J Korean Ophthalmol Soc.  2013 Nov;54(11):1748-1756. 10.3341/jkos.2013.54.11.1748.

Analysis of Peripapillary Atrophy According to the Optic Disc Shape Using Spectral Domain OCT

• Kim GY
• Lee YK
• Moon JI
• Park MH

• KMID: 2217923
• DOI: http://doi.org/10.3341/jkos.2013.54.11.1748

Abstract

PURPOSE
To analyze the structural changes in the beta-zone of peripapillary atrophy (PPA-beta) using cross-sectional image of the optic disc head from spectral-domain optical coherence tomography (SD-OCT) according to the optic disc shape.
METHODS
One hundred thirty-seven eyes in 137 patients with glaucoma having PPA-beta and 31 normal eyes (control group) were evaluated retrospectively. Cross-sectional images of the optic disc were taken using the Cirrus HD-OCT. We classified optic disc patterns into normal, focal, myopic, generalized enlargement and senile sclerotic appearance types and analyzed the shape of Bruch's membrane (BM), composition of retinal layer and retinal slope according to the optic disc shape.
RESULTS
Among the 137 eyes with glaucoma, 54 eyes were focal disc type, 34 eyes were myopic disc type, 28 eyes were generalized enlargement disc type and 21 eyes were senile sclerotic disc type. The myopic disc group showed a noticeable difference compared to the other groups in terms of a higher percentage of BM defect type, the lowest retinal slope (70.6 +/- 12.0degrees) and the earlier termination of retinal layers. The generalized enlargement disc group showed the highest percentage of curved BM type. Retinal slope angle increased with age and decreased with axial length.
CONCLUSIONS
In the beta-zone of peripapillary atrophy, there were several differences in the shape of Bruch's membrane, composition of retinal layers and the retinal slope according to the optic disc shape.

Keyword

Bruch's membrane; Optical coherence tomography; Optic disc appearance; Peripapillary atrophy

MeSH Terms

Atrophy*
Bruch Membrane
Glaucoma
Head
Humans
Retinaldehyde
Retrospective Studies
Tomography, Optical Coherence
Retinaldehyde

Figure

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  Figure 1. Optic disc shape (A) Focal disc pattern, (B) Myopic disc pattern, (C) General enlargement disc pattern, (D) Senile sclerotic pattern.

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  Figure 2. B-scan images of peripapillary atrophy. Two vertical lines indicate the distal edge of PPA-ß (*) and optic disc edge (). Red line passes through the center of the optic disc. (A) straight Bruch's membrane, (B) curved Bruch's membrane, (C) Bruch's membrane defect. ELM = external limiting membrane; IPL = inner plexiform layer; IS/OS = inner and outer segment of photoreceptor; RNFL = retinal nerve fiber layer; RPE/BM = retinal pigment epithelium/Bruch's membrane complex.

• 

  Figure 3. Measurement of retinal slope around optic nerve head. The retinal slope () is defined as the angle between the optic nerve junction and the retinal pigment epithelium (RPE). GCL = ganglion cell layer; ELM = external limiting membrane; IPL = inner plexiform layer; IS/OS = inner and outer segment of photoreceptor; RNFL = retinal nerve fiber layer; RPE/BM = retinal pigment epithelium/Bruch's membrane complex.

• 

  Figure 4. Scatterplot shows the relationship between retinal slope and other influencing factors. With increasing age, retinal slope (A) increased. In contrast, as axial length increased, retinal slope (C) decreased. There was no correlation between the retinal slope and refractive error (B), MD (D), PSD (E). AXL = axial length; MD = mean deviation; PSD = pattern standard deviation; SE = spherical equivalent. Pearson correleation analysis was used.

Reference

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