To analyze localized RNFL defect cases that were identified in retinal nerve fiber layer (RNFL) fundus photographs but not in optical coherence tomography (OCT).

Analysis of OCT scans and images was performed for 14 eyes (17 locations) that showed localized RNFL defects in RNFL fundus photographs but not in RNFL thickness average analysis.

With respect to the range of RNFL defects, 41.2% were less than 10°, 47.0% were 11 to 20°, and 11.8% were 21 to 30°. In 71.4% of the RNFL cases the defects were less than 10° and the decrease of RNFL thickness was not readily observable on the OCT scan images. In all cases of RNFL defects in the 11 to 30° range the decrease in RNFL thickness could be assessed on the OCT scan images. Nonetheless, the decrease of RNFL thickness could not be seen on the OCT analysis images in which the results of the RNFL thickness made through an automated computer algorithm were displayed.

The range of localized RNFL defects that were difficult to detect with OCT consisted of those cases that were almost less than 20°. The limitations of the OCT scan itself in patients with RNFL with an angular width defect less than 10° and the problems of RNFL thickness analysis processing in patients with an angular width of 11 to 30° may decrease the sensitivity of OCT in diagnosing RNFL defects.