title: Hypodense regions (holes) in the retinal nerve fiber layer in frequency-domain OCT scans of glaucoma patients and suspects.
abstract: OBJECTIVE
  To better understand hypodense regions (holes) that appear in the retinal nerve fiber layer (RNFL) of frequency-domain optical coherence tomography (fdOCT) scans of patients with glaucoma and glaucoma suspects.
  
  
  METHODS
  Peripapillary circle (1.7-mm radius) and cube optic disc fdOCT scans were obtained on 208 eyes from 110 patients (57.4 ± 13.2 years) with glaucomatous optic neuropathy (GON) and 45 eyes of 45 controls (48.0 ± 12.6 years) with normal results of fundus examination. Holes in the RNFL were identified independently by two observers on the circle scans.
  
  
  RESULTS
  Holes were found in 33 (16%) eyes of 28 (25%) patients; they were not found in any of the control eyes. Twenty-four eyes had more than one hole. Although some holes were relatively large, others were small. In general, the holes were located adjacent to blood vessels; only three eyes had isolated holes that were not adjacent to a vessel. The holes tended to be in the regions that are thickest in healthy controls and were associated with arcuate defects in patients. Holes were not seen in the center of the temporal disc region. They were more common in the superior (25 eyes) than in the inferior (15 eyes) disc. Of the 30 eyes with holes with reliable visual fields, seven were glaucoma suspect eyes with normal visual fields.
  
  
  CONCLUSIONS
  The holes in the RNFL seen in patients with GON were probably due to a local loss of RNFL fibers and can occur in the eyes of glaucoma suspects with normal visual fields.
authors.affiliation: Department of Psychology, Columbia University, New York, New York 10027, USA.
authors.forename: Daiyan
authors.initials: D
authors.lastname: Xin
authors.forename: Christine L
authors.initials: CL
authors.lastname: Talamini
authors.forename: Ali S
authors.initials: AS
authors.lastname: Raza
authors.forename: Carlos Gustavo V
authors.initials: CG
authors.lastname: de Moraes
authors.forename: Vivienne C
authors.initials: VC
authors.lastname: Greenstein
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Liebmann
authors.forename: Robert
authors.initials: R
authors.lastname: Ritch
authors.forename: Donald C
authors.initials: DC
authors.lastname: Hood
mesh_terms: D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009798:Ocular Hypertension / Q000175:diagnosis; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000175:diagnosis; D014794:Visual Fields