Diagnostic specificities of retinal nerve fiber layer, optic nerve head, and macular ganglion cell-inner plexiform layer measurements in myopic eyes

Ahmad A. Aref, Fouad E. Sayyad, Jean Claude Mwanza, William J. Feuer, Donald L. Budenz

Research output: Contribution to journalArticle

18 Scopus citations


Purpose: To evaluate and compare the diagnostic specificities of peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell-inner plexiform layer (GC-IPL) thickness, and optic nerve head (ONH) measurements in nonglaucomatous myopic individuals.

Methods: In a prospective, cross-sectional study, participants underwent a complete ophthalmic examination, a screening automated visual field test, and axial length measurement. The study eye then underwent optic nerve head and macular scanning using spectral-domain optical coherence tomography (OCT) instrumentation to determine RNFL thickness, GC-IPL thickness, and ONH measurements. False-positive rates for each of the OCTderived parameters, using predefined criteria for an abnormal test, were calculated. Comparative analysis was performed using the McNemar test.

Results: Data from 43 eligible subjects were analyzed. The mean age was 30±6.8 years (range, 22 to 50 y) with an average axial length of 25.26±1.21mm (range, 23.06 to 29.07mm) and mean spherical equivalent of -4.50±1.93D (range, -1.00 to -9.00 D). The falsepositive rate was higher when using RNFL parameters compared with both ONH (47% vs. 7%, respectively; P<0.001) and GC-IPL (47% vs. 26%, respectively; P=0.049) parameters. The false-positive rate was higher when using GC-IPL parameters, compared with ONH parameters (26% vs. 7%, respectively; P=0.039).

Conclusions: Caution should be exercised when relying on OCTderived RNFL and GC-IPL thickness values to diagnose glaucoma in myopic individuals. OCT-derived ONH parameters perform better than RNFL and GC-IPL parameters and may increase diagnostic specificity in this population.

Original languageEnglish (US)
Pages (from-to)487-493
Number of pages7
JournalJournal of glaucoma
Issue number8
StatePublished - Dec 10 2014



  • Ganglion cell
  • Imaging
  • Myopia
  • Optic nerve
  • Optical coherence tomography
  • Retinal nerve fiber layer

ASJC Scopus subject areas

  • Ophthalmology

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