Significance of Peripapillary Atrophy in the Diagnosis of Open-angle Glaucoma

ABSTRACT

This study was performed to determine whether peripapillary atrophy can be helpful in diagnosis of glaucoma and to investigate the correlation between peripapillary atrophy and optic disc head configuration in patients with primary open-angle glaucoma and normal-tension glaucoma. For all eyes, color polaroid optic disc photographs had been taken with Topcon retinal camera and reviewed. 93 eyes of normal subjects, 47 eyes of 47 patients with primary open-angle glaucoma and 47 eyes of 47 patients with normal-tension glaucoma were analyzed. Zone beta was detected more often in patients with normal-tension glaucoma and primary open-angle glaucoma (P<0.05). There was no significant difference in frequency of peripapillary atrophy between in patients with normal-tension glaucoma and primary open-angle glaucoma (P=0.071). In primary open-angle glaucoma,total,nasal and temporal neuroretinal rim area and total, inferior, nasal and temporal neuroretinal rim area/disc area ratio were smaller in patients with zone beta than without zone beta (P<0.05). The presence of zone beta was associated with neural tissue loss and progression of visual field in primary open-angle glaucoma (P<0.05). In conclusion,peripapillary atrophy, especially zone beta, is associated with glaucoma. Therefore, evaluation of peripapillary atrophy can be help-ful in diagnosing glaucoma. The presence of zone beta is associated with functional and structural optic nerve damage and is of predictive value in the future glaucomatous damage in primary open-angle glaucoma.