Characteristics of Patients Showing Discrepancy Between Bruch's Membrane Opening-Minimum Rim Width and Peripapillary Retinal Nerve Fiber Layer Thickness

Background: To investigate clinical characteristics of patients showing discrepancy between Bruch's membrane opening minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness. Correlation with the visual field (VF) was also inspected. Methods: In this prospective, cross-sectional study, 106 eyes (106 subjects) showing normal BMO-MRW classification but abnormal RNFL classification were included. All patients underwent confocal scanning laser ophthalmoscopy, spectral-domain optical coherence tomography, and standard automated perimetry. Results: Clinical characteristics were as follows: mean age: 52.79 +/- 14.75 years; spherical equivalent (SE), -2.52 +/- 3.48 diopter (D); SE < -5.0 D, 34 (32.1%) eyes; large disc (>2.43 mm(2)), 40.6%; small disc (<1.63 mm(2)), 12.5%; VF index, 96.72 +/- 9.58%; mean deviation, -1.74 +/- 3.61 dB; beta-peripapillary atrophy (PPA), 96.2%; gamma-PPA, 75.5%. Majority (86.1%) of these cases demonstrated normal (71.3%) or borderline (14.9%) on VF. Temporal and nasal RNFL showed significant differences among disc size subgroups (all p < 0.05). Nasal RNFL was significantly thicker in a large disc group than other subgroups. Temporal, superotemporal, inferotemporal, inferonasal RNFL, and superior RNFL peak location showed significant differences (all p < 0.05) among SE subgroups. Temporal RNFL was significantly thicker in the high myopia group than other subgroups. Conclusions: Temporalization of RNFL peaks in myopia and nasalization of RNFL peaks in large disc that display abnormal classifications might show normal classification of BMO-MRW. These findings of discrepancy between classifications should be considered in the diagnosis of early glaucoma.