While each of the commercially available imaging devices (confocal scanning laser ophthalmoscopy, scanning laser polarimetry, optical coherence tomography 2) has had its own set of normative RNFL thickness values collected, these values have not been validated histologically. By contrast, we know relatively little about histological estimates of RNFL thickness in normal and diseased human eyes. 1, 2, 3, 4, 5 In parallel, the implementation of RNFL evaluation both by clinical assessment as well as with imaging devices in routine clinical practice of glaucoma patients is on the rise. The measurement of this parameter may play a central role in the early detection of glaucomatous damage given the changes that can be seen in the RNFL prior to the onset of visual field loss. ![]() The last decade has seen a dramatic increase in the number of articles addressing the clinical estimation of retinal nerve fibre layer (RNFL) thickness in glaucoma. Further studies may help better characterize the RNFL thickness in health and disease and to facilitate the correlation with clinical methods for nerve fibre layer assessment. We conclude that limited data are available to describe the normal variation in RNFL thickness in the normal human eye. Despite the diverse study methodology taken, a consistent feature of all the data is that the superior and inferior quadrants of the peripapillary retina are thicker than the nasal and temporal quadrants that the RNFL thickness rapidly diminishes with increasing distance from the disc margin and that apparently at different locations the ratio of axons to supportive tissue varies significantly. Six studies have so far analysed RNFL thickness. MethodsĪ review of the literature on histological analysis of RNFL thickness in the context of glaucomatous damage. In this review, we summarize the knowledge currently available about RNFL thickness in human and primate eyes. ![]() However, when drawing clinical inference concerning the state of the RNFL, it is important to have valid reference data on RNFL thickness in both healthy and diseased eyes. The in vivo measurement of RNFL thickness by a variety of digital imaging technologies is becoming an important measure for early detection, as well as for follow-up, of glaucomatous damage. Accurate assessment of the retinal nerve fibre layer (RNFL) is central to the diagnosis and follow-up of glaucoma.
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