Scanning laser ophthalmoscopy as a tool for detecting atrophy of the central retinal nerve fibre layer in Leber's hereditary optic neuropathy

Purpose: To study the central retinal nerve fibre layer with scanning laser ophthalmoscopy (SLO) in subjects with Leber's hereditary optic neuropathy (LHON), a disease primarily affecting retinal nerve fibres in the macular area. Methods: SLO was performed using combinations of laser wavelengths and aperture settings in subjects with LHON and in age-matched normal controls. Results: Six subjects with LHON were examined. The reduction of central retinal nerve fibre layer was clearly demonstrated on the SLO images. Consistent findings were abnormal visibility and apparent broadening of perifoveal blood vessels. In all six normal controls the temporal nerve fibre raphe could be demonstrated. Conclusions: SLO imaging is an easy way of depicting the central retinal nerve fibre layer, requiring no special photographic skills. The demonstration of nerve fibre reduction is valuable in the early diagnosis of LHON.