A method for measuring neuroretinal rim area

A practical method for measuring the neuroretinal rim area (NRA) of the optic nervehead is described. Sequential stereo photographs are taken on 35 mm colour transparencies using a Zeiss fundus camera with Allen stereoseparator. While examining a stereo pair with a pocket viewer the disc and cup margins are traced against the stereo image with a Rotring pen (0.1 mm tip) on a clear transparency overlying one of the photographs. This tracing is digitised and analysed by an 'edge detection' algorithm which measures the area between the traced lines, i.e. NRA. The intraobserver intraphotograph coefficient of variation (standard deviation/mean) was calculated for measurements of disc area, cup area and NRA made on 10 stereo photographs of discs with various topographies. Coefficients for NRA ranged from 3.2% to 3.9% for discs with easily discernible cup margins and from 1.6% to 7.2% for discs with less obvious cups.