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.
