Assessment of the retinal nerve fiber layer in clinical trials of glaucomaneuroprotection

Assessment of the retinal nerve fiber layer (RNFL) is appealing for use in clinical trials of glaucoma neuroprotection, as it is directly correlated w ith loss of ganglion cells, which is assumed to be a primary event in glauc omatous damage. Qualitative assessment of the RNFL includes ophthalmoscopy, color stereophotography, and red-free monochromatic photography. In contra st, confocal scanning laser ophthalmoscopy (CSLO), scanning laser polarimet ry (GDx), optical coherence tomography (OCT), and retinal thickness analysi s (RTA) objectively and quantitatively measure the RNFL thickness. These la tter techniques are still in evolution. Continuing meticulous objective val idation is necessary to assess the usefulness and limitations of these powe rful tools. Nevertheless, there are excellent prospects for using longitudi nal assessment of the RNFL in clinical trials of glaucoma neuroprotection. (C) 2001 by Elsevier Science Inc. All rights reserved.