A perspective on neural tissue measurements in glaucoma

Given the present advancement in the management of glaucoma, in comparison to retinal nerve fibre layer (RNFL), neural tissue parameters are much more reliable and accurate in discriminating glaucomatous and non-glaucomatous changes. Pertaining to the article titled Retinal nerve fibre layer thickness measured by spectral domain optical coherence tomography amongst early primary open-angle glaucoma patients at Hospital Melaka , published in Malaysian Journal of Ophthalmology issue 2-3, it was concluded that optical coherence tomography (OCT) of the RNFL is not suitable to be used as a diagnostic tool alone to detect early glaucomatous changes. Here we would like to suggest the use of neural tissue parameters such as Bruch’s membrane opening-minimum rim width (BMO-MRW) and prelaminar neural tissue thickness (PNTT) to assess these changes reliably (Fig. 1). As Bruch’s membrane ends around the optic nerve head (ONH), it forms Bruch’s membrane opening (BMO), i.e. , an aperture for the passage of retinal ganglion cells (RGC) as they exit