Purpose: The purpose of this research was to study the accuracy of mea
surements that rely on Littmann curves to determine the real size of f
undus images. Methods: Retinal tacks of known dimensions were placed n
ear the optic disc in one eye of each of two cynomolgus monkeys. Image
s of the retinal tack and optic nerve head of these two eyes were then
obtained with a Zeiss Fundus camera. The dimensions of the retinal ta
cks and optic discs were measured directly on the film from the Zeiss
fundus camera. These measurements were then corrected with Littmann's
mathematical approximations. Results: In the cynomolgus eye with 19.9
mm axial length, Littmann's mathematical approximations of the real si
zes of the retinal tack and optic disc from measurements on the Zeiss
film had median percent bias [(calculated size - real size)/real size]
of -0.2% (range, -3.2% to 3.9%). In the other eye with 17.9 mm axial
length, the median percent bias was 14.7% (range, 5.1% to 29.7%). Conc
lusion: The estimation of the real size of fundus images with Littmann
's mathematical approximations from images on Zeiss film have <4% bias
if the eye's dimensions fall in the range over which Littmann's curve
s were produced.