Although ophthalmologists are becoming increasingly reliant upon optical coherence tomography (OCT), clinicians who care for glaucoma patients are not taking full advantage of the potential of this powerful technology. First, we ask, how would one describe the nature of glaucomatous damage if only OCT scans were available? In particular, a schematic model of glaucomatous damage is developed in section 2, and the nature of glaucomatous damage seen on OCT scans described in the context of this model in section 3. In particular, we illustrate that local thinning of the circumpapillary retinal nerve fiber layer (cpRNFL) around the optic disc can vary in location, depth, and/or width, as well as homogeneity of damage. Second, we seek to better understand the relationship between the thinning of the cpRNFL and the various patterns of sensitivity loss seen on visual fields obtained with standard automated perimetry. In sections 4 and 5, we illustrate why one should expect a wide range of visual field patterns, and iilustrate why they should not be placed into discrete categories. Finally, section 6 describes how the clinician can take better advantage of the information in OCT scans. The approach is summarized in a single-page report, which can be generated from a single wide-field scan. The superiority of this approach, as opposed to the typical reliance on summary metrics, is described.

尽管眼科医生越来越依赖光学相干断层扫描 (OCT)，但治疗青光眼患者的临床医生并未充分利用这项强大技术的潜力。首先，我们要问，如果只有 OCT 扫描可用，人们将如何描述青光眼损伤的性质？特别是，第 2 节开发了青光眼损伤的示意性模型，并在第 3 节中描述了在 OCT 扫描中看到的青光眼损伤的性质。特别是，我们说明了周围视乳头视网膜神经纤维的局部变薄视盘周围的层（cpRNFL）的位置、深度和/或宽度以及损伤的均匀性可能有所不同。其次，我们试图更好地了解 cpRNFL 变薄与通过标准自动视野检查获得的视野中看到的各种敏感性损失模式之间的关系。在第 4 节和第 5 节中，我们说明了为什么人们应该期待广泛的视野模式，并说明为什么不应将它们分为离散的类别。最后，第 6 节描述了临床医生如何更好地利用 OCT 扫描中的信息。该方法总结在单页报告中，该报告可以通过单次广域扫描生成。描述了这种方法相对于典型的对汇总指标的依赖的优越性。