title: Details of Glaucomatous Damage Are Better Seen on OCT En Face Images Than on OCT Retinal Nerve Fiber Layer Thickness Maps.
abstract: OBJECTIVE
  High-resolution images of glaucomatous damage to the retinal nerve fiber layer (RNFL) were obtained with an adaptive optics-scanning light ophthalmoscope (AO-SLO) and used as a basis for comparisons between en face slab images and thickness maps derived from optical coherence tomography (OCT) scans.
  
  
  METHODS
  Wide-field (9 × 12 mm) cube scans were obtained with swept-source OCT (DRI-OCT) from six eyes of six patients. All eyes had a deep defect near fixation as seen on a 10-2 visual field test. Optical coherence tomography en face images, based on the average reflectance intensity, were generated (ATL 3D-Suite) from 52-μm slabs just below the vitreal border of the inner limiting membrane. The RNFL thickness maps were generated from the same OCT data. Both were compared with the AO-SLO peripapillary images that were previously obtained.
  
  
  RESULTS
  On AO-SLO images, three eyes showed small regions of preserved and/or missing RNFL bundles within the affected region. Details in these regions were seen on the OCT en face images but not on the RNFL thickness maps. In addition, in the healthier hemi-retinas of two eyes, there were darker, arcuate-shaped regions on en face images that corresponded to abnormalities seen on AO-SLO. These were not seen on RNFL thickness maps.
  
  
  CONCLUSIONS
  Details of local glaucomatous damage, missing or easily overlooked on traditional OCT RNFL thickness analysis used in clinical OCT reports, were seen on OCT en face images based on the average reflectance intensity. While more work is needed, it is likely that en face slab imaging has a role in the clinical management of glaucoma.
authors.affiliation: Departments of Psychology and Ophthalmology Columbia University, New York, New York, United States.
authors.forename: Donald C
authors.initials: DC
authors.lastname: Hood
authors.affiliation: Legacy Health, Legacy Research Institute, Portland, Oregon, United States.
authors.forename: Brad
authors.initials: B
authors.lastname: Fortune
authors.affiliation: Department of Psychology, Columbia University, New York, New York, United States.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Mavrommatis
authors.affiliation: Legacy Health, Legacy Research Institute, Portland, Oregon, United States.
authors.forename: Juan
authors.initials: J
authors.lastname: Reynaud
authors.affiliation: Department of Psychology, Columbia University, New York, New York, United States.
authors.forename: Rithambara
authors.initials: R
authors.lastname: Ramachandran
authors.affiliation: Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Ritch
authors.affiliation: Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Rosen
authors.affiliation: Department of Psychology, Columbia University, New York, New York, United States.
authors.forename: Hassan
authors.initials: H
authors.lastname: Muhammad
authors.affiliation: Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, United States.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Dubra
authors.affiliation: Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States.
authors.forename: Toco Y P
authors.initials: TY
authors.lastname: Chui
mesh_terms: D005901:Glaucoma / Q000473:pathology*; D006801:Humans; D007429:Intraocular Pressure; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D014792:Visual Acuity; D014794:Visual Fields