Three-Dimensional Imaging of the Macular Retinal Nerve Fiber Layer in Glaucoma with Spectral-Domain Optical Coherence Tomography

RESULTS. Fourteen (30.4%) more RNFL defects were detected on 3D,SD-OCT images than on color fundus photographs. Of these 14, 12 were detected in 10 (90.9%) of 11 eyes with tessellated fundi (P 0.0001). On 3D,SD-OCT images, complete loss of the RNFL reflectivity was seen in 63.0% of the RNFL defects and thinning of the RNFL in the rest. On TD-OCT cpRNFL analysis, RNFL defects that appeared on 3D,SD-OCT as a complete loss of RNFL reflectivity were detected more often (P 0.012) than those that appeared as thinning of the RNFL. Inter-rater agreement was better for RNFL defects on 3D,SDOCT (0.85) than for those on color (0.62–0.64) or red-free (0.68–0.70) fundus photographs. However, 3D,SD-OCT macular RNFL thickness measurements were substantially reproducible but not as reproducible as macular retinal thickness measurements, and neither was as sensitive as TD-OCT cpRNFL thickness measurements for detecting glaucoma.