Increasing peripapillary atrophy is associated with progressive glaucoma☆
Presented in part at the Annual Meeting of the Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, 1997.
Received 7 July 1997; accepted 7 January 1998.
Abstract
Objective
This study aimed to determine the incidence and degree of progression of peripapillary atrophy in progressive and nonprogressive glaucoma.
Study design
A retrospective cohort study.
Participants
A total of 75 eyes of 75 patients were examined.
Main outcome measures
Qualitative assessment of optic disc, peripapillary atrophy, and visual field change was performed by three experienced, masked, independent observers.
Methods
Rim-disc area ratio and peripapillary atrophy-disc area ratio were measured at baseline and follow-up with computer-aided planimetry.
Results
Among 75 eyes studied with an average duration of follow-up of 8 years (range, 4–19 years), 33 (44%) showed progressive optic disc damage. Twenty-one (64%) of 33 eyes with progressive disc damage showed peripapillary atrophy progression, and 7 (17%) of 42 eyes without progressive disc damage showed peripapillary atrophy progression; this difference was significant (P < 0.01). In groups with and without peripapillary atrophy, no statistically significant differences were found for mean intraocular pressure, baseline rim-disc area ratio, or baseline peripapillary atrophy-disc area ratio. However, optic disc progression and visual field progression were statistically more frequent in the group with peripapillary atrophy progression (75% and 54%, respectively) than in the group without peripapillary atrophy progression (26% and 11%, respectively) (P < 0.01). There was a statistically significant correlation between measurements of peripapillary atrophy area increase and disc rim loss over time (r = −0.35, P = 0.002).
Conclusion
Progression of peripapillary atrophy is associated with progressive optic disc damage and progressive visual field loss in glaucoma and may be used as a marker for progressive glaucomatous damage.
Manuscript no. 97365.
aGlaucoma Section, Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA
Reprint requests to Joseph Caprioli, MD, UCLA/Jules Stein Eye Institute, 100 Stein Plaza, 2–118 JSEI, Los Angeles, CA 90095–7004 USA
☆ Supported in part by grants from the National Institutes of Health (EY07353), Bethesda, Maryland (JC); Research to Prevent Blindness Inc., New York, New York; and the Alcon Research Institute Award, Ft. Worth, Texas (JC). Also supported in part by Gifu University, School of Medicine, Gifu, Japan (HU), and in part by the Scientific and Technical Research Council of Turkey, Ankara, Turkey (SU).
ABSTRACT