The nerve fibre layer symmetry test: computerized evaluation of human retinal nerve fibre layer thickness as measured by optical coherence tomography

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Abstract
Purpose: To present and test a new interpretative concept, the nerve fibre lay er symmetry test (NST), for computerized evaluation of retinal nerve fibre layer thickness (RNFLT) as measured by optical coherence tomography (OCT) in glaucoma . Methods: The NST concept was constructed and tested in a pilot study. A total of 32 healthy and 40 age-matched glaucomatous eyes were included and examined b y OCT, computerized perimetry, RNFL/disc photography, tonometry and a general op hthalmologic examination. Results: The observed NST sensitivity and specificity were high, at 38/40 eyes (95%)-and 32/32 eyes (100%), respectively, and 40/40 eyes (100%), and 31/32 eyes (97%), respectively, when correcting the OCT RNFL T measurement for the influence of variability in image signal/quality. The NST sensitivity was 8-10%higher than the single most sensitive traditional OCT RNF LT parameter; this difference was not statistically significant in this small sa mple. Conclusion: The NST showed high specificity and sensitivity for detection of RNFLT attenuation indicating early to severe glaucoma. Although promising, th e NST needs to be further developed and validated in larger study samples and in patients with various stages of glaucomatous damage.

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