• Many clinicians rely upon the results of circumpapillary retinal nerve fiber layer (RNFL) measurements obtained with OCT to diagnose and manage their glaucoma patients.
  • Other objective measurements, such as GDx and OCT Ganglion Cell Complex (GCC) as well as subjective visual fields often correlate well with the OCT RNFL results.
  • Although such concordant findings are often assumed, widely discordant findings if encountered, force us to reconsider what many clinicians have long taken for granted.
  • Here we present a carefully documented case utilizing virtually all available technologies which clearly documents the apparent insensitivity of OCT RNFL measurements with four different SD OCT systems.
  • Reasons for these discordant results and suggestions for improved diagnosis and patient care are considered and apply to both glaucoma and to the non-glaucomatous optic neuropathies.