Ability of a neuro-ophthalmologist to estimate retinal nerve fiber layer thickness

BACKGROUND: Qualitative description of the optic disc has clinical value, but optical coherence tomography (OCT) has provided the ability to quantify retinal nerve fiber layer (RNFL) thickness. METHODS: We asked three neuro-ophthalmologists of at least 20 years’ experience to estimate the average OCT RNFL thickness of 37 eyes based on fundus photos. RESULTS: The overall correlation coefficient for RNFL thickness estimation variance between two physicians and between physician and OCT was 0.53. The likelihood that the RNFL thickness estimation between physicians, or between physician and OCT, was within 10 μm of each other was 47%–62%. All physicians had disparities in RNFL thickness estimation greater than 30 μm. CONCLUSION: This study provides information on the ability of an experienced neuro-ophthalmologist to estimate the RNFL thickness based on fundus photos.