Assessing the Benefits of Optic Nerve Imaging

Several imaging technologies are currently available to provide an objective means of assessment and allow quantitative evaluation and documentation of optic nerve head (ONH) and retinal nerve fiber layer (RNFL) structure. Output from imaging technologies can complement clinical examination in the accurate diagnosis as well as staging of glaucoma. Imaging can be utilized to corroborate or confirm physical findings of glaucoma damage or progression. It can also be of value in the follow up of eyes suspected of having glaucoma by identifying those who are at risk of developing the disease.

Recommendations regarding assessment of structural damage in glaucoma have been published. The following consensus statements about structural assessment are derived from a global meeting of the World Glaucoma Association (formerly the AIGS).

“A method for detecting abnormality and also documenting optic nerve structure should be part of routine clinical management of glaucoma.”
“According to limited evidence, available sensitivity and specificity of imaging instruments for detection of glaucoma are comparable to expert interpretation of stereo color photography and should be considered when such expert advice is not available.”
“Digital imaging is recommended as a clinical tool to enhance and facilitate the assessment of the optic nerve and retinal nerve fiber layer in the management of glaucoma.”
“Automated analysis of the results using appropriate databases is helpful for identifying abnormalities consistent with glaucoma.”
“Different imaging technologies may be complementary, and detect different abnormal features in the same patients.”