01/04/2026
The temporal raphe sign refers to a straight, well-demarcated horizontal line seen on the macular GCIPL thickness map on OCT.
It represents the anatomical boundary between the superior and inferior hemiretinal ganglion cell axons, which do not cross the horizontal raphe.
Why It Matters Clinically
1. Differentiating Glaucoma from Nonglaucomatous Optic Neuropathy
· Present in 91% of glaucomatous eyes.
• Present in only 28.8% of nonglaucomatous optic neuropathies.
High-sensitivity marker for glaucoma when macular GCIPL thinning is present.
2. Diagnostic Performance
•AUC:0.811
· Sensitivity: 91%
• Specificity: 71% When combined with RAPD diagnostic accuracy-further.
3. Utility in High Myopia
Adds diagnostic value in high myopes
Conversion
when RNFL and ONH parameters are
4. Predictive Value for Glaucoma
when RNFL and ONH parameters are
· Present in 94.7.7% of converters
· Present in 5.7% of non-converters .
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Dr Ahmad Aldiwani
