattern Standard Deviation (PSD) 3.83+/-1.59 and Corrected Pattern Standard Deviation (CPSD) 2.84+/-1.85. The RNFL thickness could not be significantly correlated with global indices of visual fields in ocular hypertensives. CONCLUSION: Optical coherence tomography is capable of detecting changes at the level of RNFL in ocular hypertensive eyes with normal appearance of discs and W/W perimetry fields.