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An Analysis of Normal Variations in Retinal Nerve Fiber Layer Thickness Profiles Measured With Optical Coherence Tomography

Ghadiali, Quraish BS*; Hood, Donald C. PhD* †; Lee, Clara BA*; Manns, Jack MD; Llinas, Alex MD, PhD; Grover, Larissa K. BS*; Greenstein, Vivienne C. PhD; Liebmann, Jeffrey M. MD; Odel, Jeffrey G. MD; Ritch, Robert MD‡ §

doi: 10.1097/IJG.0b013e3181650f8b
Original Studies

Purpose To assess the normal variations in retinal nerve fiber layer (RNFL) thickness measured with optical coherence tomography (OCT).

Subjects and Methods Both eyes of 48 individuals (age 56.4±9.5 y) with normal vision and refractive errors between ±6.0 D were tested with the fast RNFL scan protocol of the OCT3 (Zeiss Meditech). Their 256-point RNFL profiles were exported for analysis. The location and peak amplitude of the maxima of the RNFL profiles were measured. Intersubject and interocular variations were assessed with a coefficient of determination, R2. An R2 of 1.0 indicated that the average profile from all 48 individuals (or of the 2 eyes) accounted for 100% of the variation of an individual eye's profile.

Results The R2 for the interocular comparison was good, with averages of 0.91±0.07 (right eye) and 0.92±0.05 (left eye). The R2 for the comparison of the individual's profile to the mean group profile was only 0.61±0.29 (right eye) and 0.65±0.24 (left eye), with 27% of the R2 values below 0.5. Even after normalizing each individual's profile by its mean, R2 was only 0.75±0.16 (0.75±0.16) for the right (left) eye. The location of the peaks for the right (left) eye ranged over 91 degrees (88 degrees) for the superior peak and over 64 degrees (66 degrees) for the inferior peak. The range of peak amplitudes for the right (left) eye spanned a factor of 1.7 (1.8) and 2.0 (1.7) for the superior and inferior peaks, respectively.

Conclusions There was a wide variation in the amplitude and shape of the individual RNFL profiles. However, the RNFL profiles of the 2 eyes of an individual were extremely similar. Adding an interocular comparison with OCT RNFL tests should help identify some false positives.

Departments of *Psychology

Ophthalmology, Columbia University

Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York

§Department of Ophthalmology, The New York Medical College, Valhalla, NY

Supported by National Eye Institute grants RO1-EY-09076 and RO1-EY-02115 and the Ephraim and Catherine Gildor Research Fund of the New York Glaucoma Research Institute.

Reprints: Dr Donald C. Hood, PhD, Department of Psychology, 406 Schermerhorn Hall, Columbia University, New York, NY 10027 (e-mail:

Received for publication July 18, 2007; accepted December 7, 2007

© 2008 Lippincott Williams & Wilkins, Inc.