Anatomical Location of the Raphe and Extended Raphe in the Human Retina: Implications for Assessment of the Optic Nerve with OCT

PURPOSE: To determine the location of (1) the superior–inferior watershed between the fovea and optic disc (extended raphe) at the peripapillary optical coherence tomography (OCT) measurement circle and (2) the raphe, temporal to the fovea. METHODS: We used existing data consisting of 2285 traced retinal nerve fiber bundle trajectories from 83 fundus images. For localization of the extended raphe at the 3.46-mm-diameter OCT measurement circle, trajectories were classified as belonging to the superior or inferior hemiretina, using predefined criteria. For the raphe, we localized the endings of trajectories coming from the superior and inferior arcuate bundles. RESULTS: At the measurement circle, the extended raphe is located 14° (range, 12°–16°) inferiorly to a horizontal line through the optic disc center. The raphe follows a horizontal line at the latitude of the fovea if the disc is assumed to be located 15° nasal to and 2° above the fovea. CONCLUSIONS: At the measurement circle, OCT brands use either the 9 o'clock location or a straight line connecting the center of the optic disc and the fovea as a reference for separating the hemiretinas. This results, on average, in a 14° and 6° misalignment with respect to the anatomical watershed, respectively. For the macular area, the commonly used line through the center of the optic disc and the fovea fails to describe the raphe adequately. TRANSLATIONAL RELEVANCE: An unbiased asymmetry assessment of the optic nerve requires a detailed knowledge of the shape and location of the (extended) raphe.