Case 1: Zeiss Cirrus RNFL Analysis OU

Although not widely known, patients with retinal degenerations such as RP often have a thicker than normal RNFL.2 In 10 consecutive RP patients with at least 20/30 BCVA, 9 had a statistically significant thickened RNFL. This also occurs in LHON (RR #38) and may be a compensatory mechanism.2,3,4 The problem in our present case is that a normal RNFL may mask glaucomatous loss of the RNFL.

In this case, it is certainly possible that the RNFL was thicker than normal because of the RP but now has thinned somewhat due to glaucoma and now appears essentially normal. Diurnal IOPs may be helpful and cupping can be monitored with HRT. Note that both RP and glaucoma progress and any further field loss may be difficult to attribute to only one of the two conditions.