Objective:

To establish normative ranges for interocular differences in retinal nerve fiber layer (RNFL) thickness and cup-to-disc ratio (CDR) using optical coherence tomography (OCT) to aid in glaucoma diagnosis.

Approach:

Key Findings:

• Mean peripapillary RNFL thickness was 88.1 µm (right eye) and 87.7 µm (left eye), with a non-significant interocular difference of 0.4 µm.
• The 2.5th and 97.5th percentile values for interocular RNFL difference ranged from -12.7 µm to 12.7 µm.
• The 95% central range for interocular CDR difference was from -0.19 to 0.21 units.
• Significant predictors of RNFL asymmetry included differences in rim area and signal strength.

Interpretation:

The established normative ranges for RNFL and CDR differences may help clinicians distinguish between physiological variations and pathological asymmetries, particularly in diagnosing early or asymmetric glaucoma.

Limitations:

• The study's findings should not be used in isolation but as part of a comprehensive assessment of optic nerve health.
• Previous normative datasets were limited by small sample sizes or manufacturer-specific data.

Conclusion:

Defining normative ranges for interocular RNFL and CDR differences can reduce overdiagnosis and misclassification in glaucoma assessments, emphasizing the need for careful interpretation of OCT data.

Sources:

• Translational Vision Science & Technology
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