Document Detail


Three-dimensional nature of retinal nerve fiber layer defects.
MedLine Citation:
PMID:  20179626     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To demonstrate the 3-dimensional nature of wedge-shaped retinal nerve fiber layer (RNFL) losses. To study the impact of training glaucoma fellows in this identification technique by evaluating their rate of RNFL loss detection on stereo disc photographs.
METHODS: Wedge-shaped RNFL defects were identified in stereo disc photographs of early-glaucoma patients. The 3-dimensional nature of RNFL defects and overlying retinal blood vessel contour changes were identified. Four glaucoma fellows were given stereophotographs to identify the presence or absence of RNFL defects. After training in identification of RNFL defects by noting their 3-dimensional nature and overlying blood vessel contour changes, the same set of photographs were reevaluated by the fellows. We determined whether there was a difference between the before and after assessments in the probability of a correct response for each of the fellows.
RESULTS: Loss of retinal thickness in the form of grooves and the resulting 3-dimensional nature of the RNFL defects were visualized on stereoscopic examination. Overlying retinal blood vessels coursed into and out of the RNFL defects. Three case examples of such wedge-shaped RNFL defects are presented. For each fellow, the proportion of RNFL defects correctly identified after training was greater than the proportion before training (P<0.001).
CONCLUSIONS: Identifying the 3-dimensional nature of wedge-shaped RNFL defects may improve rate of detection of RNFL defects during clinical examination.
Authors:
Sanjay G Asrani; Inder Paul Singh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of glaucoma     Volume:  19     ISSN:  1536-481X     ISO Abbreviation:  J. Glaucoma     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-03     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9300903     Medline TA:  J Glaucoma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  592-7     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, Duke University Eye Center, Durham, NC 27710, USA. asran002@mc.duke.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Education, Medical, Graduate
Fellowships and Scholarships
Female
Glaucoma / diagnosis*
Humans
Imaging, Three-Dimensional
Male
Middle Aged
Nerve Fibers / pathology*
Ophthalmology / education
Optic Disk / pathology*
Optic Nerve Diseases / diagnosis*
Photography
Retinal Ganglion Cells / pathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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