Relationship between Retinal Nerve Fiber Layer Thickness and Hemoglobin Present in the Optic Nerve Head in Glaucoma

Purpose. To observe the relationship between topographic hemoglobin levels in the optic nerve head (ONH), the rim thickness (BMO-MRW), and retinal nerve fiber layer (RNFL) thickness. Methods. 96 normal eyes and 82 glaucomas were examined using TOP strategy (Octopus 300 perimeter), SPECTRALIS OCT, and Laguna ONhE program which estimates hemoglobin from conventional color photographs (Horus Scope DEC 200 fundus camera). Results. The correlation between Laguna ONhE glaucoma discriminant function (GDF) and SPECTRALIS BMO-MRW was R = 0.81 (P < 0.0001), similar to that between the BMO-MRW and BMO-RNFL thicknesses (R = 0.85, P < 0.0001) (P = 0.227 between both R values). GDF correlated well with RNFL thicknesses in the 360 degrees around the nerve, similar to mean perimetric sensitivity (MS) and BMO-MRW. The amount of hemoglobin in the nasal and temporal sectors showed low correlation with superior and inferior RNFL thicknesses. The superotemporal and inferotemporal sectors located on the vertical diameter of the disk showed good intercorrelation but without a clear RNFL topographic relationship. Conclusion. GDF showed high correlation with RNFL thickness. Except in the nasal and temporal sectors, ONH hemoglobin correlated well with RNFL thickness.