Case #21 – The Disc at Risk

The Disc at Risk – Page 37 of 47

10-2 Visual Fields The 10-2 visual field OD suggests a superior arcuate defect which could possibly be due to early glaucoma. Although the entire central field OS is dramatically suppressed with a mean deviation of -33 dB, note the nasal inferior quadrant is most abnormal which is typical in NA-AION.1,3

The Disc at Risk – Page 37 of 472020-10-02T21:06:16+00:00

The Disc at Risk – Page 36 of 47

30-2 Visual Fields Although the characteristic field loss in NA-AION is inferior nasal, field defects including both hemispheres have been reported.1,3 Even with a large stimulus (V, white) most of the visual field has been lost in the affected left eye save for some preservation in the superior temporal quadrant. The right field result

The Disc at Risk – Page 36 of 472020-10-02T21:17:25+00:00

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Patient Optovue RTVue GCC Significance Map OD and OS Normative Data: Some features on report not available in the US. The GCC significance map reveals no areas of statistically significant loss. See page 30 for more detailed information on the significance map.

The Disc at Risk – Page 35 of 472020-10-13T08:53:21+00:00

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Patient Optovue RTVue Outer Retinal Thickness OD and OS The full retinal thickness, which includes the GCC outer retinal thickness, is within normal limits.

The Disc at Risk – Page 34 of 472020-10-02T21:17:58+00:00

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Patient Optovue RTVue Outer Retinal Thickness OD and OS Normative Data: Some features on report not available in the US. The outer retinal thickness, measured from inner-plexiform layer to the RPE, is within normal limits.

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Patient Optovue RTVue GCC Map OD and OS Although the patient is a glaucoma suspect, the GCC is completely normal. The ganglion cell complex includes the retinal nerve fiber layer, the ganglion cells and the inner-plexiform layer. See page 29&30 for more detailed information.

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Significance Map Explanation A Significance Map is provided that shows the regions on the Deviation Map where the percent loss is statistically significant. The Significance Map shows normal areas as green, borderline areas as yellow, and outside normal areas as red (see figure below). These are based on probability values of p <

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GCC Map Comparison Background information The GCC map for a normal eye shows a bright circular band surrounding the macula representing a thick GCC from healthy ganglion cells (figure A). The center of the macula is thinner because there are no ganglion cells in this area. In glaucoma, as the ganglion cells are

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Ganglion Cell Complex (GCC) Background Information Excerpt from "Direct Ganglion Cell Assessment with the RTVue by Optovue: The Ganglion Cell Complex Analysis" by Mike Sinai, Ph.D. Retinal ganglion cells encompass three layers in the retina: The retinal nerve fiber layer (RNFL) is made up of the ganglion cell axons The ganglion cell layer

The Disc at Risk – Page 29 of 472020-10-02T21:09:13+00:00

The Disc at Risk – Page 28 of 47

Optovue RTVue RNFL Analysis Normative data: Some features on report not available in the US. Note the dramatically thickened RNFL in the left eye as contrasted to the normal in the right. Also note the RNFL is least thick in the temporal region or papillomacular bundle.

The Disc at Risk – Page 28 of 472020-10-13T08:49:19+00:00