Wong D, Chua J, Baskaran M, et al. - Researchers performed the analysis to analyze the factors influencing the diagnostic performance of circumpapillary retinal nerve fibre layer (RNFL) thickness measurements in the detection of primary open-angle glaucoma (POAG). One thousand five hundred ninety-two eyes from 1,076 healthy controls and 758 eyes from 502 patients with POAG had optical coherence tomography (OCT) imaging to evaluate RNFL parameters. Visual field mean deviation from standard automated perimetry has been used to show severity in patients with glaucoma. RNFL thickness decreased significantly with age and increased with spherical equivalent (SE) refractive error in healthy and glaucoma groups, but showed significant reduction with SE in healthy subjects' temporal RNFL. SE affected the diagnostic accuracy in glaucoma but could be mitigated by the use of controls with identical refractive characteristics. Increasing the severity of the disease has led to significantly better diagnostic accuracy. Such factors should be considered in practice when using OCT for diagnosis of glaucoma.