Effect of Media Opacity on Retinal Nerve Fiber Layer Thickness Measurements by Optical Coherence Tomography

PURPOSE: To assess the effect of ocular media opacity on retinal nerve fiber layer (RNFL) thickness measurements by optical coherence tomography (OCT). METHODS: In this prospective, non-randomized clinical study, ocular examinations and OCT measurements were performed on 77 cataract patients, 80 laser refractive surgery patients and 90 patients whose signal strength on OCT was different on two consecutive measurements. None of the eyes had preexisting retinal or optic nerve pathology, including glaucoma. Cataracts were classified according to the Lens Opacity Classification System III (LOCS III). All eyes were scanned with the Stratus OCT using the Fast RNFL program before and three months after surgery. Internal fixation was used during scanning and all eyes underwent circular scans around the optic disc with a diameter of 3.4 mm. RESULTS: Average RNFL thickness, quadrant thickness and signal strength significantly increased after cataract surgery (P<0.05). Cortical and posterior subcapsular cataracts, but not nuclear cataracts, had a significant influence on RNFL thickness measurements (P<0.05). There was no significant difference between OCT parameters before and after laser refractive surgery. In eyes for which different signal strengths were observed, significantly larger RNFL thickness values were obtained on scans with higher signal strengths. CONCLUSION: OCT parameters are affected by ocular media opacity because of changes in signal strength; cortical cataracts have the most significant effect followed by posterior subcapsular opacities. Laser refractive procedures do not seem to affect OCT parameters significantly.