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Clinical Summary

A 41-year-old white female with early glaucoma was taking levobunolol 0,5% twice daily. Examination of her right eye (A, B) showed a normal optic nerve with an intraocular pressure (IOP) of 17 mm 11g> A Humphrey visual field (D) was normal.

Optical Coherence Tomography

Horizontal and linear scans (C) through the optic disc revealed a healthy nerve fiber layer (NFL), NFL thickness

/ j was measured from the images at the lamina cribosa as the height of the superficial, red reflective layer. The disc diameter was also assessed between points on the retinal surface perpendicular to the edge of the choroid. The cup diameter was assumed to lie 140 um below the disc diameter. Neuroretinal rim area was calculated from these measurements.

A circular scan (E) around the disc in the peripapillary region was acquired at a diameter of 3.4 mm. The NFL reached its thickest points superotemporally and infer-otemporally NFi thickness was estimated using a computer algorithm and reported as averaged over quadrant and clock hour.

Comment

This patient's early glaucoma was controlled with levobunolol 0.5% twice daily. When not on medication, her IOP was 30 mm Hg or higher. Her optic nerve heads showed little cupping, and her visual field was full OCT demonstrated that glaucomatous damage, if any, was minimal. Her NFL thickness was in the normal range.

Log Reflection

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