Automated Segmentation Errors When Using Optical Coherence Tomography to Measure Retinal Nerve Fiber Layer Thickness in Glaucoma

Automated segmentation without manual refinement resulted in reduced global RNFL thickness and overestimated the classification of glaucoma. Differences increased in eyes with a thinner RNFL thickness, older age, and decreased scan quality. Operators should inspect and manually refine OCT retinal layer segmentation when assessing RNFL thickness in the management of patients with glaucoma.