U.3.2.1 Retinal Nerve Fiber Layer Exam

The Retinal Nerve Fiber Layer (RNFL) is made up of the axons of the ganglion cells of the retina. These axons exit the eye as the optic nerve carrying visual signals to the brain. RNFL thinning is a sign of glaucoma and other optic nerve diseases.

An ophthalmic tomography study contains one or more circular scans, perhaps at varying distances from the optic nerve. Each circular scan can be “unfolded” and treated as a B-scan used to assess the thickness of the nerve fiber layer (see Figure U.3-3). A fundus image that shows the scan location on the retina may be associated with each B-scan. To detect a loss of retinal nerve fiber cells the exam might be repeated one or multiple times over some period of time. The change in thickness of the nerve fiber tissue or a trend (serial plot of thickness data) might be used to support the diagnosis.

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Figure U.3-3 Example tomogram of the retinal nerve fiber layer with a corresponding fundus image.

In the Figure, the pseudo-colored image on the left shows the various layers of the retina in cross section with the nerve fiber layer between the two white lines. The location of the scan is indicated by the bright circle in the photograph on the right.