[The significance of retinal nerve fiber layer examination in the diagnosis of glaucoma].

To evaluate the significance of nerve fiber layer (NFL) changes in the diagnosis of glaucoma, the authors examined 197 cases (347 eyes) of normal subjects, primary open angle glaucoma (POAG), low tension glaucoma (LTG) and suspects of these two types of glaucoma. The sensitivity of NFL atrophy to glaucoma was high: in POAG eyes with field loss, 88.9% (64/72) had NFL atrophy. In 123 normal eyes, NFL atrophy was found in only one eye, the specificity of NFL atrophy being 99.2%. All LTG patients and suspects of LTG had NFL atrophy. In the fellow eyes of POAG with normal fields and eyes of POAG suspects, NFL defects occurred in 53.8% (7/13) and 20.6% (15/73) respectively. The examination of NFL is a simple procedure; the nerve fibers themselves are directly observed rather than their function. When half of the thickness of NFL is lost, it Will be manifested clinically. With its high sensitivity and specificity, NFL atrophy can be regarded as an important indicator in the diagnosis of glaucoma.