Question:
I went to see an ophthamologist who examined me and could not see anything wrong with my eyes until he did Retina Tomograph which showed problems with my optic nerve.
Retina tomograph on the right eye showed that on the RIM the MRA: was outside of the normal limits which show 1 red and 1 yellow.
On the left eye MRA was bordeline wich show 1 yellow.
He said i have to see him in 1 year for another countrol.
I know something must be causing the problem to my optic never, what i wanted to know is, if it possible to stop the optic nerve from keeping on deterioting to glaucoma, by stopping what is causing the deterioration.
Another thing i want to know is if the cause of the Optic nerve damages is stopped will what the Retina Tomograph showed remain the same?
Thanks for your help.
Answer:
Retinal nerve fibre analysis is the best way of detecting glaucoma early. However pressures and corneal thickness are also important. If you have thin corneas (which we measure with a pachymeter) then you are more prone to glaucoma. Corneal thickness readings also allow for corrected pressure readings making this more accurate. With regard to your tomography, I am assuming this was carried out with an HRT. I havent used an HRT for a while but it is not my favoured instrument for several reasons, but it is still better than not having laser retinal nerve fibre analysis. The HRT looks at the topography of the retina - in basic terms much like the topography of a landscape - is it raised or not. If there is retinal nerve fibre thinning then there will be a dip. The other problem is that the user has to circle your optic disc allowing for errors and I have seen several cases where depending where you put the markers a patient may have glaucoma or not! Hence... I prefer the GDxVCC - this measures the actual nerve fibre thickness using polarised lasers which pass throught the nerve fibre layer - therefore it is a direct measurement and is more accurate as per the most recent study (on the IGA home page at the mo). You can have areas of thinning that show up on either instrument and as long as there is no progression (ie it doesnt get worse) you probably don't have glaucoma hence the ongoing monitoring. The best methods for detecting glaucoma are by having a battery of tests:
Nerve Fibre Analysis
Threshold Humphrey Visual Fields
Pachymetry
Anterior chamber/trabeculum assessment
Disc Assessment
Intra-Ocular Pressures
In answer to your final question - if you were found to have glaucoma and it was completely controlled your nerve fibre analysis and visual fields should not change
