J Korean Ophthalmol Soc.  2007 Sep;48(9):1248-1256.

Change in Optic Nerve Head Topography in Progression of Early Glaucoma

• Han ER
• Suh W
• Lee SY
• Choi KR

Abstract

PURPOSE: To investigate the clinical manifestation and the structural optic disc changes according to the development of reproducible visual field defects in a group of preperimetric patients converting to early glaucoma.
METHODS
Standard automated perimetry (Humphrey Field Analyzer) was performed every six months in 294 preperimetric patients. Each subject was classified as either converter or non-converter according to glaucomatous visual field changes, and the clinical manifestations were analyzed retrospectively. Sequential optic disc images were obtained using the TopSS scanning laser ophthalmoscope (TopSS(TM)) and optic disc parameters were measured to determine if any change had occurred.
RESULTS
A total of 44 eyes from 44 subjects (14.9%) in 294 patients subsequently developed early glaucomatous field loss (converters). The progression rate of visual field defect is 0.43dB/year. In respect to age, sex, refractive error, and diabetes mellitus, no significant differences were observed. Elevated IOP, hypertension, and family history of glaucoma were detected more frequently in the converter group than in the non-converter group. Among TopSS parameters, cup-to-disc ratio, effective area, volume above, maximum slope, and neuroretinal rim area showed statistically significant change. Changes of the neuroretinal rim were prominent in superior and inferior sectors.
CONCLUSIONS
Among TopSS parameters, cup-to-disc ratio, effective area, volume above, and neuroretinal rim are useful in detecting the progression of glaucoma. Furthermore, neuroretinal rim changes in each sector may provide clinically relevant information in detecting and monitoring the progression of glaucoma.

Keyword

Early glaucoma; Optic nerve head topography; Visual field progression

MeSH Terms

Diabetes Mellitus
Glaucoma*
Humans
Hypertension
Ophthalmoscopes
Optic Disk*
Optic Nerve*
Refractive Errors
Retrospective Studies
Visual Field Tests
Visual Fields

Figure

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  Figure 1. Diagram of neuroretinal rim area in 12 sectors in the left eye. Each sectors counted in a clockwise manner in the left eyes and in a counterclockwise in the right eyes. (12 o'clock=superior, 3 o'clock=temporal).

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  Figure 2. Comparisons of neuroretinal rim area by sector within converter group Each sectors counted in a clockwise manner in the left eyes and in a counterclockwise in the right eyes.

Reference

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