Peripapillary Atrophy: 2. Its Correlations with Glaucomatous Optic Nerve Damage

ABSTRACT

This study was undertaken to evaluate how closely peripapillary atrophy(PPA) is related to structual and functional optic nerve damage in primary open-angle glaucoma. Magnification-corrected morphometry of photographs using computer graphic program and automated static threshold perimetry were performed on 234 eyes of 141 patients with primary open-angle glaucoma and 139 eyes of 86 normal subjects(control). For the data analysis, only one eye of each patient was randomly selected. Both groups did not differ significantly in age, refractive error and disc area. PPA differentiated into two different zone(alpha and beta). The area of zone alpha, zone beta and the total PPA enlarged significantly)P=0.0001) with a decreasing rim/disc area ratio(r=0.36, r=0.46, r=0.50, respectively), rim area(r=-0.27, r=-0.44, r=-0.43, respectively) and mean deviation(r=-0.30, r=-0.34, r=-0.39, respectively). They enlarged significantly(P=0.0001) with an increasing vertical(r=0.35, r=0.42, r=0.46, respectively) and horizontal cup to disc ratio(r=0.31, r=0.37, r=0.41, respectively) and cup area(r=0.36, r=0.41, r=0.46, respectively). Concerning peripapillary parameters, the correlation coefficients were generally lowest for zone beta and the highest for total PPA. The peripapillary atrophy showed a spatial relation to neuroretinal rim loss. These results indicate that enlargement of PPA is related to the severity of the glaucomatous optic nerve damage and visual field defects.