A patient with suspected normal tension glaucoma undergoes OCT of the retinal nerve fiber layer (RNFL). Which pattern of RNFL thinning is MOST characteristic of glaucomatous damage?

• A Diffuse uniform thinning in all quadrants
• B Temporal sector thinning only
• C Thinning confined to the papillomacular bundle
• D Focal thinning in the superior and inferior arcuate regions ✓

Explanation

Glaucomatous RNFL loss characteristically affects the superior and inferior arcuate fiber bundles, corresponding to the arcuate visual field defects. Diffuse loss (option A) is seen in some cases but focal arcuate thinning is more specific. Papillomacular bundle loss (option C) is more typical of toxic/nutritional optic neuropathies.

Reference: AAO BCSC Section 10: Glaucoma, 2023-2024 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.