Abstract
Primary open-angle glaucoma is characterized by a loss of retinal nerve fibres. The aim of our present study was to evaluate the diagnostic value of retinal nerve fibre layer (RNFL) photography as a routine examination for the early diagnosis of glaucomatous damage. Between 1991 and 2000 we monitored 96 patients with ocular hypertension in a prospective study. RNFL photography was performed in 91 subjects. These photos were evaluated by two independent observers. The mean image quality of the photos was mediocre. The correlation coefficient for the intraindividual reproducibility (image quality) was 0.713-0.863 (Kendall's coefficient). For the interindividual reproducibility the correlation coefficient was 0.541-0.581 (Somers' coefficient). Regarding the evaluation "RNFL defect yes/no", the correlations were better but there was a discrepancy between the observers. Quality, reproducibility and prognostic value of RNFL photography were disappointing. Although RNFL photography may be convincing and informative in several situations, it is not efficient as a routine technique for the early diagnosis of RNFL damage in glaucoma patients.
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