Case 12-22 continued

Optical Coherence Tomography

Circular OCT images were acquired on the initial visit at a diameter of 3.4 mm around the optic disc of both eyes (D,I). Both tomograms demonstrated thinning of the nerve fiber laver, particularly inferiorly, consistent with the visual field defect.

On follow-up OCT examination one year later, there was evidence of a global decrease in nerve fiber layer thickness in both eves (E,J). The thinnest region bilaterally was inferotemporallv, again corresponding to the visual field change. Of interest was the presence on OCT of nerve fiber layer attenuation, not only in the area of the visual field change, but throughout the tomograms, indicating that the progressive, glaucomatous process affected the entire nerve fiber layer while presenting only as a localized visual field change. These results demonstrate the ability of OCT to document changes in nerve fiber layer thickness associated with glaucomatous progression.

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