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The present study aimed to analyze the clinical usefulness of the thinnest cross section of the nerve fibers in the optic nerve head averaged over the circumference of the optic nerve head. 3D volumes of the optic nerve head of the same eye was captured at two different visits spaced in time by 1-4 weeks, in 13 subjects diagnosed with early to moderate glaucoma. At each visit 3 volumes containing the optic nerve head were captured independently with a Topcon OCT- 2000 system. In each volume, the average shortest distance between the inner surface of the retina and the central limit of the pigment epithelium around the optic nerve head circumference, PIMD-Average [0;2π], was determined semiautomatically. The measurements were analyzed with an analysis of variance for estimation of the variance components for subjects, visits, volumes and semi-automatic measurements of PIMD-Average [0;2π]. It was found that the variance for subjects was on the order of five times the variance for visits, and the variance for visits was on the order of 5 times higher than the variance for volumes. The variance for semi-automatic measurements of PIMD-Average [0;2π] was 3 orders of magnitude lower than the variance for volumes. A 95 % confidence interval for mean PIMD-Average [0;2π] was estimated to 1.00 ±0.13 mm (D.f. = 12). The variance estimates indicate that PIMD-Average [0;2π] is not suitable for comparison between a onetime estimate in a subject and a population reference interval. Cross-sectional independent group comparisons of PIMD-Average [0;2π] averaged over subjects will require inconveniently large sample sizes. However, cross-sectional independent group comparison of averages of within subject difference between baseline and follow-up can be made with reasonable sample sizes. Assuming a loss rate of 0.1 PIMD-Average [0;2π] per year and 4 visits per year it was found that approximately 18 months follow up is required before a significant change of PIMDAverage [0;2π] can be observed with a power of 0.8. This is shorter than what has been observed both for HRT measurements and automated perimetry measurements with a similar observation rate. It is concluded that PIMDAverage [0;2π] has the potential to detect deterioration of glaucoma quicker than currently available primary diagnostic instruments. To increase the efficiency of PIMD-Average [0;2π] further, the variation among visits within subject has to be reduced.
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