Retinal Nerve Fiber Layer Defect in a Patient With Healthy Neuroretinal Rim

Characteristics of patients with a localized retinal nerve fiber layer defect and normal optic disc appearance

“…It is also supported by the fact that RNFL defects are common in patients with early diabetic retinopathy and by the fact that RNFL defects are frequently followed by cotton wool spots. 6,[8][9][10][11] In this study, systemic diseases, such as DM and hypertension, were significantly more frequent in group A than in group B (62.5% vs 25%). These conditions may affect RNFL in group A and it may cause localized RNFL defects in many of the patients in group A.…”

“…7 Some authors also have reported localized RNFL defects after retinal cotton wool spots. [8][9][10][11] According to previous reports, some of these RNFL defects have presented corresponding visual field (VF) defects and detectable changes in optical coherence tomography as RNFL defects in glaucoma have.…”

Multiple wedge-shaped retinal nerve fiber layer defects in a patient with optic nerve glioma in the contralateral eye: case report

“…The presence of RNFL defects in a patient without glaucoma is very unusual and it has been shown to be among the earliest signs of glaucomatous damage (8) . However, a young patient with normal IOP and physiological cup-to-disk ratio, as we have just described, is unlikely to have glaucoma.…”

“…Although RNFL defects have been observed after optic disc hemorrhages in normal-tension glaucoma cases (11) , our patient was young with no signs of glaucomatous optic neuropathy, and thus unlikely to have this condition. Alencar et al (8) have described a similar case presenting a RNFL defect associated with visual field loss in a normal patient with a healthy neuroretinal rim. This idiopathic RNFL defect should also be considered as a possible explanation for the present case.…”

“…It was first described by Hoyt as the earliest objective evidence of nerve fiber loss in eyes with chronically elevated intraocular pressure (IOP) (1) . Although wedge-shaped RNFL defects are suggestive of glaucomatous optic neuropathy, they have been described in association with different ocular conditions, such as optic nerve drusen (2) , optic neuritis (3) , anterior ischemic optic neuropathy (4) , retinal cotton wool spots (5) , toxoplasmosis chorioretinal scars (6) , diabetic retinopathy (7) , and have been found in normal eyes as well (8) . A case of a young non-glaucomatous patient presenting multiple wedge-shaped RNFL defects and a chorioretinal scar in his right eye, with a previous diagnosis of optic nerve glioma in the left eye is described.…”