QuizWise :
Q.1 What is the age-related rate of retinal nerve fibre layer thinning?
A) 0.1 micron per year
B) 0.2 micron per year
C) 0.3 micron per year
D) 0.4 micron per year
Q.2 What is the rate of retinal nerve fibre thinning in glaucoma?
A) -1.12 microns per year
B) -2.12 microns per year
C) -3.12 microns per year D) -4.12 microns per year
Q.3 In which of following the rate of retinal nerve fiber thinning is high?
A) Glaucoma not associated with visual field defect
B) Glaucoma associated with visual field defect
C) Both A and B D) None of the above
Q.4 Which of following imaging techniques are useful in monitoring glaucoma progression?
A) Color fundus photograph
B) Optical coherence tomography
C) Visual field
D) All of the above.
Q.1 ANS – C
The actual age-associated rate of reduction of RNFL thickness in normal eyes is
approximately 0.3 μm/yr. it is important to know this to be able to differentiate normal
age-related loss from slow glaucomatous loss. It is also important to know that there
may periods where the loss may exceed the normal average in association with other
non-glaucomatous, systemic or ocular conditions. It is in the treatment of glaucoma
always important to be able to or to attempt to differentiate, different types of RNFL
loss.
Jeong D, Sung KR, Jo YH, Yun SC. Age-related physiologic thinning rate of the retinal nerve
fibre layer in different levels of myopia. Journal of Ophthalmology. 2020 Jan 20;2020.
Q.2 ANS- B: Using SD-OCT, the circumferential RNFL thickness was found to be -2.12 µm per year in
patients with progressive optic disc changes, which was significantly faster when compared to
glaucoma patients without progression (-1.18µm/year, P=0.002). While this is important
information, it is only a generalization. There may be patients, as demonstrated in this image
wise, where the loss may exceed the value mentioned above. Also, all values. Even in a
particular patient are averaged for the segment or for the global values. While it may be
important to consider point loss which is likely to show a significant variation and may take a
varied course, where some areas undergo loss much faster and other areas much slower, and
some areas may, over the course of follow-up, appear to be almost resistant to undergoing damage. It is, therefore, important to look at different areas for follow up rather than go by a
generalized rule.
Abe RY, Gracitelli CP, Medeiros FA. The use of spectral-domain optical coherence tomography to detect
glaucoma progression. The Open Ophthalmology Journal. 2015; 9:78.
Q.3 Ans-D: The estimated mean rate of global RNFL loss was significantly faster in the eyes that
developed visual field defects compared with eyes that did not develop visual field
defect (−2.02 µm/year versus −0.82 µm/year; P < 0.001). Using joint longitudinal
survival model, they showed that each 1 µm/year faster rate of global RNFL loss
corresponded to a 2.05 times higher risk of developing visual field defects.
Abe RY, Gracitelli CP, Medeiros FA. The use of spectral-domain optical coherence
tomography to detect glaucoma progression. The Open Ophthalmology Journal. 2015;9:78.
Q.4 Ans-D:
Abe RY, Gracitelli CP, Medeiros FA. The use of spectral-domain optical coherence
tomography to detect glaucoma progression. The Open Ophthalmology Journal. 2015;9:78.