Prevalence of disc cupping in non-glaucomatous eyes.

This study assessed optic disc size and cupping, using a commercially available ophthalmoscope, in order to show norms of these values for clinical practice. Subjects were office-workers referred from their respective workplaces for a routine medical examination, which included eye examination. The optic disc size was classified as small, medium or large, for having a diameter < 1.0, 1.0-1.5, or > 1.5 times (respectively) the diameter of the ophthalmoscope's selected light spot on the posterior pole. The cupping was classified as the ratio of the vertical cupping diameter and the vertical disc diameter on a relative decimal scale from 0.0 to 1.0.This study included 184 subjects with a mean age of 40.5 ± 9.5 years; 149 (81%) were males. Their mean ocular pressure was 12.4 ± 1.5 mmHg (range 10-17 mmHg). There was a high correlation between optic disc sizes and cupping in the right and left eyes (Pearson Correlation r = 0.866, p < 0.001); therefore, for simplicity only the data for right eyes are presented. According to our definition, the optic discs in these eyes comprised 27 (14.7%) small, 141 (76.6%) medium and 16 (8.7%) large. The small optic discs were rarely cupped, and the large optic discs were always cupped. Optic disc cupping greater than 0.7 was rarely found and should be suspect of glaucoma. Clinical doctors should be aware of this and refer those subjects with abnormal cupping to the specialist.

Prevalence of disc cupping in non-glaucomatous eyes

This study assessed optic disc size and cupping, using a commercially available ophthalmoscope, in order to show norms of these values for clinical practice. Subjects were office-workers referred from their respective workplaces for a routine medical examination, which included eye examination. The optic disc size was classified as small, medium or large, for having a diameter < 1.0, 1.0-1.5, or > 1.5 times (respectively) the diameter of the ophthalmoscope's selected light spot on the posterior pole. The cupping was classified as the ratio of the vertical cupping diameter and the vertical disc diameter on a relative decimal scale from 0.0 to 1.0.This study included 184 subjects with a mean age of 40.5 ± 9.5 years; 149 (81%) were males. Their mean ocular pressure was 12.4 ± 1.5 mmHg (range 10-17 mmHg). There was a high correlation between optic disc sizes and cupping in the right and left eyes (Pearson Correlation r = 0.866, p < 0.001); therefore, for simplicity only the data for right eyes are presented. According to our definition, the optic discs in these eyes comprised 27 (14.7%) small, 141 (76.6%) medium and 16 (8.7%) large. The small optic discs were rarely cupped, and the large optic discs were always cupped. Optic disc cupping greater than 0.7 was rarely found and should be suspect of glaucoma. Clinical doctors should be aware of this and refer those subjects with abnormal cupping to the specialist.

Este estudio fue concebido para desarrollar normas clínicas sobre el tamaño y la excavación de la papila usando un simple oftalmoscopio en una población emétrope sin glaucoma. Los sujetos fueron oficinistas enviados al Centro Médico San Luis para un chequeo general de salud que incluye el examen oftalmológico. El tamaño de la papila o disco óptico fue clasificado en tres diámetros (pequeño, mediano y grande) comparando con el tamaño de la proyección retinal de la luz de un oftalmoscopio de bolsillo. La excavación papilar fue clasificada como la relación entre el diámetro horizontal de la excavación y el diámetro horizontal de la papila en escala decimal de 0.0 a 1.0. El estudio incluye 184 sujetos (edad media de 40.5 ± 9.5 años) y 149 (81%) fueron varones. Su presión ocular promedio fue de 12.4 ± 1.5 mmHg (entre 10-17 mmHg). La correlación tanto de los tamaños de disco óptico como de su excavación, fue alta entre ambos ojos (Correlación de Pearson, r = 0.866, p < 0.001) de modo que se presentan solamente datos de los ojos derechos. Según nuestra definición de tamaños papilares hubo 27 (14.7%) papilas pequeñas, 141 (76.6%) medianas y 16 (8.7%) grandes. Las papilas pequeñas rara vez tuvieron excavación y las grandes estuvieron siempre excavadas. Fue raro hallar papilas ópticas con una excavación mayor a 0.7, las que deberían hacer sospechar una lesión por glaucoma. Los clínicos avezados en oftalmoscopia deberían tener esto en cuenta para referir los sujetos con excavaciones grandes al especialista para su estudio oftalmológico.

Prevalence of disc cupping in non-glaucomatous eyes

This study assessed optic disc size and cupping, using a commercially available ophthalmoscope, in order to show norms of these values for clinical practice. Subjects were office-workers referred from their respective workplaces for a routine medical examination, which included eye examination. The optic disc size was classified as small, medium or large, for having a diameter < 1.0, 1.0-1.5, or > 1.5 times (respectively) the diameter of the ophthalmoscopes selected light spot on the posterior pole. The cupping was classified as the ratio of the vertical cupping diameter and the vertical disc diameter on a relative decimal scale from 0.0 to 1.0.This study included 184 subjects with a mean age of 40.5 ± 9.5 years; 149 (81%) were males. Their mean ocular pressure was 12.4 ± 1.5 mmHg (range 10-17 mmHg). There was a high correlation between optic disc sizes and cupping in the right and left eyes (Pearson Correlation r = 0.866, p < 0.001); therefore, for simplicity only the data for right eyes are presented. According to our definition, the optic discs in these eyes comprised 27 (14.7%) small, 141 (76.6%) medium and 16 (8.7%) large. The small optic discs were rarely cupped, and the large optic discs were always cupped. Optic disc cupping greater than 0.7 was rarely found and should be suspect of glaucoma. Clinical doctors should be aware of this and refer those subjects with abnormal cupping to the specialist.(AU)

Este estudio fue concebido para desarrollar normas clínicas sobre el tamaño y la excavación de la papila usando un simple oftalmoscopio en una población emétrope sin glaucoma. Los sujetos fueron oficinistas enviados al Centro Médico San Luis para un chequeo general de salud que incluye el examen oftalmológico. El tamaño de la papila o disco óptico fue clasificado en tres diámetros (pequeño, mediano y grande) comparando con el tamaño de la proyección retinal de la luz de un oftalmoscopio de bolsillo. La excavación papilar fue clasificada como la relación entre el diámetro horizontal de la excavación y el diámetro horizontal de la papila en escala decimal de 0.0 a 1.0. El estudio incluye 184 sujetos (edad media de 40.5 ± 9.5 años) y 149 (81%) fueron varones. Su presión ocular promedio fue de 12.4 ± 1.5 mmHg (entre 10-17 mmHg). La correlación tanto de los tamaños de disco óptico como de su excavación, fue alta entre ambos ojos (Correlación de Pearson, r = 0.866, p < 0.001) de modo que se presentan solamente datos de los ojos derechos. Según nuestra definición de tamaños papilares hubo 27 (14.7%) papilas pequeñas, 141 (76.6%) medianas y 16 (8.7%) grandes. Las papilas pequeñas rara vez tuvieron excavación y las grandes estuvieron siempre excavadas. Fue raro hallar papilas ópticas con una excavación mayor a 0.7, las que deberían hacer sospechar una lesión por glaucoma. Los clínicos avezados en oftalmoscopia deberían tener esto en cuenta para referir los sujetos con excavaciones grandes al especialista para su estudio oftalmológico.(AU)

A 6-week, multicenter, randomized, double-masked, parallel-group study comparing travoprost 0.004% to latanoprost 0.005% followed by 6-week, open-label treatment with travoprost 0.004%.

OBJECTIVE: The aim of this study was to compare the tolerability and efficacy of once-daily travoprost 0.004% versus latanoprost 0.005% for 6 weeks followed by 6 weeks of once-daily travoprost 0.004% in decreasing intraocular pressure (IOP) in patients with open-angle glaucoma (OAG) or ocular hypertension (OH). METHODS: This multicenter, randomized, doublemasked, active-controlled, parallel-group trial was conducted at 32 centers across Latin America. Patients aged > or =18 years with OAG or OH were randomly assigned to receive topical travoprost 0.004% or latanoprost 0.005% 1 drop QD (9 PM) for 6 weeks (masked phase). At 6 weeks, all patients were assigned to receive open-label travoprost 0.004% 1 drop QD (9 PM) for 6 additional weeks (open-label phase). Study visits were scheduled at weeks 1, 2, 4, 6, 8, and 12. At each study visit, IOP was measured at 5 PM (+/-1 hour; approximately 20 hours after study drug administration). IOP changes from baseline were combined (pooled) from the 1-, 2-, 4-, and 6-week data to provide a comparison between the 2 treatment groups. Ocular adverse events (AEs) were monitored using slit-lamp examination. RESULTS: A total of 302 patients were enrolled (travoprost group, 155 patients; latanoprost group, 147 patients). The mean (SD) age of the travoprost group was 61.9 (10.6) years; 60.6% were female; and 47.1% were white. The mean (SD) age of the latanoprost group was 60.5 (12.4) years; 62.6% were female; and 49.0% were white. Mean IOP values were not significantly different between the travoprost and latanoprost groups at baseline (24.7 vs 24.2 mm Hg) or 6 weeks; however, the between-group difference in reductions from baseline in pooled IOP during the masked phase of the study was statistically significant (-8.3 vs -7.5 mm Hg; P = 0.009). At weeks 6 and 12, mean lOP levels were 16.1 and 16.2 mm Hg, respectively, in the travoprost group and 16.4 and 16.1 mm Hg in the group that was switched from latanoprost to travoprost (all, P = NS). The most common ocular AEs that occurred with masked travoprost, latanoprost, and open-label travoprost were hyperemia (26.9%, 12.2%, and 5.3%, respectively), discomfort (3.2%, 3.4%, and 1.1%), and pruritus (4.5%, 2.0%, and 2.1%). CONCLUSIONS: In this population of patients with OAG or OH, 6-week treatment with travoprost 0.004% was associated with a significantly greater decrease from baseline in pooled IOP compared with latanoprost 0.005% 20 hours after administration. There were no significant differences between the 2 groups. Travoprost and latanoprost were well tolerated.